title: Surface peroneal nerve stimulation in lower limb hemiparesis: effect on quantitative gait parameters.
abstract: OBJECTIVE
  The objective of this study was to evaluate possible mechanisms for functional improvement and compare ambulation training with surface peroneal nerve stimulation vs. usual care via quantitative gait analysis.
  
  
  METHODS
  This study is a randomized controlled clinical trial.
  
  
  METHODS
  The setting of this study is a teaching hospital of an academic medical center.
  
  
  METHODS
  One hundred ten chronic stroke survivors (>12 wks poststroke) with unilateral hemiparesis participated in this study.
  
  
  METHODS
  The subjects were randomized to a surface peroneal nerve stimulation device or usual care intervention. The subjects were treated for 12 wks and followed up for 6-mo posttreatment.
  
  
  METHODS
  Spatiotemporal, kinematic, and kinetic parameters of gait were the main outcome measures.
  
  
  RESULTS
  Cadence (F3,153 = 5.81, P = 0.012), stride length (F3,179 = 20.01, P < 0.001), walking speed (F3,167 = 18.2, P < 0.001), anterior-posterior ground reaction force (F3,164 = 6.61, P = 0.004), peak hip power in preswing (F3,156 = 8.76, P < 0.001), and peak ankle power at push-off (F3,149 = 6.38, P = 0.005) all improved with respect to time. However, peak ankle ankle dorsiflexion in swing (F3,184 = 4.99, P = 0.031) worsened. In general, the greatest change for all parameters occurred during the treatment period. There were no significant treatment group × time interaction effects for any of the spatiotemporal, kinematic, or kinetic parameters.
  
  
  CONCLUSIONS
  Gait training with peroneal nerve stimulation and usual care was associated with improvements in peak hip power in preswing and peak ankle power at push-off, which may have resulted in improved cadence, stride length, and walking speed; however, there were no differences between treatment groups. Both treatment groups also experienced a decrease in peak ankle ankle dorsiflexion in swing, although the clinical implications of this finding are unclear.
authors: From the Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, Ohio (LRS, JC); Cleveland Veterans Affairs Functional Electrical Stimulation Center of Excellence, Cleveland, Ohio (LRS, JC); Department of Physical Medicine and Rehabilitation, MetroHealth Rehabilitation Institute of Ohio, MetroHealth Medical Center, Cleveland, Ohio (LRS, MJI, JC); The National Clinical FES Center, Salisbury District Hospital, Salisbury, United Kingdom (PNT); Louis Stokes Veterans Affairs Medical Center, Cleveland, Ohio (SNB); Center for Health Policy Research, MetroHealth Medical Center, Cleveland, Ohio (DDG); Roessingh Research and Development, Enschede, the Netherlands (JHB); Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands (MJI); and Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio (JC).
authors: Lynne R
authors: LR
authors: Sheffler
authors: Paul N
authors: PN
authors: Taylor
authors: Stephanie Nogan
authors: SN
authors: Bailey
authors: Douglas D
authors: DD
authors: Gunzler
authors: Jaap H
authors: JH
authors: Buurke
authors: Maarten J
authors: MJ
authors: IJzerman
authors: John
authors: J
authors: Chae
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000842:Ankle / Q000503:physiopathology; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006615:Hip / Q000503:physiopathology; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D051346:Mobility Limitation; D010291:Paresis / Q000150:complications / Q000534:rehabilitation*; D010543:Peroneal Nerve / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D012656:Self-Help Devices; D020521:Stroke / Q000150:complications; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome