title: ActiGait implantable drop foot stimulator in multiple sclerosis: a new indication.
abstract: OBJECTIVE Direct stimulation of the peroneal nerve by the ActiGait implantable drop foot stimulator is a potent therapy that was described previously for stroke-related drop foot. The authors report here successful long-term application of the ActiGait implantable drop foot stimulator in patients with multiple sclerosis (MS). METHODS Six patients with MS and 2 years of persisting central leg paresis received an implantable ActiGait drop foot stimulator after successful surface test stimulation. Ten weeks and 1 year after surgery, their gait speed, endurance, and safety were evaluated. Patient satisfaction was assessed with a questionnaire. RESULTS In the 20-m gait test, stimulation with the ActiGait stimulator significantly reduced the time needed, on average, by approximately 23.6% 10 weeks after surgery, and the time improved further by 36.3% after 1 year. The median distance covered by patients with the stimulator after 6 minutes of walking increased significantly from 217 m to 321 m and remained stable for 1 year; the distance covered by patients after surface stimulation was 264 m. Patients with an implanted ActiGait stimulator noticed pronounced improvement in their mobility, social participation, and quality of life. CONCLUSIONS The ActiGait implantable drop foot stimulator improved gait speed, endurance, and quality of life in all patients over a period of 1 year. It may serve as a new therapeutic option for patients with MS-related drop foot.
authors.affiliation: Department of Neurosurgery and.
authors.forename: K Daniel
authors.initials: KD
authors.lastname: Martin
authors.affiliation: Department of Neurosurgery and.
authors.forename: Witold H
authors.initials: WH
authors.lastname: Polanski
authors.affiliation: Department of Neurosurgery and.
authors.forename: Anne-Kathrin
authors.initials: AK
authors.lastname: Schulz
authors.affiliation: Neurologic Rehabilitation Centre, Brandenburg Klinik, Bernau-Waldsiedlung, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Jöbges
authors.affiliation: Center of Clinical Neuroscience, Department of Neurology, University Hospital Carl-Gustav-Carus, Technical University of Dresden; and.
authors.forename: Tjalf
authors.initials: T
authors.lastname: Ziemssen
authors.affiliation: Department of Neurosurgery and.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Schackert
authors.affiliation: Department of Neurosurgery and.
authors.forename: Thomas
authors.initials: T
authors.lastname: Pinzer
authors.affiliation: Department of Neurosurgery and.
authors.forename: Stephan B
authors.initials: SB
authors.lastname: Sobottka
mesh_terms: D000328:Adult; D000368:Aged; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005260:Female; D005684:Gait; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000534:rehabilitation; D010291:Paresis / Q000209:etiology / Q000628:therapy*; D017060:Patient Satisfaction; D010543:Peroneal Nerve; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: ActiGait; MS = multiple sclerosis; drop foot; functional neurosurgery; multiple sclerosis; neuromodulation; peripheral nerve