title: Wireless, accelerometry-triggered functional electrical stimulation of the peroneal nerve in spastic paresis: A randomized, controlled pilot study.
abstract: In hemiparesis, Wireless, Accelerometry-Triggered Functional Electrical Stimulation (WAFES) of the common peroneal nerve may hold intrinsic rehabilitative properties. The present pilot study analyzes WAFES against conventional therapy. Twenty adults with chronic hemiparesis (time since lesion 7(6) years; median (interquartile range)) were randomized into 2 10-week rehabilitation programs: a 45-minute (min) daily walk using WAFES (n = 10) and conventional physical therapy (CPT), 3 × 45 min per week (n = 10). The outcomes were 3D sagittal speed measurements, step length, cadence, maximal amplitude and velocity of hip, knee, and ankle during gait at free and fast speed without WAFES and clinical assessments of plantar flexor angles of shortening, spasticity, and weakness, before (D1) and after the program (W10). Kinematic and spasticity improvements occurred in the WAFES group only: (i) ankle dorsiflexion velocity (D1 versus W10, free speed, WAFES, +4(5)°/sec, p = 0.002; CPT, -3(8)°/sec, p = 0.007; fast, WAFES, +8(6)°/sec, p = 0.03; CPT, -1(4)°/sec, NS); (ii) maximal passive ankle dorsiflexion (WAFES,+26(85)%; CPT,+0(27)%; group-visit, p = 0.007) and knee flexion (WAFES, +13(17)%; CPT, -1(11)%; group-visit, p = 0.006) at fast speed only; (iii) 15% plantar flexor spasticity grade reduction with WAFES. Over 10 weeks, gait training using WAFES improved ankle and knee kinematics and reduced plantar flexor spasticity compared with CPT. Studies with longer WAFES use should explore functional effects.
authors.affiliation: a Laboratoire Analyse et Restauration du Mouvement, BIOTN-EA 7377, IMRB , Université Paris-Est, Fédération de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris , Créteil , France.
authors.forename: Mouna
authors.initials: M
authors.lastname: Ghédira
authors.affiliation: a Laboratoire Analyse et Restauration du Mouvement, BIOTN-EA 7377, IMRB , Université Paris-Est, Fédération de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris , Créteil , France.
authors.forename: Inke Marie
authors.initials: IM
authors.lastname: Albertsen
authors.affiliation: a Laboratoire Analyse et Restauration du Mouvement, BIOTN-EA 7377, IMRB , Université Paris-Est, Fédération de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris , Créteil , France.
authors.forename: Valentina
authors.initials: V
authors.lastname: Mardale
authors.affiliation: a Laboratoire Analyse et Restauration du Mouvement, BIOTN-EA 7377, IMRB , Université Paris-Est, Fédération de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris , Créteil , France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gracies
authors.affiliation: a Laboratoire Analyse et Restauration du Mouvement, BIOTN-EA 7377, IMRB , Université Paris-Est, Fédération de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris , Créteil , France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bayle
authors.affiliation: a Laboratoire Analyse et Restauration du Mouvement, BIOTN-EA 7377, IMRB , Université Paris-Est, Fédération de Rééducation Neurolocomotrice, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris , Créteil , France.
authors.forename: Émilie
authors.initials: É
authors.lastname: Hutin
mesh_terms: D061725:Accelerometry / Q000379:methods*; D000328:Adult; D001696:Biomechanical Phenomena; D004558:Electric Stimulation / Q000379:methods*; D005080:Exercise Test; D005260:Female; D005684:Gait / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000534:rehabilitation* / Q000628:therapy*; D010543:Peroneal Nerve / Q000502:physiology*; D010865:Pilot Projects; D016138:Walking / Q000502:physiology
keywords: active ankle dorsiflexion; functional electrical stimulation; gait; spastic paresis