Randomized Controlled Trial of Surface Peroneal Nerve Stimulation for Motor Relearning in Lower Limb Hemiparesis

Overview

Journal Arch Phys Med Rehabil

Specialty Rehabilitation Medicine

Date 2013 Feb 13

PMID 23399456

Citations 13

Authors

Lynne R Sheffler

Paul N Taylor

Douglas D Gunzler

Jaap H Buurke

Maarten J IJzerman

John Chae

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the motor relearning effect of a surface peroneal nerve stimulator (PNS) versus usual care on lower limb motor impairment, activity limitation, and quality of life among chronic stroke survivors.

Design: Single-blinded randomized controlled trial.

Setting: Teaching hospital of academic medical center.

Participants: Chronic stroke survivors (N=110; >12wk poststroke) with unilateral hemiparesis and dorsiflexion strength of ≤4/5 on the Medical Research Council scale.

Interventions: Subjects were stratified by motor impairment level and then randomly assigned to ambulation training with either a surface PNS device or usual care (ankle-foot orthosis or no device) intervention. Subjects were treated for 12 weeks and followed up for 6 months posttreatment.

Main Outcome Measures: Lower limb portion of the Fugl-Meyer (FM) Assessment (motor impairment), the modified Emory Functional Ambulation Profile (mEFAP) performed without a device (functional ambulation), and the Stroke Specific Quality of Life (SSQOL) scale.

Results: There was no significant treatment group main effect or treatment group by time interaction effect on FM, mEFAP, or SSQOL raw scores (P>.05). The time effect was significant for the 3 raw scores (P<.05). However, when comparing average change scores from baseline (t1) to end of treatment (t2, 12wk), and at 12 weeks (t3) and 24 weeks (t4) after end of treatment, significant differences were noted only for the mEFAP and SSQOL scores. The change in the average scores for both mEFAP and SSQOL occurred between t1 and t2, followed by relative stability thereafter.

Conclusions: There was no evidence of a motor relearning effect on lower limb motor impairment in either the PNS or usual-care groups. However, both the PNS and usual-care groups demonstrated significant improvements in functional mobility and quality of life during the treatment period, which were maintained at 6-month follow-up.

Citing Articles

Effect of Functional Electrical Stimulation in Convalescent Stroke Patients: A Multicenter, Randomized Controlled Trial.

Matsumoto S, Shimodozono M, Noma T, Miyara K, Onoda T, Ijichi R J Clin Med. 2023; 12(7).

PMID: 37048728 PMC: 10095003. DOI: 10.3390/jcm12072638.

A 6-Month Home-Based Functional Electrical Stimulation Program for Foot Drop in a Post-Stroke Patient: Considerations on a Time Course Analysis of Walking Performance.

David R, Billot M, Ojardias E, Parratte B, Roulaud M, Ounajim A Int J Environ Res Public Health. 2022; 19(15).

PMID: 35954558 PMC: 9367978. DOI: 10.3390/ijerph19159204.

Application of neuromuscular electrical stimulation on the support limb during reactive balance control in persons with stroke: a pilot study.

Varas-Diaz G, Bhatt T Exp Brain Res. 2021; 239(12):3635-3647.

PMID: 34609544 DOI: 10.1007/s00221-021-06209-2.

Motor neuroprosthesis for promoting recovery of function after stroke.

Mendes L, Lima I, Souza T, do Nascimento G, Resqueti V, Fregonezi G Cochrane Database Syst Rev. 2020; 1:CD012991.

PMID: 31935047 PMC: 6984639. DOI: 10.1002/14651858.CD012991.pub2.

Rationale and design of the theRapeutic effects of peroneal nerve functionAl electrical stimuLation for Lower extremitY in patients with convalescent poststroke hemiplegia (RALLY) study: study protocol for a randomised controlled study.

Matsumoto S, Shimodozono M, Noma T BMJ Open. 2019; 9(11):e026214.

PMID: 31772078 PMC: 6886987. DOI: 10.1136/bmjopen-2018-026214.

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