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Spatiotemporal, kinematic and kinetic assessment of the effects of a foot drop stimulator for home-based rehabilitation of patients with chronic stroke: a randomized clinical trial.

Journal of neuroengineering and rehabilitation
January 1, 1970
Yu Rong Mao et al. (7 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine whether a portable peroneal nerve-targeting electrical stimulator (tPNS) could improve gait ability in patients with chronic stroke undergoing home-based rehabilitation compared to conventional gait training.

Results Summary

The tPNS group showed significant improvements in spatiotemporal gait parameters, ankle and foot angles, and clinical motor and balance function compared to the conventional therapy group, though both groups improved in motor and balance scores.

Population

Patients with chronic stroke and ankle-foot motor impairment (n=31) and 16 age-matched healthy adults as controls.

Effective Dosage

Not specified (intervention involved using the tPNS device during walking tasks).

Duration

3 weeks

Interactions

None mentioned

Extracted Claims (15)
InterventionDirectionEndpointPopulationDosageImpactClaim #
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
Fugl-Meyer Assessment of Lower Extremity (FMA-LE) scores
patients with chronic stroke and ankle-foot motor impairment
p=0.004
improved
#1
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
Berg Balance scales (BBS) scores
patients with chronic stroke and ankle-foot motor impairment
p=0.001
improved
#2
conventional home and/or community gait training therapy (CT)
increase
Fugl-Meyer Assessment of Lower Extremity (FMA-LE) scores
patients with chronic stroke and ankle-foot motor impairment
p=0.034
improved
#3
conventional home and/or community gait training therapy (CT)
increase
Berg Balance scales (BBS) scores
patients with chronic stroke and ankle-foot motor impairment
p=0.028
improved
#4
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
double feet support
patients with chronic stroke and ankle-foot motor impairment
p=0.043
exhibited significant differences in
#5
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
stride length
patients with chronic stroke and ankle-foot motor impairment
p=0.017
exhibited significant differences in
#6
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
walking speed of affected side
patients with chronic stroke and ankle-foot motor impairment
p=0.001
exhibited significant differences in
#7
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
unaffected foot off within a gait cycle
patients with chronic stroke and ankle-foot motor impairment
p=0.010
exhibited significant differences in
#8
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
ankle angle at the transverse plane upon initial contact
patients with chronic stroke and ankle-foot motor impairment
p=0.021
exhibited significant differences in
#9
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
foot progression angle at the frontal plane upon initial contact
patients with chronic stroke and ankle-foot motor impairment
p=0.009
exhibited significant differences in
#10
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
peak ankle joint angle at the transverse plane during gait cycles
patients with chronic stroke and ankle-foot motor impairment
p=0.023
exhibited significant differences in
#11
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
foot progression angle (FPA) at the frontal plane during gait cycles
patients with chronic stroke and ankle-foot motor impairment
p=0.032
exhibited significant differences in
#12
transcutaneous peroneal nerve stimulator while walking (tPNS)
increase
foot progression angle (FPA) at the transverse plane during gait cycles
patients with chronic stroke and ankle-foot motor impairment
p=0.046
exhibited significant differences in
#13
portable tPNS device during walking tasks
increase
spatiotemporal gait parameters and ankle and foot angles
patients with chronic stroke
-
appeared to improve more effectively than conventional home rehabilitation
#14
home-based rehabilitation training services and market devices
no change
motor function and balance
-
-
no evidence for improvement was superior to conventional rehabilitation
#15
Abstract

BACKGROUND: Gait disability affects the daily lives of patients with stroke in both home and community settings. An abnormal foot-ankle position can cause instability on the supporting surface and negatively affect gait. Our research team explored the ability of a portable peroneal nerve-targeting electrical stimulator to improve gait ability by adjusting the foot-ankle position during walking in patients with chronic stroke undergoing home-based rehabilitation. METHODS: This was a double-blinded, parallel-group randomized controlled trial. Thirty-one patients with chronic stroke and ankle-foot motor impairment were randomized to receive 3 weeks of gait training, which involved using the transcutaneous peroneal nerve stimulator while walking (tPNS group; n = 16, mean age: 52.25 years), or conventional home and/or community gait training therapy (CT group; n = 15, mean age: 54.8 years). Functional assessments were performed before and after the 3-week intervention. The outcome measures included spatiotemporal gait parameters, three-dimensional kinematic and kinetic data on the ankle-foot joint, and a clinical motor and balance function assessment based on the Fugl-Meyer Assessment of Lower Extremity (FMA-LE) and Berg Balance scales (BBS). Additionally, 16 age-matched healthy adults served as a baseline control of three-dimensional gait data for both trial groups. RESULTS: The FMA-LE and BBS scores improved in both the tPNS groups (p = 0.004 and 0.001, respectively) and CT groups (p = 0.034 and 0.028, respectively) from before to after training. Participants in the tPNS group exhibited significant differences in spatiotemporal gait parameters, including double feet support, stride length, and walking speed of affected side, and the unaffected foot off within a gait cycle after training (p = 0.043, 0.017, 0.001 and 0.010, respectively). Additionally, the tPNS group exhibited significant differences in kinematic parameters, such as the ankle angle at the transverse plane (p = 0.021) and foot progression angle at the frontal plane (p = 0.009) upon initial contact, and the peak ankle joint angle at the transverse plane (p = 0.023) and foot progression angle (FPA) at the frontal and transverse planes (p = 0.032 and 0.046, respectively) during gait cycles after 3 weeks of training. CONCLUSIONS: Use of a portable tPNS device during walking tasks appeared to improve spatiotemporal gait parameters and ankle and foot angles more effectively than conventional home rehabilitation in patients with chronic stroke. Although guidelines for home-based rehabilitation training services and an increasing variety of market devices are available, no evidence for improvement of motor function and balance was superior to conventional rehabilitation. Trial registration Chictr, ChiCTR2000040137. Registered 22 November 2020, https://www.chictr.org.cn/showproj.aspx?proj=64424.

Medical Subject Headings (MeSH)
AdultBiomechanical PhenomenaGaitGait Disorders, NeurologicHumansMiddle AgedPeroneal NeuropathiesStrokeStroke RehabilitationTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations5
Citations/Year1.7
Relative Citation Ratio1.09
NIH Percentile53.3%
Research Impact Scores
APT Score0.25
Weight Score1.70
Normalized Score0.72
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