Evaluation of the Efficacy and Robustness of a Second Generation Implantable Stimulator in a Patient With Hemiplegia During 20 Years of Functional Electrical Stimulation of the Common Peroneal Nerve

2016 ◽  
Vol 40 (11) ◽  
pp. 1085-1091 ◽  
Author(s):  
Polona Pečlin ◽  
Janez Rozman ◽  
Janez Krajnik ◽  
Samo Ribarič
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Peroneal Nerve ◽  
Second Generation ◽  
Common Peroneal Nerve ◽  
Implantable Stimulator ◽  
The Common ◽  
Stimulation Of

Functional electrical stimulation using microstimulators to correct foot drop: a case study

2004 ◽  
Vol 82 (8-9) ◽  
pp. 784-792 ◽  
Author(s):  
D J Weber ◽  
R B Stein ◽  
K M Chan ◽  
G E Loeb ◽  
F J.R Richmond ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Peroneal Nerve ◽  
Walking Speed ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Cost Index ◽  
Cord Injury ◽  
Stimulation Of

This paper presents a case study that tested the feasibility and efficacy of using injectable microstimulators (BIONs®) in a functional electrical stimulation (FES) device to correct foot drop. Compared with surface stimulation of the common peroneal nerve, stimulation with BIONs provides more selective activation of specific muscles. For example, stimulation of the tibialis anterior (TA) and extensor digitorum longus (EDL) muscles with BIONs produces ankle flexion without excessive inversion or eversion of the foot (i.e., balanced flexion). Efficacy was assessed using a 3-dimensional motion analysis of the ankle and foot trajectories during walking with and without stimulation. Without stimulation, the toe on the affected leg drags across the ground. BION stimulation of the TA muscle and deep peroneal nerve (which innervates TA and EDL) elevates the foot such that the toe clears the ground by 3 cm, which is equivalent to the toe clearance in the less affected leg. The physiological cost index (PCI) measured effort during walking. The PCI equals the change in heart rate (from rest to activity) divided by the walking speed; units are beats per metre. The PCI is high without stimulation (2.29 ± 0.37, mean ± SD) and greatly reduced with surface (1.29 ± 0.10) and BIONic stimulation (1.46 ± 0.24). Also, walking speed increased from 9.4 ± 0.4 m/min without stimulation to 19.6 ± 2.0 m/min with surface and 17.8 ± 0.7 m/min with BIONic stimulation. These results suggest that FES delivered by a BION is an alternative to surface stimulation and provides selective control of muscle activation.Key words: FES, BION, foot drop, stroke, spinal cord injury.

60. Changes in motor cortical excitability following electrical stimulation of the common peroneal nerve

2010 ◽  
Vol 121 (7) ◽  
pp. e33
Author(s):  
Mutsumi Sugaya ◽  
Mitsuhiko Kodama ◽  
Koji Aono ◽  
Hiroshi Tanaka ◽  
Takashi Kasahara ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Peroneal Nerve ◽  
Cortical Excitability ◽  
Common Peroneal Nerve ◽  
Motor Cortical Excitability ◽  
The Common ◽  
Motor Cortical ◽  
Stimulation Of

Does Functional Electrical Stimulation for Foot Drop Strengthen Corticospinal Connections?

2009 ◽  
Vol 24 (2) ◽  
pp. 168-177 ◽  
Author(s):  
Dirk G. Everaert ◽  
Aiko K. Thompson ◽  
Su Ling Chong ◽  
Richard B. Stein
Keyword(s):  
Electrical Stimulation ◽  
Therapeutic Effect ◽  
Functional Electrical Stimulation ◽  
Peroneal Nerve ◽  
Walking Speed ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Walking Performance ◽  
The Common

Background. Long-term use of a foot-drop stimulator applying functional electrical stimulation (FES) to the common peroneal nerve improves walking performance even when the stimulator is off. This “therapeutic” effect might result from neuroplastic changes. Objective. To determine the effect of long-term use of a foot-drop stimulator on residual corticospinal connections in people with central nervous system disorders. Methods. Ten people with nonprogressive disorders (eg, stroke) and 26 with progressive disorders (eg, multiple sclerosis) used a foot-drop stimulator for 3 to 12 months while walking in the community. Walking performance and electrophysiological variables were measured before and after FES use. From the surface electromyogram of the tibialis anterior muscle, we measured the following: (1) motor-evoked potential (MEP) from transcranial magnetic stimulation over the motor cortex, (2) maximum voluntary contraction (MVC), and (3) maximum motor wave (Mmax) from stimulating the common peroneal nerve. Results. After using FES, MEP and MVC increased significantly by comparable amounts, 50% and 48%, respectively, in the nonprogressive group and 27% and 17% in the progressive group; the changes were positively correlated ( R2 = .35; P < .001). Walking speed increased with the stimulator off (therapeutic effect) by 24% ( P = .008) and 7% ( P = .014) in the nonprogressive and progressive groups, respectively. The changes in Mmax were small and not correlated with changes in MEP. Conclusions. The large increases in MVC and MEP suggest that regular use of a foot-drop stimulator strengthens activation of motor cortical areas and their residual descending connections, which may explain the therapeutic effect on walking speed.

The pulse duration of electrical stimulation influences H-reflexes but not corticospinal excitability for tibialis anterior

2014 ◽  
Vol 92 (10) ◽  
pp. 821-825
Author(s):  
Alyssa R. Hindle ◽  
Jenny W.H. Lou ◽  
David F. Collins
Keyword(s):  
Electrical Stimulation ◽  
Pulse Duration ◽  
Peroneal Nerve ◽  
Motor Evoked Potentials ◽  
Common Peroneal Nerve ◽  
H Reflex ◽  
M Wave ◽  
Recruitment Curve ◽  
Afferent Volley ◽  
The Common

The afferent volley generated by neuromuscular electrical stimulation (NMES) influences corticospinal (CS) excitability and frequent NMES sessions can strengthen CS pathways, resulting in long-term improvements in function. This afferent volley can be altered by manipulating NMES parameters. Presently, we manipulated one such parameter, pulse duration, during NMES over the common peroneal nerve and assessed the influence on H-reflexes and CS excitability. We hypothesized that compared with shorter pulse durations, longer pulses would (i) shift the H-reflex recruitment curve to the left, relative to the M-wave curve; and (ii) increase CS excitability more. Using 3 pulse durations (50, 200, 1000 μs), M-wave and H-reflex recruitment curves were collected and, in separate experiments, CS excitability was assessed by comparing motor evoked potentials elicited before and after 30 min of NMES. Despite finding a leftward shift in the H-reflex recruitment curve when using the 1000 μs pulse duration, consistent with a larger afferent volley for a given efferent volley, the increases in CS excitability were not influenced by pulse duration. Hence, although manipulating pulse duration can alter the relative recruitment of afferents and efferents in the common peroneal nerve, under the present experimental conditions it is ineffective for maximizing CS excitability for rehabilitation.

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