The Therapeutic Effect of Outpatient Use of a Peroneal Nerve Functional Electrical Stimulation Neuroprosthesis in People with Stroke: A Case Series

2011 ◽  
Vol 18 (6) ◽  
pp. 738-745 ◽  
Author(s):  
Susan Israel ◽  
Susan Kotowski ◽  
Nancy Talbott ◽  
Keri Fisher ◽  
Kari Dunning
Keyword(s):  
Electrical Stimulation ◽  
Therapeutic Effect ◽  
Functional Electrical Stimulation ◽  
Peroneal Nerve ◽  
Case Series

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.

scholarly journals Evaluation of Individualized Functional Electrical Stimulation-Induced Acute Changes during Walking: A Case Series in Children with Cerebral Palsy

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4452
Author(s):  
Nicole Zahradka ◽  
Ahad Behboodi ◽  
Ashwini Sansare ◽  
Samuel C. K. Lee
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Case Series ◽  
Phase Detection ◽  
Lower Extremity Muscle ◽  
Children With Cerebral Palsy ◽  
Muscle Groups

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

scholarly journals The effectiveness of peroneal nerve functional electrical simulation for the reduction of bradykinesia in Parkinson’s disease: A feasibility study for a randomised control trial

2020 ◽  
pp. 026921552097251
Author(s):  
Paul N Taylor ◽  
Trish Sampson ◽  
Ben Beare ◽  
Maggie Donavon-Hall ◽  
Peter W Thomas ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Electrical Stimulation ◽  
Randomised Controlled Trial ◽  
Study Design ◽  
Functional Electrical Stimulation ◽  
Standard Care ◽  
Peroneal Nerve ◽  
Controlled Trial ◽  
Randomised Controlled

Objectives: To assess the feasibility of a multi-site randomised controlled trial to evaluate the effect of functional electrical stimulation on bradykinesia in people with Parkinson’s disease. Design: A two-arm assessor blinded randomised controlled trial with an 18 weeks intervention period and 4 weeks post-intervention follow-up. Setting: Two UK hospitals; a therapy outpatient department in a district general hospital and a specialist neuroscience centre. Participants: A total of 64 participants with idiopathic Parkinson’s disease and slow gait <1.25 ms−1. Interventions: Functional electrical stimulation delivered to the common peroneal nerve while walking in addition to standard care compared with standard care alone. Main measures: Feasibility aims included the determination of sample size, recruitment and retention rates, acceptability of the protocol and confirmation of the primary outcome measure. The outcome measures were 10 m walking speed, Unified Parkinson’s Disease Rating Scale (UPDRS), Mini Balance Evaluation Systems Test, Parkinson’s Disease Questionnaire-39, EuroQol 5-dimension 5-level, New Freezing of Gait questionnaire, Falls Efficacy Score International and falls diary. Participants opinion on the study design and relevance of outcome measures were evaluated using an embedded qualitative study. Results: There was a mean difference between groups of 0.14 ms−1 (CI 0.03, 0.26) at week 18 in favour of the treatment group, which was maintained at week 22, 0.10 ms−1 (CI –0.05, 0.25). There was a mean difference in UPDRS motor examination score of –3.65 (CI –4.35, 0.54) at week 18 which was lost at week 22 –0.91 (CI –2.19, 2.26). Conclusion: The study design and intervention were feasible and supportive for a definitive trial. While both the study protocol and intervention were acceptable, recommendations for modifications are made.

The Effects of Peroneal Nerve Functional Electrical Stimulation Versus Ankle-Foot Orthosis in Patients With Chronic Stroke

2014 ◽  
Vol 28 (7) ◽  
pp. 688-697 ◽  
Author(s):  
Francois Bethoux ◽  
Helen L. Rogers ◽  
Karen J. Nolan ◽  
Gary M. Abrams ◽  
Thiru M. Annaswamy ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Peroneal Nerve ◽  
Chronic Stroke ◽  
Ankle Foot Orthosis ◽  
Foot Orthosis

scholarly journals Inverted Pendulum Standing Apparatus for Investigating Closed-Loop Control of Ankle Joint Muscle Contractions during Functional Electrical Stimulation

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
John F. Tan ◽  
Kei Masani ◽  
Albert H. Vette ◽  
José Zariffa ◽  
Mark Robinson ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Ankle Joint ◽  
Functional Electrical Stimulation ◽  
Closed Loop ◽  
Inverted Pendulum ◽  
Control Strategies ◽  
Angular Position ◽  
Case Series ◽  
Effective Control ◽  
Free Standing

The restoration of arm-free standing in individuals with paraplegia can be facilitated via functional electrical stimulation (FES). In developing adequate control strategies for FES systems, it remains challenging to test the performance of a particular control scheme on human subjects. In this study, we propose a testing platform for developing effective control strategies for a closed-loop FES system for standing. The Inverted Pendulum Standing Apparatus (IPSA) is a mechanical inverted pendulum, whose angular position is determined by the subject’s ankle joint angle as controlled by the FES system while having the subject’s body fixed in a standing frame. This approach provides a setup that is safe, prevents falling, and enables a research and design team to rigorously test various closed-loop controlled FES systems applied to the ankle joints. To demonstrate the feasibility of using the IPSA, we conducted a case series that employed the device for studying FES closed-loop controllers for regulating ankle joint kinematics during standing. The utilized FES system stimulated, in able-bodied volunteers, the plantarflexors as they prevent toppling during standing. Four different conditions were compared, and we were able to show unique performance of each condition using the IPSA. We concluded that the IPSA is a useful tool for developing and testing closed-loop controlled FES systems for regulating ankle joint position during standing.

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