Effects of implantable peroneal nerve stimulation on gait quality, energy expenditure, participation and user satisfaction in patients with post-stroke drop foot using an ankle-foot orthosis

Objective. To compare the efficacy of the Odstock Dropped-Foot Stimulator (ODFS), a transcutaneous peroneal nerve stimulation device, versus an ankle foot orthosis (AFO) in improving functional ambulation of chronic stroke survivors. Intervention. Fourteen chronic stroke survivors with foot-drop participated in the study. Participants received ambulation training under 3 test conditions: 1) ODFS, 2) customized AFO, and 3) no device. Each participant was evaluated using the modified Emory Functional Ambulation Profile under the 3 test conditions. All participants were evaluated with a post-evaluation survey to solicit device feedback and preferences. Results. Functional ambulation with the AFO was significantly improved, relative to no device, on the floor ( P = 0.000), carpet ( P = 0.013), and “up and go” test ( P = 0.042). There was a trend toward significance on the obstacle ( P = 0.092) and stair ( P = 0.067) trials. Functional ambulation with the ODFS was significantly improved, relative to no device, on the carpet( P = 0.004). A trend toward significance on floor ( P = 0.081), obstaclxze ( P = 0.092), and stair ( P = 0.079) trials was observed. The difference in functional ambulation between the AFO and ODFS showed a trend toward statistical significance on floor ( P = 0.065) and up and go ( P = 0.082) trials only. Given a choice between the ODFS and AFO for long-term correction of footdrop, participants indicated a preference for the ODFS. Conclusion. The AFO and the ODFS may be comparable in their effect on improving functional ambulation as compared to no device. Specific characteristics of the ODFS may make it a preferred intervention by stroke survivors. More rigorously controlled trials are needed to confirm these findings.

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Effect of Post-Stroke Ambulation Training with Surface Peroneal Nerve Stimulation versus Usual Care Using Quantitative Gait Analysis

PM&R ◽

10.1016/j.pmrj.2013.08.005 ◽

2013 ◽

Vol 5 ◽

pp. S130-S130 ◽

Cited By ~ 1

Author(s):

Lynne R. Sheffler ◽

Paul N. Taylor ◽

Stephanie N. Bailey ◽

Douglas D. Gunzler ◽

Jaap H. Buurke ◽

...

Keyword(s):

Gait Analysis ◽

Usual Care ◽

Nerve Stimulation ◽

Peroneal Nerve ◽

Post Stroke ◽

Ambulation Training ◽

Peroneal Nerve Stimulation ◽

Quantitative Gait Analysis

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Walking ability and energy expenditure in post-stroke patients with a ankle-foot orthosis

Gait & Posture ◽

10.1016/j.gaitpost.2011.10.323 ◽

2012 ◽

Vol 36 ◽

pp. S83 ◽

Cited By ~ 2

Author(s):

J. Kato ◽

N. Maeda ◽

M. Murakami

Keyword(s):

Energy Expenditure ◽

Walking Ability ◽

Stroke Patients ◽

Ankle Foot Orthosis ◽

Post Stroke ◽

Foot Orthosis

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The effect of different shoes on functional mobility and energy expenditure in post-stroke hemiplegic patients using ankle–foot orthosis

Prosthetics and Orthotics International ◽

10.1177/0309364615592704 ◽

2016 ◽

Vol 40 (5) ◽

pp. 591-597 ◽

Cited By ~ 6

Author(s):

Farzad Farmani ◽

Mohammad Ali Mohseni Bandpei ◽

Mahmood Bahramizadeh ◽

Gholamreza Aminian ◽

Mohammad Reza Nikoo ◽

...

Keyword(s):

Energy Expenditure ◽

Walking Speed ◽

Functional Mobility ◽

Timed Up And Go ◽

Ankle Foot Orthosis ◽

Post Stroke ◽

Group I ◽

Ankle Foot Orthoses ◽

Rocker Shoes ◽

Foot Orthosis

Background:Ankle–foot orthoses could be utilized both with and without shoes. While several studies have shown that ankle–foot orthoses improve gait abilities in hemiplegic patients, it remains unclear whether they should be used with shoes or without.Objectives:The study purpose was to compare the effect of standard shoes and rocker shoes on functional mobility in post-stroke hemiplegic patients utilizing ankle–foot orthosis.Study design:Randomized clinical study.Methods:Thirty post-stroke hemiplegic patients participated in this study randomly assigned to two groups. Group I received standard shoes + ankle–foot orthosis and group II were provided with rocker shoes + ankle–foot orthosis. Their functional mobility and energy expenditure parameters including timed up and go, timed up stairs, timed down stairs, preferred walking speed, and oxygen (O2) cost (mL/kg/m) were measured.Results:In group I, no significant changes were seen in outcome measures after wearing standard shoes. While in group II, O2cost and timed up and go time significantly decreased, and preferred walking speed increased when patients wore rocker shoes. Also, there was a significant difference between rocker shoes and standard shoes in improvement of timed up and go, preferred walking speed, and O2cost.Conclusion:When patients using ankle–foot orthosis wore rocker shoes, their functional mobility improved and oxygen cost diminished. Also, rocker shoes was significantly more effective than standard shoes in improving functional mobility parameters.Clinical relevanceThis study suggests that in post-stroke hemiplegic patients using ankle–foot orthosis, wearing rocker shoes can lead to much more improved functional mobility and decreased energy expenditure compared to ankle–foot orthosis only. Thus, in stroke patients, the combination of ankle–foot orthosis-rocker shoes is recommended for both rehabilitation programs and ankle–foot orthosis efficacy investigations.

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Role of the newly designed hybrid passive ankle–foot orthosis on self-reported balance confidence in post stroke drop foot

Journal of Bodywork and Movement Therapies ◽

10.1016/j.jbmt.2020.11.022 ◽

2020 ◽

Author(s):

Ensieh Pourhoseingholi ◽

Hassan Saeedi

Keyword(s):

Drop Foot ◽

Ankle Foot Orthosis ◽

Balance Confidence ◽

Post Stroke ◽

Foot Orthosis

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Developing an Active Ankle Foot Orthosis Based on Shape Memory Alloy Actuators

ASME 2007 Summer Bioengineering Conference ◽

10.1115/sbc2007-176911 ◽

2007 ◽

Cited By ~ 1

Author(s):

Ehsan Tarkesh ◽

Mohammad H. Elahinia ◽

Mohamed Samir Hefzy

Keyword(s):

Multiple Sclerosis ◽

Cerebral Palsy ◽

Shape Memory Alloy ◽

Shape Memory ◽

Muscle Activity ◽

Heel Strike ◽

Drop Foot ◽

Ankle Foot Orthosis ◽

Foot Orthosis

This paper is on development of an active ankle foot orthosis (AAFO). This device will fill the gap in the existing research aimed at helping patients with drop foot muscle deficiencies as well as rehabilitation activities. Drop foot patients are unable to lift their foot because of reduced or no muscle activity around the ankle. The major causes of drop foot are severing of the nerve, stroke, cerebral palsy and multiple sclerosis. There are two common complications from drop foot. First, the patient cannot control the falling of their foot after heel strike, so that it slaps the ground on every step. The second complication is the inability to clear the toe during swing. This causes the patients to drag their toe on the ground throughout the swing.

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