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

被引:49
作者
Sheffler, Lynne R. [1 ,2 ,3 ]
Taylor, Paul N. [4 ]
Gunzler, Douglas D. [5 ]
Buurke, Jaap H. [6 ]
IJzerman, Maarten J. [1 ,7 ]
Chae, John [1 ,2 ,3 ,8 ]
机构
[1] Case Western Reserve Univ, Dept Phys Med & Rehabil PM&R, Cleveland, OH 44109 USA
[2] Cleveland Vet Affairs Funct Elect Stimulat FES Ct, Cleveland, OH USA
[3] MetroHlth Med Ctr, MetroHlth Rehabil Inst Ohio, Dept PM&R, Cleveland, OH USA
[4] Salisbury Dist Hosp, Natl Clin FES Ctr, Salisbury, Wilts, England
[5] MetroHlth Med Ctr, Ctr Hlth Policy Res, Cleveland, OH USA
[6] Roessingh Res & Dev, Enschede, Netherlands
[7] Univ Twente, Dept Hlth Technol & Serv Res, NL-7500 AE Enschede, Netherlands
[8] Case Western Reserve Univ, Dept Biomed Engn, Cleveland, OH 44109 USA
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2013年 / 94卷 / 06期
基金
美国国家卫生研究院;
关键词
Gait; Hemiplegia; Peroneal nerve; Rehabilitation; QUALITY-OF-LIFE; FUNCTIONAL ELECTRICAL-STIMULATION; ANKLE-FOOT ORTHOSIS; FUGL-MEYER ASSESSMENT; DROPPED FOOT; NEUROMUSCULAR STIMULATION; STROKE SURVIVORS; MUSCLE-ACTIVITY; WALKING SPEED; CLINICAL-USE;
D O I
10.1016/j.apmr.2013.01.024
中图分类号
R49 [康复医学];
学科分类号
100232 [康复医学];
摘要
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. (C) 2013 by the American Congress of Rehabilitation Medicine
引用
收藏
页码:1007 / 1014
页数:8
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