Phase II trial to evaluate the ActiGait implanted drop-foot stimulator in established hemiplegia

Objective: To evaluate a selective implantable drop foot stimulator (ActiGait) in terms of effect on walking and safety. Design: A phase 11 trial in which a consecutive sample of participants acted as their own controls. Subjects: People who had suffered a stroke at least 6 months prior to recruitment and had a drop-foot that affected walking were recruited from 3 rehabilitation centres in Denmark. Methods: Stimulators were implanted into all participants. Outcome measures were range of ankle dorsiflexion with stimulation and maximum walking speed and distance walked in 4 minutes. Measurements were applied before implantation, at 90 days and at a long-term follow-up assessment. Changes over time and with and without stimulation are reported. Safety was evaluated by nerve conduction velocity and adverse events. Results: Fifteen participants were implanted and 13 completed the trial. Long-term improvements were detected in walking speed and distance walked in 4 minutes when stimulated, and the orthotic effect of stimulation showed statistically significant improvement. The device did not compromise nerve conduction velocity and no serious device-related adverse events were reported. Technical problems were resolved by the long-term follow-up assessment at which further improvement in walking was observed. Conclusion: This trial has evaluated the safety and performance of the device, which was well accepted by patients and did not compromise safety.