The effects of functional electrical stimulation on walking in hereditary and spontaneous spastic paraparesis

This source preferred by Ian Swain

Authors: Swain, I., Marsden, J., Stevenson, V., McFadden, C. and Taylor, P.

Journal: Neuromodulation

DOI: 10.1111/j.1525-1403.2012.00494.x

Objectives:  To investigate in people with spastic paraparesis (SP): 1) the factors contributing to foot drop and reduced toe clearance while walking; 2) short-term effects of bilateral functional electrical stimulation (FES) of the common peroneal nerve. Materials and Methods:  Long term (>0.5 years) users of FES with SP were compared to matched controls (N = 11 per group). Ankle strength and plantarflexor stiffness and walking kinematics were objectively recorded. The effects of FES on: 1) perceived efficacy; 2) muscle torque and ankle motion; 3) clinical outcome measures and walking kinematics were assessed. Results were compared using an analysis of covariance. Results:  Ankle weakness and stiffness is higher among people with SP. Higher plantarflexor stiffness is associated with reduced swing phase dorsiflexion; higher toe clearance while walking is associated with increased hip flexion. FES increases dorsiflexor torque, improves toe clearance and dorsiflexion in swing phase, and significantly improves walking speed (p < 0.05). Conclusions:  There are multiple causes of tripping in people with SP; FES reduces foot drop and improves walking speed.

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Authors: Marsden, J., Stevenson, V., McFadden, C., Swain, I. and Taylor, P.

Journal: Neuromodulation

Volume: 16

Issue: 3

Pages: 256-260

eISSN: 1525-1403

ISSN: 1094-7159

DOI: 10.1111/j.1525-1403.2012.00494.x

Objectives: To investigate in people with spastic paraparesis (SP): 1) the factors contributing to foot drop and reduced toe clearance while walking; 2) short-term effects of bilateral functional electrical stimulation (FES) of the common peroneal nerve. Materials and Methods: Long term (>0.5 years) users of FES with SP were compared to matched controls (N = 11 per group). Ankle strength and plantarflexor stiffness and walking kinematics were objectively recorded. The effects of FES on: 1) perceived efficacy; 2) muscle torque and ankle motion; 3) clinical outcome measures and walking kinematics were assessed. Results were compared using an analysis of covariance. Results: Ankle weakness and stiffness is higher among people with SP. Higher plantarflexor stiffness is associated with reduced swing phase dorsiflexion; higher toe clearance while walking is associated with increased hip flexion. FES increases dorsiflexor torque, improves toe clearance and dorsiflexion in swing phase, and significantly improves walking speed (p < 0.05). Conclusions: There are multiple causes of tripping in people with SP; FES reduces foot drop and improves walking speed. © 2012 International Neuromodulation Society.

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