Article

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.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS