Article

The objective of this study was to evaluate possible mechanisms for
functional improvement and compare ambulation training with surface peroneal
nerve stimulation vs. usual care via quantitative gait analysis.
DESIGN: This study is a randomized controlled clinical trial.
SETTING: The setting of this
study is a teaching hospital of an academic medical center. PARTICIPANTS: One
hundred ten chronic stroke survivors (>12 wks poststroke) with unilateral
hemiparesis participated in this study. INTERVENTIONS: The subjects were
randomized to a surface peroneal nerve stimulation device or usual care
intervention. The subjects were treated for 12 wks and followed up for 6-mo
posttreatment. MAIN OUTCOME MEASURES: Spatiotemporal, kinematic, and kinetic
parameters of gait were the main outcome measures.
RESULTS: Cadence (F3,153 =
5.81, P = 0.012), stride length (F3,179 = 20.01, P < 0.001), walking speed
(F3,167 = 18.2, P < 0.001), anterior-posterior ground reaction force (F3,164 =
6.61, P = 0.004), peak hip power in preswing (F3,156 = 8.76, P < 0.001), and peak
ankle power at push-off (F3,149 = 6.38, P = 0.005) all improved with respect to
time. However, peak ankle ankle dorsiflexion in swing (F3,184 = 4.99, P = 0.031)
worsened. In general, the greatest change for all parameters occurred during the
treatment period. There were no significant treatment group x time interaction
effects for any of the spatiotemporal, kinematic, or kinetic parameters.
CONCLUSIONS: Gait training with peroneal nerve stimulation and usual care was
associated with improvements in peak hip power in preswing and peak ankle power
at push-off, which may have resulted in improved cadence, stride length, and
walking speed; however, there were no differences between treatment groups. Both
treatment groups also experienced a decrease in peak ankle ankle dorsiflexion in
swing, although the clinical implications of this finding are unclear.

Langue : ANGLAIS