Document Detail


Neuroprosthesis for footdrop compared with an ankle-foot orthosis: effects on postural control during walking.
MedLine Citation:
PMID:  19110144     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to compare the effects of a radio frequency-controlled neuroprosthesis on gait stability and symmetry to the effects obtained with a standard ankle-foot orthosis (AFO). METHODS: A total of 15 patients (mean age: 52.2 +/- 3.6 years) with prior chronic hemiparesis resulting from stroke or traumatic brain injury (5.9 +/- 1.5 year) whose walking was impaired by footdrop and regularly used an AFO participated in the study. There was a 4-week adaptation period during which participants increased their daily use of the neuroprosthesis, while using the AFO for the rest of the day. Gait was then assessed in a 6-minute walk while wearing force-sensitive insoles, by using the neuroprosthesis and the AFO in a randomized order. An additional gait assessment was conducted after using the neuroprosthesis for a further 4 weeks. Gait speed and stride time (inverse of cadence) were determined, as were gait asymmetry index and swing time variability. RESULTS: After the 4-week adaptation period, there were no differences between walking with the neuroprosthesis and walking with the AFO (P > .05). After 8 weeks, there was no significant difference in gait speed, whereas stride time improved from 1.48 +/- 0.21 seconds with the AFO to 1.41 +/- 0.16 seconds with the neuroprosthesis (P < .02). Swing time variability decreased from 5.3 +/- 1.6% with the AFO to 4.3 +/- 1.4% with the neuroprosthesis (P = .01). A gait asymmetry index improved by 15%, from 0.20 +/- 0.09 with the AFO to 0.17 +/- 0.08 with the neuroprosthesis (P < .05). CONCLUSIONS: Compared with AFO, the studied neuroprosthesis appears to enhance balance control during walking and, thus, more effectively manage footdrop.
Authors:
Haim Ring; Iuly Treger; Leor Gruendlinger; Jeffrey M Hausdorff
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association     Volume:  18     ISSN:  1532-8511     ISO Abbreviation:  J Stroke Cerebrovasc Dis     Publication Date:  2009 Jan 
Date Detail:
Created Date:  2008-12-26     Completed Date:  2009-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111633     Medline TA:  J Stroke Cerebrovasc Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-7     Citation Subset:  IM    
Affiliation:
Neurological Rehabilitation Department, Loewenstein Rehabilitation Center, Ranana, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological
Artificial Limbs*
Biomechanics
Boston
Brain Injuries / complications*,  physiopathology,  rehabilitation
Electric Stimulation Therapy*
Equipment Design
Female
Gait Disorders, Neurologic / etiology,  physiopathology,  rehabilitation*
Humans
Israel
Male
Middle Aged
Orthotic Devices*
Patient Satisfaction
Perception
Peroneal Nerve / physiopathology
Postural Balance*
Prosthesis Design
Recovery of Function
Stroke / complications*,  physiopathology,  rehabilitation
Treatment Outcome
Walking*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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