Peroneal stimulator; evaluation for the correction of spastic drop foot in hemiplegia

Abstract

Objective: The objective of the study was to assess the orthotic and therapeutic value of the peroneal stimulator (PS) for adult hemiplegic patients.

Design: This was a two-period crossover study lasting 11 weeks. After recruitment each patient had a 4-week control period followed by a 4-week treatment period. The patients were assessed before the control period, after the control period, and after the treatment period.

Setting: Nineteen patients were recruited from physiotherapy departments in the Glasgow area; 2 subsequently dropped out before the treatment period.

Patients: All patients had hemiplegia as a result of cerebrovascular accident (CVA) and were greater than 3 months but less than 36 months post-CVA. Average time since stroke was 7 months.

Main outcome measures: The patients' gait was assessed over smooth linoleum, carpet, and uneven ground. Gait was evaluated using a switch-based portable system. Outcome measures were the temporal gait parameters of speed, symmetry, heel strike, and foot inversion during stance. The gait evaluation was repeated on 5 separate days at each assessment. The Barthel Index was applied to each session.

Results: There was a significant orthotic improvement in inversion on all surfaces and for symmetry on linoleum (AN-OVA, p = .05). There was no significant improvement in patients' gait when not using the PS. There was a significant improvement in the Barthel Index over the treatment period (Wilcoxon, p = .05).

Conclusion: Use of the PS an an orthotic device late in the rehabilitation program would be appropriate for a selected subpopulation of patients.