Peroneal stimulator: Evaluation for the correction of spastic drop foot in hemiplegia

Abstract

Objective: The objective of this study was to assess the orthotic and therapeutic value of the peroneal stimulator (PS) for adult hemiplegic patients. Design: This was a 2-period crossover study lasting 11 weeks. After recruitment each patient tha 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 a cerebro-vascular 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 linoleumf, 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 at each session. Results: There was a significant orthotic improvement in inversion on all surfaces and for symmetry on linoleum (ANOVA, 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 as an orthotic device late in the rehabilitation program would be appropriate for a selected subpopulation of patients.