The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

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    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    TENS for patients using ankle-foot orthosis following stroke

    Orthosis is a device applied to a human limb in order to control or enhance movement or prevent bone movement or deformity. An example is shown in the photo.

    Researchers at Radboud University Nijmegen Medical Centre, in The Netherlands, evaluated whether community-dwelling chronic stroke patients wearing an ankle-foot orthosis would benefit from changing to functional electrical stimulation of the peroneal nerve.

    The peroneal tendon runs behind the bone on the outside of the ankle.

    First, the details.

    • 26 community-dwelling patients at least 6 months after their stroke participated.
    • Their ankle-foot orthosis was replaced by a surface-based functional electrical stimulation device (NESS L300).
    • Comfortable walking speed over 10 meters with the ankle-foot orthosis was measured at the start of the study and after 2 and 8 weeks with both ankle-foot orthosis and functional electrical stimulation.
    • The level of physical activity was assessed with a pedometer.
    • Patient satisfaction was assessed with a questionnaire.

    And, the results.

    • Ankle-foot orthosis and functional electrical stimulation were equally effective with regard to walking speed and activity level.
    • The participants were more satisfied with functional electrical stimulation than with their ankle-foot orthosis for the following outcomes.
      • Effort and stability of walking
      • Quality of the gait pattern
      • Walking distance
      • Comfort of wearing
      • Appearance of the device

    The bottom line?

    The authors concluded, “The patients judged functional electrical stimulation superior to their ankle-foot orthosis.”

    It would be interesting to evaluate these patients after another 8 weeks with TENS (transcutaneous electrical nerve stimulation).

    6/29/10 21:14 JR

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