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