IMPLANTED PERONEAL NERVE STIMULATOR TREATMENT FOR DROP FOOT CAUSED BY CENTRAL NERVOUS SYSTEM LESION: A TWELVE-MONTH FOLLOW-UP OF 21 PATIENTS

Abstract

Objective: Drop foot is a common impairment following stroke or other causes of central pathology. We report data on patient self-perceived performance, satisfaction with performance, walking ability, and adverse effects after surgical implantation of the ActiGait® drop foot stimulator. Design: Prospective case study with a 12-month follow-up. Subjects: Twenty-one participants with drop foot caused by central nervous system lesion. Methods: The patients’ self-perceived performance and satisfaction with performance were evaluated using the Canadian Occupational Performance Measure (COPM). Walking ability was assessed using a 10-m walk test and a 6-min walk. Nerve conduction of the peroneal nerve was examined in 10 patients. Results: At follow-up, COPM self-percieved performance from 3.2 to 6.7 points, the median increase being 2.8 (interquartile range (IQR) 2.2–5.0), p<0.001. Likewise, the COPM satisfaction with performance increased from 2.6 to 6.9 points, the median increase being 4.2 (IQR 2.8–5.8), p<0.001. Walking velocity increased 0.1 m/s from a baseline measurement of 0.73 m/s (95% confidence interval (95% CI) 0.03–0.2), n=21, p<0.01, and walking distance increased by 33 m, from a baseline measurement of 236 m (95% CI 15–51), n=21, p<0.001. Conclusion: Stimulation of the peroneal nerve by an implantable stimulator increases self-perceived performance, satisfaction with performance, and ambulation in patients with long-lasting drop foot caused by a central nervous system lesion.