Article

OBJECTIVE: To assess the tolerability and efficacy of a commercially available
footdrop neuroprosthesis for treatment of footdrop in children with hemiparetic
cerebral palsy. DESIGN: A prospective, observational pilot study. SETTING:
Marshfield Clinic, Department of Physical Medicine. PARTICIPANTS: Ten children,
ages 7-12 years, with hemiparetic cerebral palsy, who use an ankle foot orthosis
(AFO) for correction of footdrop. METHODS: Children replaced their AFO with a
transcutaneous peroneal (fibular) nerve stimulation neuroprosthesis for 3 months.
MAIN OUTCOME MEASUREMENTS: The ability to tolerate fitting and programming of the
device, device-recorded wear time, a daily-use diary, satisfaction survey, and
secondary measures, including passive range of motion and gait laboratory
measurement of gait velocity and ankle kinematics. RESULTS: All 10 participants
(100%) tolerated fitting and programming of the neuroprosthesis and wore the
device for 6 weeks. Seven of 10 (70%) wore the device for the entire 3-month
study period; 6 of 10 (60%) continued to use the device after study completion.
Wear time varied from 2 to 11 hours per day. Tolerability and satisfaction were
high; although 6 participants complained of "size" and "bulkiness" of the device,
and 2 reported skin irritation. Gait velocity increased in 5 subjects (50%).
Seven participants (70%) preferred the neuroprosthesis to their AFO. CONCLUSION:
Analysis of the preliminary evidence suggests that electrical stimulation by a
footdrop neuroprosthesis is tolerated well by children and is effective for the
treatment of footdrop in children with hemiparetic cerebral palsy. Commercially
available neuroprostheses may offer a promising alternative treatment option for
children with footdrop.
CI - Copyright (c) 2013 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.
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Langue : ANGLAIS