Article

The relative effect of a transcutaneous peroneal nerve stimulator
(tPNS) and an ankle foot orthosis (AFO) on spatiotemporal, kinematic, and kinetic
parameters of hemiparetic gait has not been well described. OBJECTIVE: To compare
the relative neuroprosthetic effect of a tPNS with the orthotic effect of an AFO
using quantitative gait analysis (QGA). DESIGN: In all, 12 stroke survivors
underwent QGA under 3 device conditions: (1) no device (ND), (2) AFO, and (3)
tPNS. A series of repeated-measures analyses of variance (rmANOVAs) were
performed with dorsiflexion status (presence or absence of volitional
dorsiflexion) as a covariate to compare selected spatiotemporal, kinematic, and
kinetic parameters for each device condition. Post hoc pairwise comparisons
and/or subset analysis by dorsiflexion status were performed for significant
effect. RESULTS: Stride length was improved with both the AFO (P = .035) and the
tPNS (P = .029) relative to ND. Those with absent dorsiflexion had longer stride
length with the tPNS relative to ND (P = .034) and a higher walking velocity with
a tPNS relative to the AFO (P = .015). There was no device effect on dorsiflexion
angle at initial contact; however, a significant Device x Dorsiflexion status
interaction effect favored the AFO relative to ND (P = .025) in those with
dorsiflexion present. CONCLUSION: This study suggests that level of motor
impairment may influence the relative effects of the tPNS and AFO devices in
chronic hemiparetic gait; however, the small sample size limits generalizability.
Future studies are necessary to determine if motor impairment level should be
considered in the clinical prescription of these devices.

Langue : ANGLAIS