Stroke Programs

Transcutaneous Peroneal Nerve Stimulation in Multiple Sclerosis

General Information on this clinical study

Principal Investigators

Lynne Sheffler, M.D.
John Chae, M.D.

Clinical Coordinator: Cathy Corrigan, R.N.

Contact Number: 216-778-8903

Contact Email: ccorrigan@metrohealth.org

Program Title: Transcutaneous Peroneal Nerve Stimulation in Multiple Sclerosis

Purpose

Footdrop is a common neurological manifestation of multiple sclerosis and can contribute significantly to physical disability. Footdrop, defined as a decreased or absent ability to dorsiflex the ankle during the swing phase of gait, results in both an inefficient and unsafe gait pattern. Due to the nature of the disease process, bilateral footdrop is a not uncommon sequelae in multiple sclerosis. In the United States, the standard of care for the correction of footdrop is the ankle foot orthosis which has the ability to maintain a specific angle at the joint, provide ankle eversion and inversion stability, and redirect torque at the knee. In the United Kingdom, the use of functional electrical stimulation has been demonstrated to be a promising alternative intervention for the correction of footdrop secondary to upper motor neuron disease, including multiple sclerosis. Figure 1 demonstrates placement of the peroneal nerve stimulator on the lower limb. Surface electrodes are placed over the peroneal nerve just below the fibula. Electrical stimulation of the peroneal nerve causes contraction of ankle muscles to allow toe clearance during ambulation. The electrodes and heel switch are attached to a stimulator which is worn on a belt. The aim of this study is to assess the efficacy of transcutaneous peroneal nerve stimulation in multiple sclerosis and compare transcutaneous peroneal nerve stimulation to an ankle foot orthosis for the treatment of footdrop.

Program Description

A total of 20 subjects with multiple sclerosis and evidence of unilateral or bilateral footdrop, presently using or in possession of a physician prescribed ankle foot orthosis(es), will be enrolled in this study. The subjects will be recruited from the outpatient Neurology and Physical Medicine and Rehabilitation Departments at Metrohealth Medical Center via direct referral, and from the Greater Cleveland Area via published advertisements. This study is currently recruiting subjects.