Stroke Programs

Functional Electrical Stimulation for Footdrop in Hemiparesis

Precise positioning of the electrodes permits fine control over the quality of movement produced by balancing dorsiflexion with inversion and eversion. The active electrode is placed over the common peroneal nerve and the indifferent electrode is placed over the motor point of the tibialis anterior.

General Information on this clinical study

Principal Investigator: John Chae, M.D.

Clinical Coordinator: Cathy Corrigan, R.N.

Contact Number: 216-778-8903

Contact Email: ccorrigan@metrohealth.org

Program Title: Stimulation for Treatment of Footdrop

Purpose

Dropped-foot or the inability to bend the ankle upward to clear the toes during walking is a common problem after stroke. A brace called an ankle foot-orthosis (AFO) is commonly used for this condition. An alternative to an AFO is an electrical stimulation system called a peroneal nerve stimulator that helps clear the toes during the gait cycle.

The stimulator is lighter than an AFO and may facilitate recovery. Figure 1 shows a picture of the electrode placement for the peroneal nerve stimulator. Electrical stimulation of the ankle is triggered by a heel switch which causes muscle contractions to clear the toes during ambulation. The electrodes and heel switch are attached to a stimulator which is worn on a belt A clinical trial is being done to compare a peroneal nerve stimulator called Odsock Dropped-Foot Stimulater (ODFS) to an AFO. The ODFS was developed in Salisbury, United Kingdom and is used widely in Europe for the treatment of dropped-foot following stroke.

Program Description

A single-blinded randomized clinical trial will be carried out to assess the effects of ambulation training with a peroneal nerve stimulator among chronic stroke survivors compared to ambulation training with an AFO. Subjects will be treated for 12 weeks (5 weeks of daily device use + ambulation training (2 sessions/week), followed by another 7 weeks of daily device use) and followed for a total of another 6 months. This project will determine the effectiveness of peroneal nerve stimulation in facilitating motor relearning and improving the mobility and quality of life of stroke survivors. This proposed approach is expected to improve patient outcome and challenge the present clinical paradigm of prescribing AFO's for stroke survivors with foot-drop. Subjects for this study are currently being enrolled.