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Tolerability and Effectiveness of a Neuroprosthesis for the Treatment of Footdrop in Pediatric Patients With Hemiparetic Cerebral Palsy
Author(s) -
Meilahn Jill R.
Publication year - 2013
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2012.11.005
Subject(s) - neuroprosthetics , cerebral palsy , medicine , tolerability , physical medicine and rehabilitation , physical therapy , activities of daily living , alternative medicine , pathology
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.