1. Catalog
  2. December 2016 CME Article No. 12: Improving Walkin ...
Image For Activity Cover
December 2016 CME Article No. 12: Improving Walking with an Implanted Neuroprosthesis for Hip, Knee, and Ankle Control After Stroke
Additional Information
Objective:
The objective of this work was to quantify the effects of a fully implanted pulse generator to activate or augment actions of hip, knee, and ankle muscles after stroke.

Design:
The subject was a 64-year-old man with left hemiparesis resulting from hemorrhagic stroke 21 months before participation. He received an 8- channel implanted pulse generator and intramuscular stimulating electrodes targeting unilateral hip, knee, and ankle muscles on the paretic side. After implantation, a stimulation pattern was customized to assist with hip, knee, and ankle movement during gait. The subject served as his own concurrent and longitudinal control with and without stimulation. Outcome measures included 10-m walk and 6-minute timed walk to assess gait speed, maximum walk time, and distance to measure endurance, and quantitative motion analysis to evaluate spatial-temporal characteristics. Assessments were repeated under 3 conditions: (1) volitional walking at baseline, (2) volitional walking after training, and (3) walking with stimulation after training.

Results:
Volitional gait speed improved with training from 0.29 m/s to 0.35 m/s and further increased to 0.72 m/s with stimulation. Most spatial-temporal characteristics improved and represented more symmetrical and dynamic gait.

Conclusions:
These data suggest that a multijoint approach to implanted neuroprostheses can provide clinically relevant improvements in gait after stroke.

Learning Objectives:
  1. Describe the rationale for the use of a multi-joint implanted neuroprosthesis to improve walking after stroke
  2. Discuss the significance and clinical benefits of gait training with stimulation
  3. Discuss the significance and clinical benefits of gait training and walking with stimulation
Summary
Availability: Retired
Cost: Member: $0.00
Non-Member: $15.00
Resident Member: $0.00
Resident Non-Member: $15.00
Credit Offered:
No Credit Offered
Recommended
Android App Download IOS App Download Powered By