gms | German Medical Science

133. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

26.04. - 29.04.2016, Berlin

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Restoration of ankle movements with the ActiGait implantable drop foot stimulator is a safe and reliable treatment option for permanent central leg palsy

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  • Klaus Daniel Martin - Klinikum Dresden-Friedrichstadt, Neurochirurgie, Dresden, Deutschland
  • Witold Polanski - Universitätsklinikum Dresden, Neurochirurgie, Dresden, Deutschland
  • Anne-Kathrin Schulz - Universitätsklinikum Dresden, Neurochirurgie, Dresden, Deutschland
  • Michael Jöbges - Universitätsklinikum Dresden, Neurochirurgie, Dresden, Deutschland
  • Hansjörg Hoff - Radiologische Praxis Dresden-Gorbitz, Radiologie, Dresden, Deutschland
  • Gabriele Schackert - Universitätsklinikum Dresden, Neurochirurgie, Dresden, Deutschland
  • Thomas Pinzer - Universitätsklinikum Dresden, Neurochirurgie, Dresden, Deutschland
  • Stephan B. Sobottka - Universitätsklinikum Dresden, Neurochirurgie, Dresden, Deutschland

Deutsche Gesellschaft für Chirurgie. 133. Kongress der Deutschen Gesellschaft für Chirurgie. Berlin, 26.-29.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16dgch181

doi: 10.3205/16dgch181, urn:nbn:de:0183-16dgch1817

Published: April 21, 2016

© 2016 Martin et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Background: The ActiGait drop foot stimulator is a promising technique for restoration of lost function by an implantable hybrid stimulation system. It allows an ankle dorsiflexion by active peroneal nerve stimulation during the swing phase of gait. Here, were report the first prospective outcome study on a larger number of patients with stroke related drop foot.

Materials and methods: Twenty-seven stroke patients with persisting spastic leg paresis received an implantable ActiGait drop foot stimulator for restoration of the ankle movement after successful surface test stimulation. After three to five weeks the stimulator was activated and gait speed, gait endurance and the activation time of the system was evaluated and compared to preoperative gait tests. In addition, patient satisfaction was assessed using a questionnaire.

Results: Postoperatively gait speed significantly improved from 33.9 sec/20m to 17.9 sec/20m (p<0.0001), gait endurance from 196 m/6min to 401 m/6min (p<0.0001), and activation time from 20.5 sec to 10.6 sec. In 2 patients with nerve injury, surgical repositioning of the electrode cuff became necessary. One patient showed a delayed wound healing and in another patient the system had to be removed because of a wound infection. Otherwise no complications occurred during surgery and postoperative care. Marked improvement in mobility, social participation, and quality of life was stated by 89% to 96% of patients.

Conclusion: The ActiGait implantable drop foot stimulator improves gait speed and endurance and quality of life in patients with stroke related drop foot. Compared to foot orthosis or surface stimulation devices, the ActiGait system seems to be advantageous.