Artikel
Gait analysis with an implanted peroneal nerve stimulator in MS patients with central drop foot syndrome
Ganganalyse von MS Patienten mit einem implantierbaren Nervus peronaeus Stimulator zur Behandlung einer zentral bedingten Fußheberparese
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Autoren
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Daniel Martin
- Carl Gustav Carus Universitätsklinikum, TU Dresden, Klinik und Poliklinik für Neurochirurgie, Dresden, Deutschland
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Thomas Pinzer
- Carl Gustav Carus Universitätsklinikum, TU Dresden, Klinik und Poliklinik für Neurochirurgie, Dresden, Deutschland
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Stephan B. Sobottka
- Carl Gustav Carus Universitätsklinikum, TU Dresden, Klinik und Poliklinik für Neurochirurgie, Dresden, Deutschland
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Gabriele Schackert
- Carl Gustav Carus Universitätsklinikum, TU Dresden, Klinik und Poliklinik für Neurochirurgie, Dresden, Deutschland
| Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Direct electrical stimulation of the peroneal nerve, using the implantable peroneal nerve stimulator, enables a therapy of the centrally caused drop foot, improving the gait of the patients. In this paper, we present the gait analysis results from MS-patients with a central drop foot. Therefore, our aim was to further investigate the effects of the implanted system on gait kinematics and spatiotemporal parameters in MS patients.
Methods: A total of 12 multiple sclerosis (MS) patients were implanted with an implantable peroneal nerve stimulator, with 6 patients completing baseline and follow-up examination. The participant’s gait was assessed with surface stimulation and stimulation with the implant. Rated as gold standard for investigating changes in gait, a computerized video-based motion analysis system with infrared cameras was used to track changes in predefined spatiotemporal parameters. The user satisfaction was evaluated with a survey.
Results: A significant increase in speed of 0.64 m/s and 0.6 m/s was achieved by the peroneal nerve stimulator and the surface stimulation compared to the baseline, respectively (p = 0.005). In addition, the stride length significantly improved by 3.6 cm with implant stimulation and 2.9 cm with surface stimulation. Compared to the surface stimulation the implantable peroneal nerve stimulator significantly improved the reduced dorsiflexion. In the user satisfaction survey all patients reported an added value in everyday life using the implant device compared to the surface stimulation with an improvement in mobility and the risk of falling.
Conclusion: The implantable peroneal nerve stimulator improves gait speed, stride length and dorsiflexion in multiple sclerosis-related foot lift weakness. It can be easily integrated into everyday life and ensures a safe gait. It could serve as a new therapeutic alternative for central foot weakness in multiple sclerosis.
