gms | German Medical Science

66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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The functional and quality of life outcome of the ActiGait implantable drop foot stimulator for permanent central leg palsy

Meeting Abstract

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  • K. Daniel Martin - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Dresden, Carl-Gustav-Carus Universität, Dresden
  • Witold Polanski - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Dresden, Carl-Gustav-Carus Universität, Dresden
  • Anne-Kathrin Schulz - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Dresden, Carl-Gustav-Carus Universität, Dresden
  • Michael Jöbges - Rehaklinik, Brandenburg Klinik, Bernau-Waldsiedlung, Deutschland
  • Hansjörg Hoff - Radiologische Praxis Dresden
  • Gabriele Schackert - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Dresden, Carl-Gustav-Carus Universität, Dresden
  • Thomas Pinzer - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Dresden, Carl-Gustav-Carus Universität, Dresden
  • Stephan B. Sobottka - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Dresden, Carl-Gustav-Carus Universität, Dresden

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMO.06.04

doi: 10.3205/15dgnc026, urn:nbn:de:0183-15dgnc0267

Published: June 2, 2015

© 2015 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

Text

Objective: 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, we report the outcome of the first prospective study on a larger number of patients with stroke-related drop foot.

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

Results: Postoperative 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 on average. In two 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 confirmed by 89% to 96% of patients.

Conclusions: The ActiGait implantable drop foot stimulator improves gait speed, 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.

Note: K. Daniel Martin and Witold Polanski contributed equally to this work.