Neurotronics (United States)

Background. Evidence supports peroneal nerve functional electrical stimulation (FES) as an effective alternative to ankle foot orthoses (AFO) for treatment of foot drop poststroke, but few long-term, randomized controlled comparisons exist. Objective. Compare changes in gait quality and function between FES and AFOs in individuals with foot drop poststroke over a 12-month period. Methods. Follow-up analysis of an unblinded randomized controlled trial (ClinicalTrials.gov #NCT01087957) conducted at 30 rehabilitation centers comparing FES to AFOs over 6 months. Subjects continued to wear their randomized device for another 6 months to final 12-month assessments. Subjects used study devices for all home and community ambulation. Multiply imputed intention-to-treat analyses were utilized; primary endpoints were tested for noninferiority and secondary endpoints for superiority. Primary endpoints: 10 Meter Walk Test (10MWT) and device-related serious adverse event rate. Secondary endpoints: 6-Minute Walk Test (6MWT), GaitRite Functional Ambulation Profile, and Modified Emory Functional Ambulation Profile (mEFAP). Results. A total of 495 subjects were randomized, and 384 completed the 12-month follow-up. FES proved noninferior to AFOs for all primary endpoints. Both FES and AFO groups showed statistically and clinically significant improvement for 10MWT compared with initial measurement. No statistically significant between-group differences were found for primary or secondary endpoints. The FES group demonstrated statistically significant improvements for 6MWT and mEFAP Stair-time subscore. Conclusions. At 12 months, both FES and AFOs continue to demonstrate equivalent gains in gait speed. Results suggest that long-term FES use may lead to additional improvements in walking endurance and functional ambulation; further research is needed to confirm these findings.

ABSTRACTObjective. To examine the relationship between physical performance and obesity in older African-American women. Methods. Obese (n = 45) and nonobese (n = 88) women were assessed using instrumental activities of daily living, physical function subscale of the Medical Outcomes Short Form-36, and the physical activity scale for the elderly. Physical performance was assessed by Berg Balance Scale, Tandem Stance and Single Test Stance Tests, Multidirectional Reach Test, Timed Up and Go Limb, Six-Minute Walk Test, gait stability ratio, and self-report of daily walking. Results. The obese group had significantly lower self-reported daily activities and poorer scores on several physical performance measures than nonobese older African-American women. Conclusions. Our findings substantiate a relationship between obesity and physical performance in African-American women. Although urban obese women have poorer physical performance, their impairments may be counterbalanced by their daily walking. Clinicians should consider this finding when developing rehabilitative and preventive strategies for older obese African-American women.