Electrical Stimulation for Recovery of Ankle Dorsiflexion in Chronic Stroke Survivors

Completed

Phase N/A Results

Eligibility Criteria

Inclusion Criteria

- Age 21 to 80 years
- >6 months from a first clinical non-hemorrhagic or hemorrhagic stroke
- Medically stable
- Unilateral lower extremity hemiparesis
- Ankle dorsiflexor strength of ≤4/5 on the Medical Research Council (MRC) scale, while seated
- Able to ambulate 16 feet (5 meters) continuously with minimal assistance or less, without the use of an ankle-foot orthosis (AFO).
- AFO is clinically indicated (footdrop during ambulation or inefficient gait patterns)
- Neuromuscular electrical stimulation (NMES) of the paretic ankle dorsiflexors produces ankle dorsiflexion to neutral without pain.
- Full voluntary dorsiflexion of the contralateral ankle
- Skin intact on hemiparetic lower extremity
- Able to don the NMES system or caregiver available to assist with device if needed.
- Able to hear and respond to stimulator auditory cues
- Able to follow 3-stage commands
- Able to recall 2 of 3 items after 30 minutes

Exclusion Criteria

- Brainstem stroke
- Severely impaired cognition and communication
- History of peroneal nerve injury
- History of Parkinson's, spinal cord injury, traumatic brain injury, or multiple sclerosis
- Uncontrolled seizure disorder
- Uncompensated hemi-neglect (extinguishing to double simultaneous stimulation)
- Edema of the affected lower extremity
- Absent sensation of lower leg and foot
- Evidence of deep venous thrombosis or thromboembolism
- History of cardiac arrhythmias with hemodynamic instability
- Cardiac pacemaker or other implanted electronic system
- Botulinum toxin injections to any lower extremity muscle in the last 3 months
- Pregnancy
- Currently receiving Physical Therapy for the lower extremity