Deans' stroke musings: Control of Stroke-Related Genu Recurvatum With Prolonged Timing of Dorsiflexor Functional Electrical Stimulation: A Case Study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, July 26, 2016

Control of Stroke-Related Genu Recurvatum With Prolonged Timing of Dorsiflexor Functional Electrical Stimulation: A Case Study

You'll have to have your doctor translate. It seems they must have been paid for using big confusing words.
http://mobile.journals.lww.com/jnpt/_layouts/15/oaks.journals.mobile/articleviewer.aspx?year=2016&issue=07000&article=00008

Chantraine, Frédéric MD; Schreiber, Céline MSc; Kolanowski, Elisabeth MD; Moissenet, Florent PhD

Journal of Neurologic Physical Therapy
July 2016
Vol. 40 - Issue 3: p 209–215

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Abstract

Background and Purpose: Abnormal knee hyperextension during the stance phase (genu recurvatum) is a common gait abnormality in persons with hemiparesis due to stroke. While ankle-foot orthoses (AFOs) are often used to prevent genu recurvatum by maintaining ankle dorsiflexion during the stance phase, AFOs reduce ankle joint mobility. Functional electrical stimulation (FES) is an alternative to the use of AFO for producing appropriately timed ankle dorsiflexion and with prolonged timing may also have value for reducing genu recurvatum.

Case Description: A 51-year-old man with chronic stroke was the subject of this case study. The patient had excessive plantarflexion during stance phase (ie, dynamic equinus foot), with associated genu recurvatum.

Intervention: Evaluation included clinical examination, instrumented gait analysis, 10-meter walk test, and 6-minute walk test. The patient underwent a trial of botulinum toxin to the plantarflexor muscles that was not effective for controlling the genu recurvatum. A subsequent trial with surface FES to elicit dorsiflexion during gait was effective, and he subsequently received an implanted FES system.

Outcomes: Stimulation-induced contraction of the dorsiflexors during terminal swing phase resulted in improved ankle dorsiflexion at initial contact. Moreover, extension of stimulation into the loading phase ensured tibial advancement, which limited knee hyperextension. The patient was reevaluated 12 months following implantation with continued positive outcomes.

Discussion: This case study illustrates the potential value of prolonged timing of dorsiflexor FES to manage genu recurvatum attributed to a dynamic equinus foot in a stroke survivor.