Contralaterally Controlled Neuromuscular Electrical Stimulation for Recovery of Ankle Dorsiflexion

So where did you put this protocol where all 10 million yearly stroke survivors  can find it and use it to train their stroke team? I do not trust top down delivery of stroke research, it has never worked.

Contralaterally Controlled Neuromuscular Electrical Stimulation for Recovery of Ankle Dorsiflexion

Jayme S. Knutson, PhD
1,2,3
,
Kristine Hansen, PT
3
,
Jennifer Nagy, PT
3
,
Stephanie N. Bailey,BSE
4
,
Douglas D. Gunzler, PhD
5
,
Lynne R. Sheffler, MD
1,2,3
, and
John Chae, MD
1,2,3
1
Dept of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, OH
2
Cleveland Functional Electrical Stimulation Center, Cleveland, OH
3
Dept of Physical Medicine and Rehabilitation, MetroHealth Rehabilitation Institute of Ohio,MetroHealth Medical Center, Cleveland, OH
4
Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH
5
Center for Health Care Research and Policy, MetroHealth Medical Center, Cleveland, OH

 Abstract

Objective—
Compare the effects of contralaterally controlled neuromuscular electrical stimulation (CCNMES) versus cyclic neuromuscular electrical stimulation (NMES) on lower extremity impairment, functional ambulation, and gait characteristics.
Design—
Twenty-six stroke survivors with chronic (≥6mo) foot drop during ambulation were randomly assigned to six weeks of CCNMES or cyclic NMES. Both groups had ten sessions per week of self-administered home application of either CCNMES or cyclic NMES plus two sessions per week of gait training with a physical therapist. Primary outcomes included lower extremity Fugl-Meyer score, modified Emory Functional Ambulation Profile, and gait velocity. Assessments were made at pretreatment, post treatment, and at 1 and 3 months post treatment.
Results—
There were no significant differences between groups in the outcome trajectories for any of the measures. With data from both groups pooled, there were significant but modest and sustained improvements in the Fugl-Meyer score and the modified Emory Functional Ambulation Profile, but not in gait velocity.
Conclusions—
The results support the hypothesis that gait training combined with either CCNMES or cyclic NMES reduces lower extremity impairment and functional ambulation, but do not support the hypothesis that CCNMES is more effective than cyclic NMES in chronic patients.
Keywords
Stroke Rehabilitation; Hemiplegia; Neuromuscular Electrical Stimulation; Footdrop
Correspondence:
 Jayme S. Knutson, PhD Dept of Physical Medicine and Rehabilitation MetroHealth Rehabilitation Institute of Ohio4229 Pearl Road, Suite N527 Cleveland, Ohio 44109, USA.
Disclosures:
 Financial disclosure statements have been obtained, and no other conflicts of interest have been reported by the authorsor by any individuals in control of the content of this article.This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providingthis early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before itis published in its final citable form. Please note that during the production process errors may be discovered which could affect thecontent, and all legal disclaimers that apply to the journal pertain.
NIH Public Access
Author Manuscript
Am J Phys Med Rehabil
. Author manuscript; available in PMC 2014 August 01.
Published in final edited form as:
Am J Phys Med Rehabil
. 2013 August ; 92(8): 656–665. doi:10.1097/PHM.0b013e31829b4c16.