Improving Walking with an Implanted Neuroprosthesis for Hip, Knee, and Ankle Control After Stroke.
Nathaniel S Makowski, Rudi Kobetic, Lisa M Lombardo and 4 others
PMID 27231842WHAT IT FOUND
In a single man with stroke, implanted stimulation plus 30 weeks of gait training raised walking speed from 0.29 to 0.72 m/s on a 10-meter test.
This case cannot show what each part contributed.
Key findings
01Walking speed was 0.29 m/s before training and 0.72 m/s with stimulation after training on the 10-meter test.
02Maximum walking distance was approximately 76 m during initial training and 1418 m with stimulation after training.
03The study cannot separate the effects of stimulation and gait training, and the authors say the results cannot be generalized.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a single case report, so the findings describe what happened to a single man, not a pattern. The participant also received 30 weeks of gait training and home exercise with stimulation, so the study cannot separate the contribution of the device from the training. The authors state the results cannot be generalized without larger trials. The speed and distance gains were measured during study assessments, and the participant was not walking with stimulation outside the laboratory. Volitional two-point gait caused repeated foot catches and trips, so safety assessments had to use a step-to gait. The analysis treated many repeated walks as independent, but they all came from the same person. Some electrodes did not target the intended muscles cleanly, and specific muscle recruitment was not evaluated. The participant had left hemisensory loss, absent ankle proprioception, left hemineglect, and took anti-spasticity medication, so his response may be unique.
Declared interests
No author conflict statement is provided in the supplied text. The article is listed as supported by U.S. Government and NIH extramural research.
The easy way to misread this
Do not conclude that the implanted stimulator alone caused the walking gains or that it works for other stroke survivors. The participant also received gait training and home exercise, the design cannot separate those contributions, and the authors state the results cannot be generalized.