Vagus Nerve Stimulation Paired With Mobility Training in Chronic Ischemic Stroke: A Case Report.

This was a single case, so the results cannot be generalized to other people with poststroke mobility impairment. The study was open-label and unblinded, so expectations could have influenced the outcome. The participant also continued home upper limb therapy paired with vagus nerve stimulation, so the contribution of mobility training paired with vagus nerve stimulation cannot be separated from the other treatment. The participant increased his walking and biking when he began pairing activity with vagus nerve stimulation, so gains could reflect more practice, higher motivation, or both. The mobility training was self-directed and unsupervised, with no fixed protocol beyond walking or biking while activating the device. Gait speed improvements were not maintained at 41 months, when self-selected and fast speeds were close to baseline values. The paper used a clinically meaningful change value from subacute stroke because a value for chronic stroke gait speed was not established.

Do not conclude that vagus nerve stimulation caused the walking gains. This was a single case, the participant also continued upper limb therapy paired with vagus nerve stimulation and increased walking and biking, and his speed returned to baseline by 41 months.