Long-term outcome of an implantable drop foot stimulator in patients with central palsy
Gregor Laengle, MD, Anna Boesendorfer, MSc, Udo Maierhofer, MD, Clemens Gstoettner, MD, PhD, Leopold Harnoncourt, MD and Oskar C Aszmann, MD, Medical University of Vienna, Vienna, Austria
Background:
Drop foot is a frequent symptom in patients with central nervous lesion like stroke or multiple sclerosis. The inability to lift the foot results in unnatural walking cycle and higher risk of falling. The ActiGait system is an implantable peroneal nerve stimulator that has been used at several centers in Europe. A follow-up period of one year showed excellent function and patient satisfaction. This study aims at presenting the long-term results after a minimum of five years with special regard to patient satisfaction and biocompatibility.
Materials & Methods:
All patients who received the ActiGait stimulator at the Medical University of Vienna were included in the study. Patient satisfaction and quality of life were evaluated with the SF-36 questionnaire and specific questions. The Falls Efficacy Scale was used to assess the subjective risk of falling during daily tasks. The Net Promotor Score was used to give a subjective estimation of the patient’s satisfaction with the system. Biocompatibility was assessed through either MRI or ultrasound studies of the implanted system and the peroneal nerve and muscles.
Results:
Ten patients could be included in the study. The questionnaire results showed high overall satisfaction and quality of life. When using the system patients felt safe and agile during daily tasks. In the radiological studies good nerve health and no signs of tissue damage could be seen. One system had to be explanted due to pain. Intraoperative evaluation during explantation showed good fascicular architecture at the region of nerve electrode interface. The explanted system revealed no signs of material damage.
Conclusions:
The presented system has a great beneficial impact on patient satisfaction and quality of life. It helps reduce the risk of falling and has a lasting performance with good biocompatibility and safety for the patient.
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