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Updated: Apr 15, 2026
Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Surface peroneal nerve stimulation in lower limb hemiparesis: effect on quantitative gait parameters
Lynne R Sheffler1, Paul N Taylor, Stephanie Nogan Bailey
1From the Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, Ohio (LRS, JC); Cleveland Veterans Affairs Functional Electrical Stimulation Center of Excellence, Cleveland, Ohio (LRS, JC); Department of Physical Medicine and Rehabilitation, MetroHealth Rehabilitation Institute of Ohio, MetroHealth Medical Center, Cleveland, Ohio (LRS, MJI, JC); The National Clinical FES Center, Salisbury District Hospital, Salisbury, United Kingdom (PNT); Louis Stokes Veterans Affairs Medical Center, Cleveland, Ohio (SNB); Center for Health Policy Research, MetroHealth Medical Center, Cleveland, Ohio (DDG); Roessingh Research and Development, Enschede, the Netherlands (JHB); Department of Health Technology and Services Research, University of Twente, Enschede, The Netherlands (MJI); and Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio (JC).
Objective:
The objective of this study was to evaluate possible mechanisms for functional improvement and compare ambulation training with surface peroneal nerve stimulation vs. usual care via quantitative gait analysis.
Design:
This study is a randomized controlled clinical trial.
Setting:
The setting of this study is a teaching hospital of an academic medical center.
Participants:
One hundred ten chronic stroke survivors (>12 wks poststroke) with unilateral hemiparesis participated in this study.
Interventions:
The subjects were randomized to a surface peroneal nerve stimulation device or usual care intervention. The subjects were treated for 12 wks and followed up for 6-mo posttreatment.
Main Outcome Measures:
Spatiotemporal, kinematic, and kinetic parameters of gait were the main outcome measures.
Results:
Cadence (F3,153 = 5.81, P = 0.012), stride length (F3,179 = 20.01, P < 0.001), walking speed (F3,167 = 18.2, P < 0.001), anterior-posterior ground reaction force (F3,164 = 6.61, P = 0.004), peak hip power in preswing (F3,156 = 8.76, P < 0.001), and peak ankle power at push-off (F3,149 = 6.38, P = 0.005) all improved with respect to time. However, peak ankle ankle dorsiflexion in swing (F3,184 = 4.99, P = 0.031) worsened. In general, the greatest change for all parameters occurred during the treatment period. There were no significant treatment group × time interaction effects for any of the spatiotemporal, kinematic, or kinetic parameters.
Conclusions:
Gait training with peroneal nerve stimulation and usual care was associated with improvements in peak hip power in preswing and peak ankle power at push-off, which may have resulted in improved cadence, stride length, and walking speed; however, there were no differences between treatment groups. Both treatment groups also experienced a decrease in peak ankle ankle dorsiflexion in swing, although the clinical implications of this finding are unclear.
