Foot Drop, Gait Disorders, Neurologic, Mobility Limitation, Peripheral Nervous System Diseases
Conditions
Brief summary
The purpose of this research study is to test the utility of an ankle robot in people with ankle weakness and foot drop from a peripheral nervous system injury due to neuromuscular or orthopedic injury.
Detailed description
Many individuals with central nervous system (CNS) injuries (e.g., a stroke) or peripheral nervous system (PNS) injuries (e.g., peroneal nerve injury, neuropathy, radiculopathy, and/or musculoskeletal injury) that affect their ankle movement have residual impairments that affect their walking and balance. These impairments include the disability foot drop, which increases the risk for falling. This study will focus on PNS injuries that cause foot drop. Current therapy to address foot drop is limited primarily to the use of ankle foot orthoses (braces) that help keep the foot from hitting the ground to prevent falling. Also, some individuals with foot drop use functional electrical stimulation to the leg nerve to lift the foot. Regardless, none of these, or other existing, methods to address foot drop cures or even improves significantly the underlying neurological deficit behind this disability. Braces improve walking safety only while they are worn, and functional electrical stimulation does not work when it is turned off, or when the nerve has been severely damaged. Thus, the increased fall risk due to foot drop is generally considered life-long and incurable. The investigators have developed a shoe-interfaced ankle robot with an adaptive control system, to assist an individual with ankle movement only as needed. Data from the investigators' previous studies on foot drop due to stroke show great promise for this ankle robot as a new rehabilitation tool for invididuals with foot drop. The investigators would like to utilize our findings from these stroke studies in learning how they can be used for PNS-related foot drop.
Interventions
DEVICESeated Ankle Robot Training
This intervention employs the use of an adaptive ankle robot control system over a 6-week intervention period.
Sponsors
Baltimore VA Medical Center
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Seated Ankle Robot Taining
Eligibility
Sex/Gender
ALL
Age
18 Years to 88 Years
Healthy volunteers
No
Inclusion criteria
1. Men and women, aged 18 to 88 years 2. Chronic foot drop and ankle weakness in one leg from a peripheral nervous system injury due to a neuromuscular or orthopedic injury 3. Ability to walk 10 meters and arise from a chair with no human assistance (but usage of usual assistive device\[s\] is permitted)
Exclusion criteria
1. Medical history that would preclude participation in low-intensity seated robotic-assisted rehabilitation 2. Current participation in orthopedic or rehabilitation medical programs 3. Active deep venous thrombosis 4. Distal paretic leg skin lesions, infections, or soft tissue inflammation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ankle dorsiflexion-plantarflexion range of motion | Change from baseline to: post-6 weeks of training, and 6 weeks after completion of training | degrees |
| Ankle inversion-eversion range of motion | Change from baseline to: post-6 weeks of training, and 6 weeks after completion of training | degrees |
| Gait velocity during self-selected overground walking | Change from baseline to: post-6 weeks of training, and 6 weeks after completion of training | cm/sec |
| Postural sway areas during quiet standing | Change from baseline to: post-6 weeks of training, and 6 weeks after completion of training | cm\^2; extent of postural deviations to assess static postural control |
| Ratio of asymmetric loading in quiet standing | Change from baseline to: post-6 weeks of training, and 6 weeks after completion of training | ratio of Newtons of force per leg while standing quietly |
| Push-off forces during gait initiation | Change from baseline to: post-6 weeks of training, and 6 weeks after completion of training | Newtons; magnitude of forward ground reaction forces. |
Countries
United States
Contacts
Primary ContactKate C. Flores
Outcome results
None listed