Brain plasticity after implanted peroneal nerve electrical stimulation to improve gait in chronic stroke patients: Two case reports.

Background: Recent studies have shown that stimulation of the peroneal nerve using an implantable 4-channel peroneal nerve stimulator could improve gait in stroke patients.

Objectives: To assess structural cortical and regional cerebral metabolism changes associated with an implanted peroneal nerve electrical stimulator to correct foot drop related to a central nervous system lesion.

Methods: Two stroke patients presenting a foot drop related to a central nervous system lesion were implanted with an implanted peroneal nerve electrical stimulator.

Proposition of a Classification of Adult Patients with Hemiparesis in Chronic Phase.

Background: Patients who have developed hemiparesis as a result of a central nervous system lesion, often experience reduced walking capacity and worse gait quality. Although clinically, similar gait patterns have been observed, presently, no clinically driven classification has been validated to group these patients' gait abnormalities at the level of the hip, knee and ankle joints. This study has thus intended to put forward a new gait classification for adult patients with hemiparesis in chronic phase, and to validate its discriminatory capacity.

The updated European Consensus 2009 on the use of Botulinum toxin for children with cerebral palsy.

An interdisciplinary European group of clinical experts in the field of movement disorders and experienced Botulinum toxin users has updated the consensus for the use of Botulinum toxin in the treatment of children with cerebral palsy (CP). A problem-orientated approach was used focussing on both published and practice-based evidence. In part I of the consensus the authors have tabulated the supporting evidence to produce a concise but comprehensive information base, pooling data and experience from 36 institutions in 9 European countries which involves more than 10,000 patients and over 45,000 treatment sessions during a period of more than 280 treatment years.

Intrathecal baclofen infusion for ambulant children with cerebral palsy.

This study assessed the effects of continuous intrathecal infusion of baclofen on the gait of ambulant children with cerebral palsy. Details, collected retrospectively before and after pump implantation, included Gillette Functional Assessment Questionnaire score, use of walking aids, Ashworth Scale score, and joint angle at which the stretch reflex was triggered. Twenty-one ambulant children and young adults with cerebral palsy were included.

Changes in gait following continuous intrathecal baclofen infusion in ambulant children and young adults with cerebral palsy.

Objective: To assess the effect of continuous intrathecal baclofen infusion (ITB) on gait parameters of ambulant children with cerebral palsy (CP).

Methods: The assessment before and 16 months after ITB on seven children with CP (mean age 15 years, SD 5.4) included: Ashworth scale score, range of motion (hip, knee, ankle), Gillette functional assessment questionnaire (FAQ), joint kinematics, spatiotemporal parameters and Gillette Gait Index (GGI).

Multidimensional outcome assessment in cerebral palsy: is it feasible and relevant?

Background: To examine feasibility and relevance of a multidimensional outcome assessment approach using instrumented 3-dimensional gait analysis, via the Gillette Gait Index (GGI), and a set of validated functional and health-related quality of life tools in diplegic cerebral palsy children, before introduction as a nationwide evaluation set.

Methods: A 3-year prospective government-funded multicenter study was conducted, recruiting patients during a 9-month period classified using the Gross Motor Function Classification System and the Rodda et al sagittal walking patterns. The Gross Motor Classification System Dimensions D and E, the 10-level Gillette Functional Assessment Questionnaire, the Energy Expenditure Index (EEI), the GGI out of 3D gait analysis, and health-related quality of life, assessed by self or proxy with the questionnaire "Vècu et Santè Perçu de l'Adolescent," were selected for the study.

Lidocaine hyperselective motor blocks of the triceps surae nerves: role of the soleus versus gastrocnemius on triceps spasticity and predictive value of the soleus motor block on the result of selective tibial neurotomy.

Objectives: This prospective study was designed to evaluate the clinical and gait parameter changes induced by two types of hyperselective motor blocks of the triceps surae nerves (superior soleus and gastrocnemius nerves) and their ability to predict the results of selective tibial neurotomy.

Design: Seven adult patients (four males and three females, mean age of 41 yrs old) with spastic foot were included in this study. Clinical (equinus foot score, ankle range of motion, spasticity, pain, and comfort wearing shoes), and gait analysis (kinematic and electromyographic parameters) assessment were performed before and after each motor block (superior soleus nerve and gastrocnemius nerve) and 1 mo after selective tibial neurotomy.