Introduction: Every year around 12.000 people suffer a stroke in Denmark. Gait retraining is an important part of their rehabilitation. The nociceptive withdrawal reflex evoked by stimulating the sole of the foot has previously been used to support gait retraining and a new technology has been developed for this purpose. The effect of this technology has not yet been proven. The present study is a pilot study aiming to develop a test battery and a protocol, which can be used in a larger study to investigate the effect of the technology. Furthermore the technology is assessed with inspiration from the MTV procedures.
Methods: The study contains three parts. The test battery is designed based on a literature review and subsequently tested. The protocol is developed on the basis of previous experiences and is adjusted following the clinical trial. 5 patients were included and divided into 2 groups – an intervention group and a control group. They received 5 treatments over a period of a maximum of 14 days. The intervention consists of gait retraining supported by intelligent electrical stimulations and conventional physiotherapy and the control treatment consists of physiotherapy only. The assessment of the technology was done through observations and interviews with patients and personnel and a previous analysis of users’ experiences with it.
Results: A test battery was composed on the basis of technological and clinical tests. This battery was tested in the clinical trial. The results from the clinical study showed general improvement in both the treatment and in the control group. Because of the small group of patients the results cannot be generalized.
Discussion and conclusion: The clinical trial showed that it is relevant to assess functional gait with Functional Ambulation Category (FAC) and 10m walk test, balance with Bergs Balance Test or Postural assessment scale for stroke patients, muscle function with Manual Muscle Test (MMT) and energy consumption with Physiological Cost Index. A new test is proposed because of the need to assess better the need of support during gait. Further proposals for making the inclusion criteria more precise have been made: Using a MMT score over the hip joint of max 2 and a FAC score of max 2. In relation to a potential implementation of the technology the biggest obstacle is considered to be the early stage in which the technology is so far.