Abstract
Many stroke patients rely on cane or ankle-foot orthosis during gait rehabilitation. The purpose of this study was to investigate the immediate effect of functional electrical stimulation (FES) to the gluteus medius (GMed) and tibialis anterior (TA) on gait performance in stroke patients, including those who needed assistive devices. Fourteen stroke patients were enrolled in this study (mean poststroke duration: 194.9 ± 189.6 d; mean age: 72.8 ± 10.7 y). Participants walked 14 m at a comfortable velocity with and without FES to the GMed and TA. After an adaptation period, lower-limb motion was measured using magnetic inertial measurement units attached to the pelvis and the lower limb of the affected side. Motion range of angle of the affected thigh and shank segments in the sagittal plane, motion range of the affected hip and knee extension-flexion angle, step time, and stride time were calculated from inertial measurement units during the middle ten walking strides. Gait velocity, cadence, and stride length were also calculated. These gait indicators, both with and without FES, were compared. Gait velocity was significantly faster with FES (p = 0.035). Similarly, stride length and motion range of the shank of the affected side were significantly greater with FES (stride length: p = 0.018; motion range of the shank: p = 0.026). Meanwhile, cadence showed no significant difference (p = 0.238) in gait with or without FES. Similarly, range of motion of the affected hip joint, knee joint, and thigh did not differ significantly depending on FES condition (p = 0.115‐0.529). FES to the GMed and TA during gait produced an improvement in gait velocity, stride length, and motion range of the shank. Our results will allow therapists to use FES on stroke patients with varying conditions.
Highlights
Strokes can cause impairments in gait kinematics, such as a drop foot, decreased knee flexion during the swing phase, lateral trunk fluctuation, impaired ability to shift weight, and reduced leg extension angle during the stance phase [1,2,3,4,5]
The purpose of this study was to investigate the immediate effect of functional electrical stimulation (FES) on the gluteus medius (GMed) and tibialis anterior (TA) in stroke patients, including those who relied on assistive devices to walk
The present results showed that FES to the GMed and TA during gait increased gait speed, stride length, and range of motion of the affected shank, and supported our hypothesis
Summary
Strokes can cause impairments in gait kinematics, such as a drop foot, decreased knee flexion during the swing phase, lateral trunk fluctuation, impaired ability to shift weight, and reduced leg extension angle during the stance phase [1,2,3,4,5]. Drop foot and decreased knee flexion are associated with decreased foot clearance [6], and reduced leg extension angle relates to short stride length and decreased propulsion force at late stance [7, 8]. These impairments impact walking ability (for example, by reducing walking speed), leading to falls and reduced walking endurance [9, 10]. Interventions to improve impaired kinematics and gait speed are important during rehabilitation in poststroke patients. Neurorehabilitation tools, such as functional electrical stimulation (FES) [13], transcranial magnetic stimulation
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