Electrical Stimulation of the Spinal Cord as a Method of Regulation Walking Kinematics in Post-Stroke Patients

Abstract

Multisegmental transcutaneous electrical stimulation of the spinal cord (sсTS), affecting spinal neural networks and motor pools of leg muscles, was used to correct treadmill walking in stroke patients. The study involved 15 patients in the recovery period after acute cerebrovascular accidents. A noninvasive spinal neuroprosthesis with a multichannel stimulator and a system for detecting phases of the walking cycle (“Cosima”, Russia) was used to activate motor pools of leg flexor muscles in the transfer phase, activation of motor pools of extensor muscles in the stance phase in combination with continuous activation of spinal locomotor networks. Using of sсTS during walking on a treadmill increased the amplitude of movements in the ankle joint and the length of the step cycle on the paresis side, as well as decreased the asymmetry of both legs in the phases of the step. The height of the paretic leg lift increased in 80% of patients. With a combination of continuous and phase-dependent stimulation, the increase in the range of motion in the joints was maximal compared to phase-dependent or only constant stimulation. The obtained data demonstrate that the proposed algorithm of the sсTS modulates the parameters of walking movements in patients with the consequences of cerebral circulation accidents and can be considered as a promising method of motor rehabilitation.