Abstract
This study aimed to determine the effects of electromyography (EMG)-triggered pedaling training to improve motor functions in the lower extremities, muscle activation, gait, postural balance, and activities of daily living in stroke patients. Subjects were randomly allocated to two groups: the EMG-triggered pedaling training group (EMG-PTG, n = 21) and the traditional pedaling training group (TPTG, n = 20). Both groups trained five times per week for four weeks, with 50 min per session. Lower extremity motor function was assessed using the Fugl–Meyer Assessment (FMA). Muscle activation of the four muscles of the lower extremities was assessed using eight-channel electromyography, while gait ability was assessed using GaitRite. Postural balance was assessed using the Berg balance scale (BBS), the timed up and go (TUG), and functional reach tests (FRT). Daily activities were assessed using the Modified Barthel Index (MBI). For lower extremity motor function, gait ability, balance ability, and activities of daily living, the EMG-PTG showed significant improvement compared to TPTG (p < 0.05). These results suggest that EMG-triggered pedaling training effectively improves lower extremity motor function, muscle activation, gait, postural balance, and activities of daily living in stroke patients.
Highlights
The number of stroke patients has increased as a result of an increase in the survival rate of acute stroke as well as an aging population [1]
The subjects who were involved in this study were recruited from inpatient stroke patients at D Hospital in Seoul, Korea, with the following inclusion criteria: (1) chronic hemiplegic stroke patients who had been diagnosed with a stroke for more than six months, (2) patients with sufficient cognitive function, and (3) a Brunnstrom motor recovery stage that was higher than the third stage
There were no notable differences between the general characteristics of the two groups, including age, height, weight, body mass index, duration of stroke, mini-mental state examination score, modified Barthel index score, sex, paretic side, and stroke type
Summary
The number of stroke patients has increased as a result of an increase in the survival rate of acute stroke as well as an aging population [1]. Quality of life declines as a consequence of impaired physical function. Hemiparesis is one major cause of gait impairments, and restoring gait function is one of the most important goals for stroke rehabilitation [4]. Stroke gait is characterized by asymmetric movement and compensatory gait patterns due to weakness on one side of the body [5]. Asymmetric gait patterns can be identified through an analysis of spatial-temporal gait variables, including step length, swing, and stance phase durations [6]. Hemiplegic gait presents with excessive hip joint and pelvic movements in order to extend the decreased step length [7]. Prolonged and repeated compensatory gaits result in serious disability, which leads to limitations in mental and social participation and an eventually cause a decline in a stroke patient’s quality of life [8]. Clinicians and researchers have been testing many treatment strategies to reduce gait asymmetry, and their results have been recorded in previous studies [6,9,10]
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