The Rehabilitation of Gait in Patients With Hemiplegia: A Comparison Between Conventional Therapy and Multichannel Functional Electrical Stimulation Therapy

Abstract

Gait rehabilitation in patients with severe hemiplegia requires substantial effort. Preliminary studies indicate potential beneficial effects of using multichannel functional electrical stimulation (MFES) for gait rehabilitation in these patients. In this study, a new method of gait rehabilitation for nonambulatory patients with hemiplegia by means of MFES added to conventional therapy was introduced. The results of the method's application were evaluated by comparing it with conventional therapeutic methods. The proposed rehabilitation method was tested on a group of 20 patients with severe hemiplegia secondary to cerebrovascular accident. Subjects were randomly assigned to one of two groups. One group received 3 weeks of MFES followed by 3 weeks of conventional therapy. The other group received 3 weeks of conventional therapy followed by 3 weeks of MFES. The effects of each therapeutic method were evaluated by measurements of temporal-distance variables and ground reaction forces and by assessment of each subject's physical status according to the Fugl-Meyer evaluation scale. There was improved performance of the subjects during MFES combined with conventional therapy as compared with conventional therapy alone. The superiority of the MFES method as compared with conventional therapy was mainly attributed to the enhanced motor learning accomplished by application of MFES. These results, however, are preliminary, and further research is needed.