Clinical Use of Functional Electrical Stimulation for Correction of Foot Drop: A Comparison Between Subacute and Chronic Stroke Patients

Sabut, Sukanta; Sikdar, Chhanda; Kumar, Ratnesh; Mahadevappa, Manjunatha

doi:10.1142/s0219519411004253

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…A thorough review on earlier FES systems to correct DF since the 1960s up to 2001 can be found elsewhere [12]. Functional electrical stimulation as a rehabilitation tool has been reported to improve gait when combined with conventional therapies [13][14][15][16][17], however it is not going to be addressed as a main topic, since it falls outside the scope of this article. Nonetheless, therapeutic effects of FES may be brought to discussion when necessary.…”

Section: Introductionmentioning

confidence: 99%

Technical developments of functional electrical stimulation to correct drop foot: Sensing, actuation and control strategies

Melo

Silva

Martins

et al. 2015

Clinical Biomechanics

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This work presents a review on the technological advancements over the last decades of functional electrical stimulation based neuroprostheses to correct drop foot. Functional electrical stimulation is a technique that has been put into practice for several years now, and has been shown to functionally restore and rehabilitate individuals with movement disorders, such as stroke, multiple sclerosis and traumatic brain injury, among others. The purpose of this technical review is to bring together information from a variety of sources and shed light on the field's most important challenges, to help in identifying new research directions. The review covers the main causes of drop foot and its associated gait implications, along with several functional electrical stimulation-based neuroprostheses used to correct it, developed within academia and currently available in the market. These systems are thoroughly analyzed and discussed with particular emphasis on actuation, sensing and control of open- and closed-loop architectures. In the last part of this work, recommendations on future research directions are suggested.

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Section: Introductionmentioning

confidence: 99%

Technical developments of functional electrical stimulation to correct drop foot: Sensing, actuation and control strategies

Melo

Silva

Martins

et al. 2015

Clinical Biomechanics

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A Clinical Practice Guideline for the Use of Ankle-Foot Orthoses and Functional Electrical Stimulation Post-Stroke

Johnston¹,

Keller²,

Denzer-Weiler³

et al. 2021

Journal of Neurologic Physical Therapy

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Background: Level of ambulation following stroke is a long-term predictor of participation and disability. Decreased lower extremity motor control can impact ambulation and overall mobility. The purpose of this clinical practice guideline (CPG) is to provide evidence to guide clinical decision-making for the use of either ankle-foot orthosis (AFO) or functional electrical stimulation (FES) as an intervention to improve body function and structure, activity, and participation as defined by the International Classification of Functioning, Disability and Health (ICF) for individuals with poststroke hemiplegia with decreased lower extremity motor control. Methods: A review of literature published through November 2019 was performed across 7 databases for all studies involving stroke and AFO or FES. Data extracted included time post-stroke, participant characteristics, device types, outcomes assessed, and intervention parameters. Outcomes were examined upon initial application and after training. Recommendations were determined on the basis of the strength of the evidence and the potential benefits, harm, risks, or costs of providing AFO or FES. Results/Discussion: One-hundred twenty-two meta-analyses, systematic reviews, randomized controlled trials, and cohort studies were included. Strong evidence exists that AFO and FES can each increase gait speed, mobility, and dynamic balance. Moderate evidence exists that AFO and FES increase quality of life, walking endurance, and muscle activation, and weak evidence exists for improving gait kinematics. AFO or FES should not be used to decrease plantarflexor spasticity. Studies that directly compare AFO and FES do not indicate overall superiority of one over the other. But evidence suggests that AFO may lead to more compensatory effects while FES may lead to more therapeutic effects. Due to the potential for gains at any phase post-stroke, the most appropriate device for an individual may change, and reassessments should be completed to ensure the device is meeting the individual's needs. Limitations: This CPG cannot address the effects of one type of AFO over another for the majority of outcomes, as studies used a variety of AFO types and rarely differentiated effects. The recommendations also do not address the severity of hemiparesis, and most studies included participants with varied baseline ambulation ability. Summary: This CPG suggests that AFO and FES both lead to improvements post-stroke. Future studies should examine timing of provision, device types, intervention duration and delivery, longer term follow-up, responders versus nonresponders, and individuals with greater impairments. Disclaimer: These recommendations are intended as a guide for clinicians to optimize rehabilitation outcomes for people with poststroke hemiplegia who have decreased lower extremity motor control that impacts ambulation and overall mobility. A Video Abstract is available as supplemental digital content from the authors (available at: http://links.lww.com/JNPT/A335).

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Application of an Evolutionary Actor–critic Reinforcement Learning Method for the Control of a Three-Link Musculoskeletal Arm During a Reaching Movement

Tahami

Jafari

Fallah

2013

J. Mech. Med. Biol.

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In this paper, the control of a planar three-link musculoskeletal arm by using a revolutionary actor–critic reinforcement learning (RL) method during a reaching movement to a stationary target is presented. The arm model used in this study included three skeletal links (wrist, forearm, and upper arm), three joints (wrist, elbow, and shoulder without redundancy), and six non-linear monoarticular muscles (with redundancy), which were based on the Hill model. The learning control system was composed of actor, critic, and genetic algorithm (GA) parts. Two single-layer neural networks were used for each part of the actor and critic. This learning control system was used to apply six activation commands to six monoarticular muscles at each instant of time. It also used a reinforcement (reward) feedback for the learning process and controlling the direction of arm movement. Also, the GA was implemented to select the best learning rates for actor–critic neural networks. The results showed that mean square error (MSE) and average episode time gradually decrease and average reward gradually increases to constant values during the learning of the control policy. Furthermore, when learning was complete, optimal values of learning rates were selected.

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Clinical Use of Functional Electrical Stimulation for Correction of Foot Drop: A Comparison Between Subacute and Chronic Stroke Patients

Cited by 4 publications

References 31 publications

Technical developments of functional electrical stimulation to correct drop foot: Sensing, actuation and control strategies

Technical developments of functional electrical stimulation to correct drop foot: Sensing, actuation and control strategies

A Clinical Practice Guideline for the Use of Ankle-Foot Orthoses and Functional Electrical Stimulation Post-Stroke

Application of an Evolutionary Actor–critic Reinforcement Learning Method for the Control of a Three-Link Musculoskeletal Arm During a Reaching Movement

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