Concurrent impact of bilateral multiple joint functional electrical stimulation and treadmill walking on gait and spasticity in post-stroke survivors: a pilot study

Abstract

Background: Stroke causes multi-joint gait deficits, so a major objective of post-stroke rehabilitation is to regain normal gait function. Design and Setting: A case series completed at a neuroscience institute. Aim: The aim of the study was to determine the concurrent impact of functional electrical stimulation (FES) during treadmill walking on gait speed, knee extensors spasticity and ankle plantar flexors spasticity in post-stroke survivors. Participants: Six post-stroke survivors with altered gait patterns and ankle plantar flexors spasticity (4=male; age 56.8 ± 4.8 years; Body Mass Index (BMI) 26.2 ±4.3; since onset of stroke: 30.8 ±10.4 months; side of hemiplegia [L/R]: 3:3) were recruited. Intervention: Nine treatment sessions using FES bilaterally while walking on a treadmill. Main Outcome Measures: Primary outcome measures included the Modified Modified Ashworth Scale (MMAS), Timed Up and Go test (TUG), 10-m walking test, gait speed, and Functional ambulation category (FAC). Secondary outcome measures included the Step Length Test (SLT), and active range of motion (ROM) of the affected ankle and the knee. Measurements were taken at baseline (T0), at the end of last treatment (T1), and one month after the final treatment session (T2). Results: The TUG, 10-m walking test, gait speed, FAC, active ROM, and SLT all significantly improved following treatment (P<0.05), while ankle plantar flexors spasticity (P=0. 135), and knee extensors spasticity (P=0.368) did not show any significant decrease. Conclusions: A short duration of bilateral FES in conjugation with treadmill walking contributed to significant improvement in gait speed, functional mobility, functional ambulation, range of motion and step length in post-stroke survivors. In contrast, no significant decrease were identified in the spasticity of the ankle plantar flexors and knee extensors muscles.

Effectiveness of Transcutaneous Electrical Nerve Stimulation with Taping for Stroke Rehabilitation

“…In a recent study, relief of spasticity in patients with spinal cord injury was observed for 4 h following 30 min of FES and TENS application, and it was reported that there was no significant difference between the two methods [ 11 ]. However, in the case of FES, there is insufficient evidence regarding its ability to reduce spasticity, especially in patients with stroke [ 9 , 12 , 13 ]. Recently, many studies have reported that TENS [ 14 , 15 ] and taping [ 16 – 18 ] are effective interventions for the management of spasticity associated with neurological disorders.…”

Effect of combined aquatic and cognitive training on quality of life, fall self-efficacy, and motor performance in aged with varying cognitive status: a proof-of-concept study

“…Static balance was evaluated by the adjusted Romberg test (McIlroy and Maki, 1997). Dynamic balance was measured using the Timed Up & Go test in which the participants were required to rise from the chair, walk three meters, turn around, walk back to the chair and sit down (Hakakzadeh et al, 2019).…”

Proprioceptive Neuromuscular Facilitation-Based Physical Therapy on the Improvement of Balance and Gait in Patients with Chronic Stroke: A Systematic Review and Meta-Analysis

“…There are many available modality and movement therapies of post-stroke rehabilitation that have positive effects on motor and gait functions in patients after stroke, e.g., cycling, treadmill walking and functional electrical stimulation [ 8 , 9 ]. However, they may be expensive and provide a limited kind of movement.…”