Effect of Functional Electrical Stimulation of the Gluteus Medius during Gait in Patients following a Stroke

Abstract

Many stroke patients rely on cane or ankle-foot orthosis during gait rehabilitation. The purpose of this study was to investigate the immediate effect of functional electrical stimulation (FES) to the gluteus medius (GMed) and tibialis anterior (TA) on gait performance in stroke patients, including those who needed assistive devices. Fourteen stroke patients were enrolled in this study (mean poststroke duration: 194.9 ± 189.6 d ; mean age: 72.8 ± 10.7 y ). Participants walked 14 m at a comfortable velocity with and without FES to the GMed and TA. After an adaptation period, lower-limb motion was measured using magnetic inertial measurement units attached to the pelvis and the lower limb of the affected side. Motion range of angle of the affected thigh and shank segments in the sagittal plane, motion range of the affected hip and knee extension-flexion angle, step time, and stride time were calculated from inertial measurement units during the middle ten walking strides. Gait velocity, cadence, and stride length were also calculated. These gait indicators, both with and without FES, were compared. Gait velocity was significantly faster with FES ( p = 0.035 ). Similarly, stride length and motion range of the shank of the affected side were significantly greater with FES (stride length: p = 0.018 ; motion range of the shank: p = 0.02 6). Meanwhile, cadence showed no significant difference ( p = 0.238 ) in gait with or without FES. Similarly, range of motion of the affected hip joint, knee joint, and thigh did not differ significantly depending on FES condition ( p = 0.115 ‐ 0.529 ). FES to the GMed and TA during gait produced an improvement in gait velocity, stride length, and motion range of the shank. Our results will allow therapists to use FES on stroke patients with varying conditions.

Results of functional electrical stimulation of leg muscles during walking in a patient in the early recovery period after a stroke

“…В нашем случае (многоканальной стимуляции) мы получили изменения в лучшую сторону и показателя периода опоры. Улучшение функции ходьбы было получено при стимуляции средней ягодичной мышцы и передней большеберцовой в двух независимых исследованиях [22,23].…”

For Patients with Stroke, Balance Ability Affects the Leg Extension Angle on the Affected Side

“…IMUs were comprised of a 3D gyroscope, an accelerometer, and a magnetometer and could calculate the 3-axis acceleration and Euler angles in a laboratory coordinate system with a sampling frequency of 100 Hz. IMUs are widely used tools in healthcare [17,[37][38][39], with high reliability [40], and are fixed along the frontal plane where possible. Software (MT manager 4.7.2, Xsens, Enschede, The Netherlands) was used to adjust the vertical axis of the IMU to align with gravity during static stance.…”