Effects of Ankle Control Training Using Neuromuscular Electrical Stimulation on Leg Muscle Activation and Balance in Patients with Stroke

Abstract

Purpose: This study examined the effects of ankle control training using neuromuscular electrical stimulation (NMES), leg muscle activation, and balance in stroke patients. Methods: Thirty-one stroke patients diagnosed with cerebral infarction and cerebral hemorrhage were selected for the study. The experimental group underwent ankle control training using NMES, while the control group applied NMES to the paretic tibialis anterior muscle for 30 minutes per session, five times a week for four weeks. The muscle activity changes were measured using surface electromyography, and balance parameters were evaluated using a functional reach test (FRT). Results: The intra-group comparison of the concentric muscle activity revealed improvements in the experimental group, including paretic tibialis anterior (TA) muscle (p< 0.05), medial gastrocnemius muscle (MG) (p< 0.01), and lateral gastrocnemius muscle (LG) (p< 0.05), as well as MG (p< 0.05), LG (p< 0.05), soleus muscle (p< 0.05) of the non-paretic side, and soleus muscle symmetry index (p< 0.05). The intra-group comparison of the eccentric muscle activity showed improvements in the experimental group, including MG (p< 0.01) and LG (p< 0.01) of the paretic side, as well as MG (p< 0.01), LG (p< 0.01) of the non-paretic side, and LG symmetry index (p< 0.01). The intra-group comparison of the functional reach test revealed significant differences in the test results in the experimental and control groups (p< 0.05). Conclusion: Ankle control training using NMES had a positive effect on the changes in muscle activation and improved balance in patients with stroke.