Restoration of Gait During Two to Three Weeks of Therapy with Multichannel Electrical Stimulation

Background and Purpose-The effectiveness of functional electrical stimulation (FES) has been investigated in chronic hemiplegia. The present study examines whether FES, given during acute stroke, was more effective in promoting motor recovery of the lower extremity and walking ability than standard rehabilitation alone. Methods-Forty-six subjects, 70.9Ϯ8.0 years old and 9.2Ϯ4.1 days after stroke, were assigned randomly to 1 of 3 groups receiving standard rehabilitation with FES or placebo stimulation or alone (control). FES was applied 30 minutes and placebo stimulation 60 minutes, 5 days per week for 3 weeks. Outcome measurements included composite spasticity score, maximum isometric voluntary contraction of ankle dorsi-flexors and planter-flexors, and walking ability. They were recorded before treatment, weekly during the 3-week treatment, and at week 8 after stroke. Results-No significant differences were found in the baseline measurements. After 3 weeks of treatment, there was a significant reduction in the percentage of composite spasticity score, and a significant improvement in the ankle dorsiflexion torque, accompanied by an increase in agonist electromyogram and a reduction in electromyogram cocontraction ratio in the FES group, when compared with the other 2 groups (PϽ0.05). All subjects in the FES group were able to walk after treatment, and 84.6% of them returned home, in comparison with the placebo (53.3%) and control (46.2%, PϽ0.05) groups. Conclusions-Fifteen sessions of FES, applied to subjects with acute stroke plus standard rehabilitation, improved their motor and walking ability to the degree that more subjects were able to return to home.

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“…2,3 Treatment period within a study was often not standardized. 3,4 Many studies failed to calculate the sample size.…”

mentioning

confidence: 99%

Functional Electrical Stimulation Improves Motor Recovery of the Lower Extremity and Walking Ability of Subjects With First Acute Stroke

Yan

Hui-Chan

2005

Stroke

278

194

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“…The new dual-channel stimulation system was designed (9) based on experiences with six-channel (1,2,3,4,5) and dual-channel electrical stimulation (6,7,8,11,12). Five prototypes were functionally tested.…”

Section: Methodsmentioning

confidence: 99%

“…This paper represents an outcome of research by the Ljubljana Rehabilitation Engineering Center on multichannel electrical stimulation for the initiation of gait of severely disabled persons with upper motor-neuron lesion (1,2,3,4,5). Studies on therapeutic and orthotic dual-channel stimulation (6), together with substantial clinical practice, led to a prototype of a dual-channel device programmed by DIP switches, which was tested on 18 stroke and brain-injury patients (7).…”

Section: Introductionmentioning

confidence: 99%

Application of a programmable dual-channel adaptive electrical stimulation system for the control and analysis of gait

Malezic¹,

Bogataj²,

Gros³

et al. 1992

JRRD

Self Cite

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Abstract-A dual-channel electrical stimulation system with a stimulator and a programmer/stride analyzer was designed for clinical rehabilitation of gait and for subsequent daily use as an orthotic aid. The stimulator, with controls to adjust amplitude only (50 mA), adapts chosen stimulation sequences to the walking rate of a patient. Pulse duration (50-500 ps), frequency (5-120 Hz), shape (symmetrical biphasic, monophasic), stimulation sequences (16 stride segments) and their cycle (2-12 sec), and right/left foot-switch choices are selected for each patient and programmed into a separate unit. The programming unit also statistically processes the footswitch data collected by the stimulator. The device was evaluated with regard to the programmable parameters, effectiveness during gait, and feasibility in clinical use. It was applied to 11 stroke patients and 10 brain injury patients during gait, stimulating 22 combinations of peroneal nerve and hamstring, quadriceps, triceps brachii, and gluteus maximus muscles. Forces on both feet, equinovarus, knee extension and hyperextension, elbow flexion, and hip extension were corrected. Selection of the stimulation sequences, their adaptation, range of pulse duration, and valid statistics were verified. Improved forces and joint angles were recorded together with significant changes in the stride time, length, and velocity by the stimulation.

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“…Liberson et al (1961) who applied the FES system to hemiplegia first reported that the FES system used electrical signs to activate peripheral nerves and control functional movements. Also, Bogataj et al (1989) reported that there was an increase of lower extremity muscle activation and an improvement of gait performance in patients who couldn't walk by an intervention using multi-channel electrical stimulation for 3 weeks. Furthermore, van Swigchem et al (2012) reported that FES applied group had more increase in ability to avoid falling obstacles on the treadmill than the AFO applied group.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Dynamic Functional Electrical Stimulation With Treadmill Gait Training on Functional Ability, Balance Confidence and Gait in Chronic Stroke Patients

Cho

Ahn

Park

et al. 2014

Physical Therapy Korea

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1)The aim of this study was to evaluate the effects of walking on a treadmill while using dynamic functional electrical stimulation (Dynamic FES) on functional ability and gait in chronic stroke patients. This was a prospective, randomized controlled study. Twelve patients with chronic stroke (>24 months) who were under grade 3 in dorsiflexor strength with manual muscle test were included and randomized into intervention (Dynamic FES) (n1=7) and control (FES) (n2=5). Both the Dynamic FES group and FES group were given a neuromuscular development treatment. The Dynamic FES group has implemented a total of 60 minutes of exercise treatment and gait training with Dynamic FES application. The FES group, with the addition of applying FES while sitting, has also implemented a total of 90 minutes of gait training on treadmill after the exercise treatment. Both two groups accomplished the program, twice a week, for a total of 24 times in a 12-week period. Exercise treatment, gait training on treadmill, and both Dynamic FES and FES were implemented for 30 minutes each. Korean version activities-specific balance confidence scale (K-ABC) was measured to determine self-efficacy in balance function. Timed up and go (TUG) test was performed to evaluate the physical performance. K-ABC, TUG, Berg balance scale (BBS), modified physical performance test (mPPT) and G-walk were evaluated at baseline and at 12 weeks. After 12 weeks, statistically significant differences (p<.05) were apparent in the Dynamic FES group in the changes in K-ABC and BBS. mPPT, TUG, gait speed, stride length and stance phase duration (%) were compared with the FES group. K-ABC had higher correlation to BBS, along with mPPT to TUG. Our results suggest that walking with Dynamic FES in chronic stroke patients may be beneficial for improving their balance confidence, functional ability and gait.

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Restoration of Gait During Two to Three Weeks of Therapy with Multichannel Electrical Stimulation

Cited by 70 publications

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Functional Electrical Stimulation Improves Motor Recovery of the Lower Extremity and Walking Ability of Subjects With First Acute Stroke

Functional Electrical Stimulation Improves Motor Recovery of the Lower Extremity and Walking Ability of Subjects With First Acute Stroke

Application of a programmable dual-channel adaptive electrical stimulation system for the control and analysis of gait

The Effects of Dynamic Functional Electrical Stimulation With Treadmill Gait Training on Functional Ability, Balance Confidence and Gait in Chronic Stroke Patients

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