BACKGROUND: Wearable technologies have been developed for healthy aging. The technology for electromyography (EMG)-controlled functional electrical stimulation (FES) systems has been developed, but research on how helpful it is in daily life has been insufficient. OBJECTIVE: The purpose of this study was to investigate the effect of the EMG-controlled FES system on muscle morphology, balance, and gait in older adults. METHODS: Twenty-nine older adults were evaluated under two randomly assigned conditions (non-FES and FES assists). Muscle morphology, balance, gait function, and muscle effort during gait were measured using ultrasonography, a physical test, a gait analysis system, and EMG. RESULTS: The EMG-controlled FES system improved gait speed by 11.1% and cadence by 15.6% (P< 0.01). The symmetry ratio of the bilateral gastrocnemius was improved by 9.9% in the stance phase and 11.8% in the swing phase (P< 0.05). The degrees of coactivation of the knee and ankle muscles were reduced by 45.1% and 50.5%, respectively (P< 0.05). Balance improved by 6–10.7% (P< 0.01). CONCLUSION: The EMG-controlled FES system is useful for balance and gait function by increasing muscle symmetry and decreasing muscle coactivation during walking in older adults.

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Objective: This study aimed to investigate the reliability and validity of muscle thickness (MT) and pennation angle (PA) measurements of the ankle muscle, including the tibialis anterior (TA) and the medial gastrocnemius (MGCM), using a hands-free fixed probe and to compare it with the conventional linear probe. Design: Observational inter-rater reliability study. Methods: Thirty-three healthy subjects (20 male, 13 female) were included. In all subjects, ultrasound images were acquired from the TA and MGCM using a hands-free fixed probe and a conventional linear probe in random sequence by two examiners at two time-points within a 7-day interval. MT and PA were calculated on the taken images. Intra-class correlation coefficients (ICC), 95% confidence intervals, standard error of measurement and the Pearson's correlation coefficient were used to estimate reliability and validity. And also, Bland-Altman plots were generated for a visual representation of MT and PA at the TA and MGCM. Results: The ICC for all intra-rater reliability was 0.943 to 0.995 and that for all inter-rater reliability was 0.928 to 0.993, indicating excellent reliability. A significantly high correlation was observed between MT and PA at the TA and MGCM with use of the hands-free fixed probe and the conventional linear probe (r>0.938; p<0.001). Conclusions: The hands-free fixed probe provided excellent images for measurement of the MT and PA of the TA and MGCM and is a useful device for making clinical measurements of muscle structure without grasping of the probe.

Objective: This study aimed to compare muscle structure, balance, and gait parameters between healthy adults and persons with stroke and to analyze the correlation among these variables. Design: Cross-sectional study. Methods: Twenty persons with stroke (11 male, 9 female) and twenty healthy participants (9 male, 11 female) were included. Ultrasound images of the triceps surae and the tibialis anterior were acquired in sitting resting, sitting co-contraction, and standing resting positions and also during the functional reach test (FRT) and single leg anterior reaching test (SLART). Muscle thickness and fascicle length were measured. Spatiotemporal parameters of gait were measured using a pressure walkway. Gait speed, cadence, step length, stride length, stance time, and swing time were measured. Results: Changes in percent fascicle length were significantly greater in the gastrocnemius and soleus (SOL) muscles of healthy adults in the sitting co-contraction position (p<0.05). The percent fascicle length of the SOL in FRT and SLART were significantly greater in healthy adults (p<0.05). The mid-stance phase of stroke patients was shorter than healthy adults (p<0.05). A negative correlation was observed between percent fascicle length of the SOL in the sitting co-contraction position and the proportion of the mid-stance phase (p<0.05). Conclusions: The function of the triceps surae is affected in persons with stroke when compared with healthy adults. This can lead to difficulty in performing tasks that involve forward transfer of weight. If the triceps surae is not sufficiently secured, the possibility of compensation in the stance phase increases during gait.

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