The superiority of the MFES method as compared with conventional therapy was mainly attributed to the enhanced motor learning accomplished by application of MFES. These results, however, are preliminary, and further research is needed.
Multichannel electrical stimulation was applied in 20 patients with hemiplegia secondary to stroke or head injury using a six-channel microprocessor stimulator-stride analyzer to restore independent gait and to reestablish a normal gait pattern in a two- to three-week therapy period. The therapy was followed up at every session by a stride analyzer incorporated into the stimulator. At the beginning and at the end of the therapy period, each subject's gait was measured with a ground reaction measuring system. Statistical results and observations are presented for the group of 20 subjects, and a detailed description of the results is given for one subject who is representative of the whole group. According to the measured gait characteristics, gait improved significantly in all subjects during the therapy period, resulting in a partly or completely independent gait. The subjects' posture and endurance also improved, and they spontaneously learned how to use a crutch. The measurements and visual assessment of the subjects' progress indicate that the described treatment protocol offers good prospects for faster and more efficient gait rehabilitation in severely impaired patients. To determine the efficacy of gait therapy with multichannel electrical stimulation, a comparative study of conventional therapeutic methods and the method described in this article should be conducted.
This presentation will review briefly the current practice and state of the art in functional electrical stimulation (FES) as applied to stroke, head injured or brain tumour operated patients. A similar application is used in paretic patients following trauma or other aetiology. Over 20 years experience in the application of FES, as practised in Ljubljana, will be highlighted and the devices currently in use will be described. The statistics show the results obtained on 2,500 hemiplegic patients examined for FES application during the last 10 years. The statistics and results of the Slovenian population indicate 0.15–0.20% new cases annually or 1,500 new cases per million inhabitants. Up to 63% of annual cases are candidates for an FES based therapeutic locomotion rehabilitation programme. Experience indicates that 60% of hemiplegic patients received single-channel stimulation to correct equinovarus or foot drop, 30% obtained dual or even three channel stimulation treatment and only 10% of patients were involved in multichannel FES of four to six or even eight channels of stimulation. The benefits and outcome of rehabilitation will be presented and discussed in regard to current trends in the field of FES for hemiplegic and paretic patients. The partly inactive but very important field of FES application to the upper extremity in hemiplegic and paretic patients will be discussed and the relatively modest achievements presented. Future developments will be presented together with advances foreseen by steadily improving technology.
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