Effects of a functional electrical stimulation-assisted leg-cycling wheelchair on reducing spasticity of patients after stroke

Lo, Hsin Chang; Tsai, Kuen-Horng; Su, Fong Chin; Chang, Guan‐Liang; Yeh, Chun Yu

doi:10.2340/16501977-0320

Cited by 31 publications

(24 citation statements)

References 25 publications

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“…The findings of the present study agree with previous studies [20][21][22]. Motl et al [21], reported that H reflex of soleus was significantly suppressed after one bout of cycling exercise for normal subjects and subjects with multiple sclerosis.…”

Section: Discussionsupporting

confidence: 95%

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Cycling exercise with functional electrical stimulation improves postural control in stroke patients

Lo¹,

Hsu²,

Hsueh³

et al. 2012

Gait & Posture

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Section: Discussionsupporting

confidence: 95%

“…Lo et al [20], found there was a significant decrease in muscle tone among higher muscle tone subjects in the cycling with FES group. In the present study, we also found a significant difference in cH/M among the higher muscle tone groups from both FES-CG and CG groups.…”

Section: Discussionmentioning

confidence: 97%

Cycling exercise with functional electrical stimulation improves postural control in stroke patients

Lo¹,

Hsu²,

Hsueh³

et al. 2012

Gait & Posture

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“…Measurement of the H-reflex has been used as an assessment of the nervous system for various neuromuscular diseases (Bakheit et al, 2003;Hodapp et al, 2009;Knikou et al, 2009;Lo et al, 2009;Phadke et al, 2007;Stewart et al, 2004;Trimble et al, 2001), as well as for the assessment of diverse therapeutic interventions, such as surgeries, medications, therapeutic modalities, and exercise training (Palmieri et al, 2004). As an example, Trimble et al reported that the amplitude of the soleus H-reflex of persons with incomplete spinal cord injury decreased after training (Trimble et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

The effects of body weight on the soleus H-reflex modulation during standing

Jeon

2011

Journal of Electromyography and Kinesiology

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“…Apkarian and Naumann performed a similar set of experiments and also measured reciprocal inhibition of triceps surae during stimulation of the peroneal nerve [66]. Unlike Thompson Interestingly, Lo et al [67], Krause et al [68], and Van der Salm et al [69] describe decreased tone from electrical stimulation of spastic muscles themselves, rather than their antagonists, in spastic stroke and SCI patients. Van der Salm et al noted that while this could be secondary to recurrent inhibition from Renshaw cells, nonneurogenic factors could also be at play, including local blood flow or mechanical factors [69].…”

Section: Combined Functional Electrical Stimulation And Botulinum Tomentioning

confidence: 99%

Review of electrical stimulation, botulinum toxin, and their combination for spastic drop foot

Wilkenfeld¹

2013

JRRD

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Abstract-Spastic drop foot is a functional impairment causing significant morbidity and mortality. Multiple treatments are available for this condition, but it is often not clear which treatment or combination of treatments is optimal for a given patient. One relatively recent therapy is the use of functional electrical stimulation to stimulate the peroneal nerve. Another is the use of botulinum toxin injections in the spastic ankle plantar flexors. While reasons exist to think these two treatments might work effectively in combination, there is no clear consensus in the literature. In this article, I review the background of the pathophysiology of spastic drop foot and its treatment options. I present some of the theoretical reasons why functional electrical stimulation and botulinum toxin injections could work synergistically and present a literature review on the topic. Recommendations for future research are discussed.Key words: ankle, botulinum toxins, chemodenervation, drop foot, functional electrical stimulation, gait, muscle spasticity, neurorehabilitation, peroneal nerve stimulation, upper motor neuron syndrome. SPASTIC DROP FOOTSpastic drop foot is a functional impairment causing significant morbidity by impairing gait, limiting activities of daily living, and contributing to injuries [1]. Spastic drop foot exists when, due to a combination of weakness of the ankle dorsiflexors (primarily tibialis anterior) and spasticity of the ankle plantar flexors (primarily gastrocnemius and soleus), the ankle has a predisposition for staying pathologically plantar flexed. Due to associated weakness of ankle evertors (e.g., peroneal musculature) and/or spasticity of invertors (e.g., tibialis posterior), pathological foot inversion is also often associated [2][3].Because ankle dorsiflexion during the swing phase of gait is essential for foot clearance, drop foot can lead to falls and injury [1]. In addition, with drop foot, foot-floor contact in stance phase can happen initially at the forefoot (as opposed to at the heel in nondisabled gait) and limited dorsiflexion can prevent forward progression of the tibia, resulting in hyperextension of the knee and limited forward translation of the body [4]. Those affected often develop pathological compensatory gaits to attempt to compensate for spastic drop foot. One of these, referred to as "steppage gait," involves abnormally flexing the hip and bending the knee to attempt to get the foot to clear the ground [5]. Other patients will hike their hip on the side of the spastic ankle with each swing phase or circumduct the lower limb to aid in foot clearance [6].Abbreviations: AAN = American Academy of Neurology, AFO = ankle-foot orthosis, BTA = botulinum toxin type A, BTB = botulinum toxin type B, BTX = botulinum toxin, CMAP = compound muscle action potential, CNS = central nervous system, FES = functional electrical stimulation, MS = multiple sclerosis, PNS = peroneal nerve stimulation, SCI = spinal cord injury, TBI = traumatic brain injury, UMNS = upper motor neuron syndro...

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Effects of a functional electrical stimulation-assisted leg-cycling wheelchair on reducing spasticity of patients after stroke

Abstract: Leg spasticity is reduced after short-term propulsion of the FES-LW and LW. The application of FES has an additional effect on reducing spasticity in subjects with higher muscle tone.

Cited by 31 publications

References 25 publications

Cycling exercise with functional electrical stimulation improves postural control in stroke patients

Cycling exercise with functional electrical stimulation improves postural control in stroke patients

The effects of body weight on the soleus H-reflex modulation during standing

Review of electrical stimulation, botulinum toxin, and their combination for spastic drop foot

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