FES for abnormal movement of upper limb during walking in post-stroke subjects

Chou, Chien-Hsing; Hwang, Young Sil; Chen, C. C.; Chen, S. C.; Lai, Chien Hung; Chen, Y. L.

doi:10.3233/thc-140836

Cited by 6 publications

(3 citation statements)

References 9 publications

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“…When having a stroke with hemiparesis the UE the movements may be non- existing or minimal, and in general then locate the affected arm in front of their chest or beside the hip during walking. While the extent of the arm swing is limited or even non-existing, the patient is in danger of falling when walking (47). Boestrom et al (48) noticed that movement of the upper body, in particular of the arms are not taken into account in several strategies of postural balance.…”

Section: Discussionmentioning

confidence: 99%

Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study

et al. 2019

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Background: Impaired postural balance is a common symptom after stroke and a common cause of falling. Most common daily tasks use arm and hand movements. Impairment in an upper extremity is a common stroke symptom, affecting 50–80% in the acute phase after stroke, and 40–50% in the sub-acute phase. The impact of leg function on postural balance has been investigated in several studies, but few have stressed the importance of arm function on postural balance. Objective: To explore whether there is any association between arm function and postural balance after stroke. Method: A cross sectional study where 121 adults (mean age: 70 ± 12.3 years, 72 men) from two different data sources, Gothenburg Very Early Supported Discharge (GOTVED), and a study by Carvalho et al. were merged. Time for assessments ranged from 1 to 13 years when the patients were in the chronic phase. The dependent variables were Berg Balance scale (BBS) and Time Up and Go (TUG) both dichotomized to “impaired postural balance” and “not impaired postural balance.” As independent variables, the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scale was used. The FMA-UE was presented with the total score. Results: The motor function in the arm affected after stroke onset correlated with postural balance both measured with the BBS (0.321, p < 0.001 ) and the TUG (−0.315, p = 0.001 ) . Having impaired motor function in the arm was significantly associated with impaired postural balance assessed with the BBS with OR = 0.879 (CI 0.826–0.934, p < 0.001). Regression analysis with the TUG showed the same result, OR = 0.868 (CI 0.813–0.927, p < 0.001) for FM-UE. Conclusion: The motor function of the affected arm was significantly associated with impaired postural balance post stroke, as assessed by BBS or TUG. It could be of clinical importance to be aware of the fact that not only lower extremity impairment, but also arm function can have an impact on postural balance in a late stage after stroke. Trial Registration: VGFOUGSB-669501.

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Section: Discussionmentioning

confidence: 99%

Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study

et al. 2019

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“…For FES, the most advanced surface‐based systems and solutions should always be the primary choice . Implantable systems should be considered if the surface system causes unpleasant sensations, skin irritations, or if the patient is going to become a long‐term user of FES . The combination of FES and a conventional rehabilitation program, using the standard ankle foot orthosis in the post stroke rehabilitation process, should also be considered .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Efficacy and Robustness of a Second Generation Implantable Stimulator in a Patient With Hemiplegia During 20 Years of Functional Electrical Stimulation of the Common Peroneal Nerve

et al. 2016

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We evaluated the efficacy and robustness of a second generation implantable stimulator for correcting drop foot (DF) in a patient with left-sided hemiplegia over 20 years of functional electrical stimulation (FES) of the common peroneal nerve (CPN). Dorsal flexion and eversion of the affected foot was partially restored by FES of the superficial region of the CPN innervating mostly the tibialis anterior (TA) and partly peroneus longus (PL) and peroneus brevis (PB) muscles. The reasons for implant failure during the long-term follow-up assessment were analyzed and resolving procedures were identified. The stimulator had an average failure rate of once every three years, due to repetitive mechanical load on the lead wires of its internal and/or external unit, and had to be serviced once per year to replace the heel switch integrated into the shoe sole. FES-associated mechanical trauma to the CPN elicited a thickening of the connective tissue around the CPN and a slightly compromised conduction velocity of the CPN. FES of the CPN, with the second generation implantable stimulator, improved gait parameters of the affected leg during the 20 years period. Long-term, daily FES enables a functional and reliable recruitment of nerve fibers, thus providing a sufficient dorsal flexion and optimal eversion of the affected foot to sustain unassisted, almost normal gait. Therefore, the presented implant is suitable for very long-term FES of the CPN.

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“…When the literature was reviewed, many studies (8,9) evaluating trunk control, balance, and lower extremity motor functions were detected; however, fewer studies were seen examining the effect of upper extremity functions on postural control and balance (10). As a matter of fact, decreased arm oscillations as a result of upper extremity problems affect postural balance negatively, and increase the risk of falls (11). Hyndman et al (12) conducted a study, and reported worse upper extremity functions of individuals with a history of fall when they compared individuals with fall history and individuals without a history of fall.…”

Section: Introductionmentioning

confidence: 99%

Investigating the relation between upper extremity function and trunk control, balance and functional mobility in individuals with stroke

Arslan

Uğurlu

Demirci

et al. 2021

Journal of Health Sciences and Medicine

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Aim:The purpose of our study was to examine the relation between upper extremity function and trunk control, balance and functional mobility and to compare trunk control, balance, and mobility with respect to upper extremity motor function level in individuals with stroke. Material and Method: This study included a total of 39 stroke patients (age 63.87±9.03 years, post stroke 19.18±16.38 month). Upper extremity motor functions were evaluated with the upper extremity sub-scale of the Stroke Rehabilitation Assessment of Movement (STREAM) Scale and Brunnstrom stages of motor recovery; trunk control, balance, and functional mobility were evaluated with Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), and Timed Up and Go Test (TUG) respectively. Result: A moderate relation was determined between the trunk control, balance and functional mobility and upper extremity functions (p<0.05). When the trunk control, balance and mobility performances of the individuals were compared according to Brunnstrom arm stages, it was seen that those with worse upper extremity motor recovery had poor trunk control, balance and mobility (p<0.05) Conclusion: As a result of our study, a relation was detected between upper extremity function and trunk control, balance and mobility. For this reason, it is important to focus on the upper extremity as well as trunk control to improve balance and mobility in physiotherapy and rehabilitation practices.

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FES for abnormal movement of upper limb during walking in post-stroke subjects

Cited by 6 publications

References 9 publications

Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study

Impaired Motor Function in the Affected Arm Predicts Impaired Postural Balance After Stroke: A Cross Sectional Study

Evaluation of the Efficacy and Robustness of a Second Generation Implantable Stimulator in a Patient With Hemiplegia During 20 Years of Functional Electrical Stimulation of the Common Peroneal Nerve

Investigating the relation between upper extremity function and trunk control, balance and functional mobility in individuals with stroke

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