Restoration of gait and motor recovery by functional electrical stimulation therapy in persons with stroke

Sabut, Sukanta; Sikdar, Chanda; Mondal, Ramkrishna; Kumar, Ratnesh; Mahadevappa, Manjunatha

doi:10.3109/09638281003599596

Cited by 97 publications

(52 citation statements)

References 25 publications

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“…631 Similarly, a meta-analysis revealed the effectiveness of NMES at improving gait speed in subjects after stroke. 632 Several RCTs have observed improved recovery of gait function after stroke in the chronic 550,[633][634][635] and acute phases 636,637 when NMES was applied in conjunction with a conventional rehabilitation program. Studies comparing the use of an AFO to NMES in controlling foot drop during walking have found similar results.…”

mentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,179

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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mentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,179

840

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“…29 Functional electrical stimulation has been shown in the literature to decrease spasticity in subjects with hemiplegia from stroke. [30][31][32] The improvement in biomechanics test and a significant decrease in the impact of MS on walking and on physical domains of QOL. A decrease in the impact of MS on walking and improvements in the Physical Function domain of the SF-36 were both seen at baseline, demonstrating that people with MS perceive an immediate positive effect with FES.…”

Section: Impact Of Ms On Walking and Qolmentioning

confidence: 99%

Effects of Functional Electrical Stimulation on Gait Function and Quality of Life for People with Multiple Sclerosis Taking Dalfampridine

Mayer

Warring

Agrella

et al. 2015

International Journal of MS Care

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Background: Multiple sclerosis (MS) can adversely affect gait, causing gait slowing, loss of balance, decreased functional mobility, and gait deficits, such as footdrop. Current treatments for gait dysfunction due to MS are pharmacologic, using dalfampridine, or orthotic, using an ankle-foot orthosis. Functional electrical stimulation (FES) to the fibular nerve stimulates active dorsiflexion and provides an alternative treatment for gait dysfunction caused by footdrop. The objective of this study was to determine the effect of FES on gait function and the impact of MS on walking and quality of life for people with MS taking a stable dalfampridine dose. Methods: Participants demonstrating gait slowing and footdrop completed the Timed 25-Foot Walk (T25FW) test, 6-Minute Walk (6MW) test, GaitRite Functional Ambulation Profile, 12-item Multiple Sclerosis Walking Scale (MSWS-12), and 36-item Short Form Health Status Survey (SF-36) at screening without FES; the measures were repeated with FES at baseline, 1 month, and 3 months. Results: Twenty participants (8 men and 12 women) completed this unblinded case series study. The mean age, duration of MS, and time taking dalfampridine were 51.7, 15.8, and 1.4 years, respectively. Changes from screening to baseline and screening to 3 months were analyzed. Significant improvement was noted from screening to baseline for the MSWS-12 (P = .024) and SF-36 Physical Function domain (P = .028) and from screening to 3 months for the T25FW (P = .015), MSWS-12 (P = .003), and SF-36 Physical Function (P = .032) and Role Limitation–Physical Health (P = .012) domains. Conclusions: Improvements above those induced pharmacologically suggest that FES can augment pharmacologic intervention and significantly improve gait function, decrease the impact of MS on walking, and improve quality of life for people with MS.

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“…No other significant results were observed in other sEMG parameters. Temporal parameter improvement showed the enhancement of muscle force produced by the tibialis anterior muscle [20,21]. Analysis of spectral parameters of sEMG signals showed a significant shift in spectral values post-FES, and shifts in the mean and median power frequencies towards the higher frequencies.…”

Section: Semg Analysismentioning

confidence: 95%

Therapeutic effects of functional electrical stimulation on gait, motor recovery, and motor cortex in stroke survivors

Shendkar¹,

Lenka²,

Biswas³

et al. 2015

Hong Kong Physiotherapy Journal

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KEYWORDS foot drop; functional electrical stimulation (FES); gait; physiotherapy; surface electromyography (sEMG)Abstract The purpose of this parallel group controlled clinical trial was to investigate the therapeutic effect of functional electrical stimulation (FES) on gait, motor recovery, and motor cortex activity. Adults experiencing foot drop <6 months poststroke were allocated to the FES group (physiotherapy and FES stimulation, n Z 14) or the control group (physiotherapy, n Z 14). Each group received their respective therapy 5 days/week for 12 weeks. Gait, surface electromyography (sEMG) of the tibialis anterior muscle in the affected leg, and electroencephalogram (EEG) signals from the foot motor area were assessed at baseline and again after the 12-week intervention. The results showed that the FES intervention induced significantly more changes in various gait swing parameters such as foot pulling acceleration (measured in unit of gravitational constant G; net between-group difference: 0.11 AE 0.02 G, p Z 0.021), swing power (0.11 AE 0.03 G, p Z 0.027) and ground impact (0.12 AE 0.04 G, p Z 0.046) than the control group. EEG analysis revealed that the FES group had significantly altered beta-3 mean (0.50 AE 0.09, p Z 0.021), beta-4 mean (0.60 AE 0.05, p Z 0.024) and alpha peak frequency (0.15 AE 0.02, p Z 0.035). Finally, analysis of sEMG data showed a significantly greater increase in amplitude (in root mean square; 13.2 AE 2.11 mV, p Z 0.033), mean power frequency (5.5 AE 0.80 Hz, p Z 0.024) and median power frequency (6.5 AE 0.90 Hz, p Z 0.021) of the tibialis anterior muscle on the affected side in the FES group. We concluded that the FES combined with physiotherapy induced better outcomes in the swing phase of the gait cycle, (M. Mahadevappa). + MODELPlease cite this article in press as: Shendkar CV, et al., Therapeutic effects of functional electrical stimulation on gait, motor recovery, and motor cortex in stroke survivors, Hong Kong Physiotherapy Journal (2014), http://dx.

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Restoration of gait and motor recovery by functional electrical stimulation therapy in persons with stroke

Abstract: These findings suggest that, the FES therapy combined with conventional therapy treatment more effectively improves the walking ability and enhances the motor recovery when compared with conventional therapy alone in stroke survivors.

Cited by 97 publications

References 25 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Effects of Functional Electrical Stimulation on Gait Function and Quality of Life for People with Multiple Sclerosis Taking Dalfampridine

Therapeutic effects of functional electrical stimulation on gait, motor recovery, and motor cortex in stroke survivors

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