We don't need weasel words like 'can help'. We need definitive EXACT STROKE PROTOCOLS. This is useless.
Functional Electrical Stimulation of Ankle Plantarflexor and Dorsiflexor Muscles: Effects on Poststroke Gait
risha M. Kesar, PT, PhD
1,
Ramu Perumal, PhD
2,
Darcy S. Reisman, PT, PhD
1,2,
AngelaJancosko, PT
2,
Katherine S. Rudolph, PT, PhD
1,2,
Jill S Higginson, PhD
2,3, and
Stuart A.Binder-Macleod, PT, PhD
1,2
1
Department of Physical Therapy, University of Delaware, Newark, DE
2
Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, DE
3
Department of Mechanical Engineering, University of Delaware, Newark, DE
1,
Ramu Perumal, PhD
2,
Darcy S. Reisman, PT, PhD
1,2,
AngelaJancosko, PT
2,
Katherine S. Rudolph, PT, PhD
1,2,
Jill S Higginson, PhD
2,3, and
Stuart A.Binder-Macleod, PT, PhD
1,2
1
Department of Physical Therapy, University of Delaware, Newark, DE
2
Graduate Program in Biomechanics and Movement Science, University of Delaware, Newark, DE
3
Department of Mechanical Engineering, University of Delaware, Newark, DE
Abstract
Background and Purpose—
Functional electrical stimulation (FES) is a popular post-stroke gaitrehabilitation intervention. Although stroke causes multi-joint gait deficits, FES is commonly used only for the correction of swing phase foot drop. Ankle plantarflexor muscles play an important roleduring gait. The aim of the current study is to test the immediate effects of delivering FES to bothankle plantarflexors and dorsiflexors on post-stroke gait.
Methods—
Gait analysis was performed as subjects (N=13) with chronic post-stroke hemiparesiswalked at their self-selected walking speeds during walking with and without FES.
Results—
Compared to delivering FES to only the ankle dorsiflexor muscles during the swing phase,delivering FES to both the paretic ankle plantarflexors during terminal stance and dorsiflexors duringswing phase provided the advantage of greater swing phase knee flexion, greater ankle plantarflexionangle at toe-off, and greater forward propulsion. Although FES of both the dorsi- and plantar-flexor muscles improved swing phase ankle dorsiflexion compared to noFES, the improvement was lessthan that observed by stimulating the dorsiflexors alone, suggesting the need to further optimizestimulation parameters and timing for the dorsiflexor muscles during gait.
Conclusions—
In contrast to the typical FES approach of only stimulating ankle dorsiflexor muscles during the swing phase, delivering FES to both the plantar- and dorsi-flexor muscles can help to correct post-stroke gait deficits at multiple joints (ankle and knee) during both the swing and stance phases of gait. Our study shows the feasibility and advantages of stimulating the ankle plantarflexors during FES for post-stroke gait.
Methods—
Gait analysis was performed as subjects (N=13) with chronic post-stroke hemiparesiswalked at their self-selected walking speeds during walking with and without FES.
Results—
Compared to delivering FES to only the ankle dorsiflexor muscles during the swing phase,delivering FES to both the paretic ankle plantarflexors during terminal stance and dorsiflexors duringswing phase provided the advantage of greater swing phase knee flexion, greater ankle plantarflexionangle at toe-off, and greater forward propulsion. Although FES of both the dorsi- and plantar-flexor muscles improved swing phase ankle dorsiflexion compared to noFES, the improvement was lessthan that observed by stimulating the dorsiflexors alone, suggesting the need to further optimizestimulation parameters and timing for the dorsiflexor muscles during gait.
Conclusions—
In contrast to the typical FES approach of only stimulating ankle dorsiflexor muscles during the swing phase, delivering FES to both the plantar- and dorsi-flexor muscles can help to correct post-stroke gait deficits at multiple joints (ankle and knee) during both the swing and stance phases of gait. Our study shows the feasibility and advantages of stimulating the ankle plantarflexors during FES for post-stroke gait.
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