DOI QR코드

DOI QR Code

Effects of Functional Electrical Stimulation During Gait Training on Gait, Balance, and Lower Extremity Function in Chronic Stroke Patients

  • Min-Ju Nam (Department of Rehabilitation Sciences, Graduate School, Daegu University) ;
  • Ye-Ji Kim (Department of Rehabilitation Sciences, Graduate School, Daegu University) ;
  • Ming-Yu Tian (Department of Rehabilitation Sciences, Graduate School, Daegu University) ;
  • Myoung-Kwon Kim (Department of Physical Therapy, College of Rehabilitation Sciences, Daegu University)
  • Received : 2024.06.19
  • Accepted : 2024.07.08
  • Published : 2024.08.31

Abstract

PURPOSE: To examine the effects of functional electrical stimulation during gait training on the gait, balance, and lower extremity function of chronic stroke patients. METHODS: A total of 20 subjects diagnosed with chronic stroke were randomly divided into experimental group that performed functional electrical stimulation during gait training, and a control group applied with only functional electrical stimulation, with 10 subjects in each group. RESULTS: In the Berg Balance Scale, the experimental group ranged from 19.80 ± 4.93 to 24.30 ± 6.63 and the control group ranged from 39.40 ± 12.72 to 40.10 ± 13.18, which showed significant differences (p < .05), and there was a significant difference between the groups (p < .05). In 10 Meter Walk Test, the experimental group ranged from 28.70 ± 4.03 to 26.42 ± 3.56, which showed significant differences (p < .05), and there was a significant difference between the groups (p > .05). In Fugl-Meyer Assessment Scale-Lower extremity, the experimental group ranged from 22.70 ± 4.49 to 25.30 ± 4.39 and the control group ranged from 21.10 ± 5.34 to 25.30 ± 4.49, which showed significant differences (p < .05), and there was no significant difference between the groups (p > .05). CONCLUSION: Functional electrical stimulation during gait training may be suggested as an effective program for improving gait, balance, and lower extremity function of stroke patients. Therefore, functional electrical stimulation during gait may be recommended as part of the rehabilitation program for chronic stroke patients.

Keywords

References

  1. Sims NR, Muyderman H. Mitochondria, oxidative metabolism and cell death in stroke. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease. 2010;1802(1):80-91.
  2. Shumway-Cook A, Woollacott MH. Theory and practical applications. Motor control. 1995:89-90.
  3. Kim JS. The change of spasticity and gait parameters in stroke patients by reciprocal inhibition. Daegu University Doctor's Degree. 2004.
  4. Lee SR, Kwon HC. The relationship between activities of daily living and cognitive score in stroke patients. PTK. 2003;10(3):41-51
  5. Van de Port I, Kwakkel G, Schepers VP, et al. Predicting mobility outcome one year after stroke: a prospective cohort study. 2006.
  6. Aoyagi Y, Tsubahara A. Therapeutic orthosis and electrical stimulation for upper extremity hemiplegia after stroke: a review of effectiveness based on evidence. Top Stroke Rehabil 2004;11(3):9-15.
  7. Kottink AI, Hermens HJ, Nene AV, et al. Therapeutic effect of an implantable peroneal nerve stimulator in subjects with chronic stroke and footdrop: a randomized controlled trial. Phys Ther. 2008;88(4):437-48.
  8. Wang GS, Yoon SW, Cho WS, et al. Effect of the combined use of FES and over ground walking with partial body-weight support on walking and balance competency in patients with chronic strokes. KACE. 2012;10(1):15-22.
  9. Kang KY, Kim TY. Effects of a combined functional electrical stimulation with action observation training for balance and gait performance in stroke patients. J Korean Soc Phys Med. 2016;11(2):93-102.
  10. Yoon JG, Kim Mh, Yook DW. The effects of self-controlled learning on balance in hemiplegics. PTK. 2005;12(1):36-44.
  11. Kim SM, Kim YM. Effect of both lower extremities proprioceptive neuromuscular facilitation training with functional electrical stimulation on the balance and gait of stroke patient: a randomized controlled trial. KSPM. 2020;15(1):123-32.
  12. Jang EJ. The effects of PNF low extremity pattern on standing balance and gait in stroke patients by ramp and stairs. Daegu University, Master's Degree. 2013.
  13. Lee SK, Park MC, Sim JM, et al. The effect of closed kinetic chain exercise with FES of the gluteus medius on gait in stroke. J Korean Soc Phys Med. 2011;6(1).
  14. Kim JH, Uhm YH. The effects of biofeedback fusion postural control training using functional electrical stimulation on the muscle activity and balance ability of the stroke patient. Journal of Digital Convergence. 2019;17(12).
  15. Lindquist AR, Prado CL, Barros RM, et al. Gait training combining partial body-weight support, a treadmill, and functional electrical stimulation: effects on poststroke gait. Phys Ther. 2007;87(9):1144-54
  16. Yang CY, Kim TJ, Joo MC, et al. The effect of functional electrical stimulation on the motor function of lower limb in hemiplegic patients. JKMA. 2009;33(1):29-35.
  17. Botner EM, Miller WC, Eng JJ. Measurement properties of the activities-specific balance confidence scale among individuals with stroke. Disabil Rehabil. 2005;27(4):156-63.
  18. Berg KO, Maki BE, Williams JI, et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992;73(11):1073-80.
  19. Ng S, Ng P, Lee C, et al. Walkway lengths for measuring walking speed in stroke rehabilitation. JRM. 2012;44(1):43-6.
  20. Fulk GD, Echternach JL. Test-retest reliability and minimal detectable change of gait speed in individuals undergoing rehabilitation after stroke. JNPT. 2008;32(1):8-13.
  21. Kang TW, Oh DW. Comparison of the effects of upper limb and lower limb task-oriented circuit trainings in patients with acute stroke. JSER. 2011; 50(3):135-51.
  22. Duncan PW, Propst M, Nelson SG. Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther. 1983;63(10):1606-10.
  23. Sanford J, Moreland J, Swanson LR, et al. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phys Ther. 1993;73(7):447-54
  24. Park CS. The inter.intra-rater reliability and longitudinal construct validity of short form of the dynamic gait index in patients with subacute stroke. JSER. 2015;54(3): 45-58.
  25. Combs S, Miller EW, Forsyth E. Motor and functional outcomes of a patient post-stroke following combined activity and impairment level training. Physiother Theory Pract. 2007;23(4):219-29.
  26. Bogataj U, Gros N, Kljajic M, et al. The rehabilitation of gait in patients with hemiplegia: a comparison between conventional therapy and multichannel functional electrical stimulation therapy. Phys Ther. 1995;75(6):490-502.
  27. Hendrickson J, Patterson KK, Inness EL, et al. Relationship between asymmetry of quiet standing balance control and walking post-stroke. Gait Posture. 2014;39(1):177-81.
  28. Suputtitada A, Yooktanan P, Rarerng-Ying T. Effect of partial body weight support treadmill training in chronic stroke patients. J Med Assoc Thai. 2004;87:S107-11.
  29. Mika A, Oleksy L, Mika P, et al. The influence of heel height on lower extremity kinematics and leg muscle activity during gait in young and middle-aged women. Gait Posture. 2012;35(4):677-80.
  30. Johanson MA, Allen JC, Matsumoto M, et al. Effect of heel lifts on plantarflexor and dorsiflexor activity during gait. Foot Ankle Int. 2010;31(11):1014-20.
  31. Hong WH, Lee YH, Lin YH, et al. Effect of shoe heel height and total-contact insert on muscle loading and foot stability while walking. Foot Ankle Int. 2013;34(2):273-81.
  32. Robertson JA, Eng JJ, Hung C. The effect of functional electrical stimulation on balance function and balance confidence in community-dwelling individuals with stroke. Physiother Can. 2010;62(2):114-9.
  33. Bethoux F, Rogers HL, Nolan KJ, et al. The effects of peroneal nerve functional electrical stimulation versus ankle-foot orthosis in patients with chronic stroke: a randomized controlled trial. Neurorehabil Neural Repair. 2014;28(7):688-97.
  34. Fugl-Meyer A, Jaasko L, Leyman I, et al. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13-31.