Functional Electrical Stimulation of Ankle Plantarflexor and Dorsiflexor Muscles Effects on Poststroke Gait
Background and Purpose— Functional electrical stimulation (FES) is a popular poststroke gait rehabilitation intervention. Although stroke causes multijoint gait deficits, FES is commonly used only for the correction of swing-phase foot drop. Ankle plantarflexor muscles play an important role during...
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| Published in | Stroke (1970) Vol. 40; no. 12; pp. 3821 - 3827 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Hagerstown, MD
Lippincott Williams & Wilkins
01.12.2009
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0039-2499 1524-4628 1524-4628 |
| DOI | 10.1161/STROKEAHA.109.560375 |
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| Abstract | Background and Purpose—
Functional electrical stimulation (FES) is a popular poststroke gait rehabilitation intervention. Although stroke causes multijoint gait deficits, FES is commonly used only for the correction of swing-phase foot drop. Ankle plantarflexor muscles play an important role during gait. The aim of the current study was to test the immediate effects of delivering FES to both ankle plantarflexors and dorsiflexors on poststroke gait.
Methods—
Gait analysis was performed as subjects (N=13) with chronic poststroke hemiparesis walked at their self-selected walking speeds during walking with and without FES.
Results—
Compared with 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 during the swing phase provided the advantage of greater swing-phase knee flexion, greater ankle plantarflexion angle at toe-off, and greater forward propulsion. Although FES of both the dorsiflexor and plantarflexor muscles improved swing-phase ankle dorsiflexion compared with noFES, the improvement was less than that observed by stimulating the dorsiflexors alone, suggesting the need to further optimize stimulation parameters and timing for the dorsiflexor muscles during gait.
Conclusions—
In contrast to the typical FES approach of stimulating ankle dorsiflexor muscles only during the swing phase, delivering FES to both the plantarflexor and dorsiflexor muscles can help to correct poststroke 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 poststroke gait. |
|---|---|
| AbstractList | Background and Purpose—
Functional electrical stimulation (FES) is a popular poststroke gait rehabilitation intervention. Although stroke causes multijoint gait deficits, FES is commonly used only for the correction of swing-phase foot drop. Ankle plantarflexor muscles play an important role during gait. The aim of the current study was to test the immediate effects of delivering FES to both ankle plantarflexors and dorsiflexors on poststroke gait.
Methods—
Gait analysis was performed as subjects (N=13) with chronic poststroke hemiparesis walked at their self-selected walking speeds during walking with and without FES.
Results—
Compared with 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 during the swing phase provided the advantage of greater swing-phase knee flexion, greater ankle plantarflexion angle at toe-off, and greater forward propulsion. Although FES of both the dorsiflexor and plantarflexor muscles improved swing-phase ankle dorsiflexion compared with noFES, the improvement was less than that observed by stimulating the dorsiflexors alone, suggesting the need to further optimize stimulation parameters and timing for the dorsiflexor muscles during gait.
Conclusions—
In contrast to the typical FES approach of stimulating ankle dorsiflexor muscles only during the swing phase, delivering FES to both the plantarflexor and dorsiflexor muscles can help to correct poststroke 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 poststroke gait. Functional electrical stimulation (FES) is a popular poststroke gait rehabilitation intervention. Although stroke causes multijoint gait deficits, FES is commonly used only for the correction of swing-phase foot drop. Ankle plantarflexor muscles play an important role during gait. The aim of the current study was to test the immediate effects of delivering FES to both ankle plantarflexors and dorsiflexors on poststroke gait. Gait analysis was performed as subjects (N=13) with chronic poststroke hemiparesis walked at their self-selected walking speeds during walking with and without FES. Compared with 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 during the swing phase provided the advantage of greater swing-phase knee flexion, greater ankle plantarflexion angle at toe-off, and greater forward propulsion. Although FES of both the dorsiflexor and plantarflexor muscles improved swing-phase ankle dorsiflexion compared with noFES, the improvement was less than that observed by stimulating the dorsiflexors alone, suggesting the need to further optimize stimulation parameters and timing for the dorsiflexor muscles during gait. In contrast to the typical FES approach of stimulating ankle dorsiflexor muscles only during the swing phase, delivering FES to both the plantarflexor and dorsiflexor muscles can help to correct poststroke 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 poststroke gait. Functional electrical stimulation (FES) is a popular poststroke gait rehabilitation intervention. Although stroke causes multijoint gait deficits, FES is commonly used only for the correction of swing-phase foot drop. Ankle plantarflexor muscles play an important role during gait. The aim of the current study was to test the immediate effects of delivering FES to both ankle plantarflexors and dorsiflexors on poststroke gait.BACKGROUND AND PURPOSEFunctional electrical stimulation (FES) is a popular poststroke gait rehabilitation intervention. Although stroke causes multijoint gait deficits, FES is commonly used only for the correction of swing-phase foot drop. Ankle plantarflexor muscles play an important role during gait. The aim of the current study was to test the immediate effects of delivering FES to both ankle plantarflexors and dorsiflexors on poststroke gait.Gait analysis was performed as subjects (N=13) with chronic poststroke hemiparesis walked at their self-selected walking speeds during walking with and without FES.METHODSGait analysis was performed as subjects (N=13) with chronic poststroke hemiparesis walked at their self-selected walking speeds during walking with and without FES.Compared with 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 during the swing phase provided the advantage of greater swing-phase knee flexion, greater ankle plantarflexion angle at toe-off, and greater forward propulsion. Although FES of both the dorsiflexor and plantarflexor muscles improved swing-phase ankle dorsiflexion compared with noFES, the improvement was less than that observed by stimulating the dorsiflexors alone, suggesting the need to further optimize stimulation parameters and timing for the dorsiflexor muscles during gait.RESULTSCompared with 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 during the swing phase provided the advantage of greater swing-phase knee flexion, greater ankle plantarflexion angle at toe-off, and greater forward propulsion. Although FES of both the dorsiflexor and plantarflexor muscles improved swing-phase ankle dorsiflexion compared with noFES, the improvement was less than that observed by stimulating the dorsiflexors alone, suggesting the need to further optimize stimulation parameters and timing for the dorsiflexor muscles during gait.In contrast to the typical FES approach of stimulating ankle dorsiflexor muscles only during the swing phase, delivering FES to both the plantarflexor and dorsiflexor muscles can help to correct poststroke 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 poststroke gait.CONCLUSIONSIn contrast to the typical FES approach of stimulating ankle dorsiflexor muscles only during the swing phase, delivering FES to both the plantarflexor and dorsiflexor muscles can help to correct poststroke 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 poststroke gait. |
| Author | Reisman, Darcy S. Jancosko, Angela Higginson, Jill S. Kesar, Trisha M. Rudolph, Katherine S. Perumal, Ramu Binder-Macleod, Stuart A. |
| Author_xml | – sequence: 1 givenname: Trisha M. surname: Kesar fullname: Kesar, Trisha M. organization: From the Department of Physical Therapy (T.M.K., D.S.R. K.S.R., S.A.B.-M.), Graduate Program in Biomechanics and Movement Science (R.P., D.S.R., A.J., K.S.R., J.S.H., S.A.B.-M.), and Department of Mechanical Engineering (J.S.H.), University of Delaware, Newark, Del – sequence: 2 givenname: Ramu surname: Perumal fullname: Perumal, Ramu organization: From the Department of Physical Therapy (T.M.K., D.S.R. K.S.R., S.A.B.-M.), Graduate Program in Biomechanics and Movement Science (R.P., D.S.R., A.J., K.S.R., J.S.H., S.A.B.-M.), and Department of Mechanical Engineering (J.S.H.), University of Delaware, Newark, Del – sequence: 3 givenname: Darcy S. surname: Reisman fullname: Reisman, Darcy S. organization: From the Department of Physical Therapy (T.M.K., D.S.R. K.S.R., S.A.B.-M.), Graduate Program in Biomechanics and Movement Science (R.P., D.S.R., A.J., K.S.R., J.S.H., S.A.B.-M.), and Department of Mechanical Engineering (J.S.H.), University of Delaware, Newark, Del – sequence: 4 givenname: Angela surname: Jancosko fullname: Jancosko, Angela organization: From the Department of Physical Therapy (T.M.K., D.S.R. K.S.R., S.A.B.-M.), Graduate Program in Biomechanics and Movement Science (R.P., D.S.R., A.J., K.S.R., J.S.H., S.A.B.-M.), and Department of Mechanical Engineering (J.S.H.), University of Delaware, Newark, Del – sequence: 5 givenname: Katherine S. surname: Rudolph fullname: Rudolph, Katherine S. organization: From the Department of Physical Therapy (T.M.K., D.S.R. K.S.R., S.A.B.-M.), Graduate Program in Biomechanics and Movement Science (R.P., D.S.R., A.J., K.S.R., J.S.H., S.A.B.-M.), and Department of Mechanical Engineering (J.S.H.), University of Delaware, Newark, Del – sequence: 6 givenname: Jill S. surname: Higginson fullname: Higginson, Jill S. organization: From the Department of Physical Therapy (T.M.K., D.S.R. K.S.R., S.A.B.-M.), Graduate Program in Biomechanics and Movement Science (R.P., D.S.R., A.J., K.S.R., J.S.H., S.A.B.-M.), and Department of Mechanical Engineering (J.S.H.), University of Delaware, Newark, Del – sequence: 7 givenname: Stuart A. surname: Binder-Macleod fullname: Binder-Macleod, Stuart A. organization: From the Department of Physical Therapy (T.M.K., D.S.R. K.S.R., S.A.B.-M.), Graduate Program in Biomechanics and Movement Science (R.P., D.S.R., A.J., K.S.R., J.S.H., S.A.B.-M.), and Department of Mechanical Engineering (J.S.H.), University of Delaware, Newark, Del |
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| Keywords | Vascular disease functional electrical stimulation Stroke Nervous system diseases variable-frequency trains ankle plantarflexors Central nervous system disease Cardiovascular disease Cerebrovascular disease Cerebral disorder |
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Functional electrical stimulation (FES) is a popular poststroke gait rehabilitation intervention. Although stroke causes multijoint... Functional electrical stimulation (FES) is a popular poststroke gait rehabilitation intervention. Although stroke causes multijoint gait deficits, FES is... |
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| SubjectTerms | Aged Ankle Joint - physiology Biological and medical sciences Electric Stimulation Therapy - methods Female Gait - physiology Gait Disorders, Neurologic - therapy Humans Knee - physiology Male Medical sciences Middle Aged Muscle, Skeletal - physiology Neurology Neuropharmacology Paresis - physiopathology Paresis - therapy Pharmacology. Drug treatments Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopharmacology Range of Motion, Articular - physiology Recovery of Function - physiology Stroke - therapy Treatment Outcome Vascular diseases and vascular malformations of the nervous system Walking - physiology |
| Subtitle | Effects on Poststroke Gait |
| Title | Functional Electrical Stimulation of Ankle Plantarflexor and Dorsiflexor Muscles |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/19834018 https://www.proquest.com/docview/734155291 |
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