Does electrical stimulation synchronized with ankle movements better improve ankle proprioception and gait kinematics in chronic stroke? A randomized controlled study

• Published in: NeuroRehabilitation (Reading, Mass.) Vol. 51; no. 2; pp. 259 - 269
• Main Authors: Cho, Ji-Eun, Shin, Joon-Ho, Kim, Hogene
• Format: Journal Article
• Language: English
• Published: Netherlands IOS Press BV 01.01.2022; IOS Press
• Subjects: Ankle; Balance; Electrical stimuli; Gait; Kinematics; Patients; Proprioception; Rehabilitation; Sensorimotor system; Stroke; Ankle; electrical stimulation; proprioception; stroke; range of motion
• ISSN: 1053-8135; 1878-6448; 1878-6448
• DOI: 10.3233/NRE-220018

Individuals with stroke have impaired sensorimotor function of ankle. To investigate the effects of passive biaxial ankle movement training synchronized with electrical stimulation therapy (AMT-EST) on ankle proprioception, passive range of motion (pROM), and strength, balance, and gait of chronic stroke patients. Thirty-five stroke patients were randomized. The experimental group received a total of 20 AMT-EST sessions. The control group received only EST. Primary outcome measures were ankle functions. Secondary outcome measures were clinical assessments of motor, balance, and gait-related functions. All assessments were compared before and after the intervention. The experimental group had significantly improved ankle dorsiflexor strength (p = 0.015) and ankle pROM during foot supination (p = 0.026) and pronation (p = 0.004) and clinical assessment (Fugl-Meyer Assessment of the lower extremities [FM-L], Berg Balance Scale, Timed Up and Go test, Fall Efficacy Scale, walking speed, and step length; all p <  0.05) values. The regression model predicting ankle proprioception showed significantly large effects (adjusted R2 = 0.493; p <  0.01) of the combined FM-L score and time since stroke. Biaxial AMT-EST resulted in better ankle pROM and strength than conventional EST. Ankle proprioception was not significantly improved after AMT-EST and was predicted by the FM-L score and time since stroke.