4.5 Article

Combined effects of fast treadmill walking and functional electrical stimulation on post-stroke gait

Journal

GAIT & POSTURE
Volume 33, Issue 2, Pages 309-313

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.gaitpost.2010.11.019

Keywords

Stroke; Gait; Functional electrical stimulation; Treadmill; Fast walking

Funding

  1. National Institute of Nursing Research [NR010786]
  2. National Institute of Bioengineering Research [HD038582]
  3. NIH [K01 HD050582, S10 RR022396-01]
  4. DOD [W911NF-05-1-0097]
  5. University of Delaware

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Gait dysfunctions are highly prevalent in individuals post-stroke and affect multiple lower extremity joints. Recent evidence suggests that treadmill walking at faster than self-selected speeds can help improve post-stroke gait impairments. Also, the combination of functional electrical stimulation (FES) and treadmill training has emerged as a promising post-stroke gait rehabilitation intervention. However, the differential effects of combining FES with treadmill walking at the fast versus a slower, self-selected speed have not been compared previously. In this study, we compared the immediate effects on gait while post-stroke individuals walked on a treadmill at their self-selected speed without FES (SS), at the SS speed with FES (SS-FES), at the fastest speed they are capable of attaining (FAST), and at the FAST speed with FES (FAST-FES). During SS-FES and FAST-FES, FES was delivered to paretic ankle plantarflexors during terminal stance and to paretic dorsiflexors during swing phase. Our results showed improvements in peak anterior ground reaction force (AGRF) and trailing limb angle during walking at FAST versus SS. FAST-FES versus SS-FES resulted in greater peak AGRF, trailing limb angle, and swing phase knee flexion. FAST-FES resulted in further increase in peak AGRF compared to FAST. We posit that the enhancement of multiple aspects of post-stroke gait during FAST-FES suggest that FAST-FES may have potential as a post-stroke gait rehabilitation intervention. (C) 2010 Elsevier B.V. All rights reserved.

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