Ann Rehabil Med.  2014 Jun;38(3):310-316. 10.5535/arm.2014.38.3.310.

Functional Electrical Stimulation to Ankle Dorsiflexor and Plantarflexor Using Single Foot Switch in Patients With Hemiplegia From Hemorrhagic Stroke

• Lee YH
• Yong SY
• Kim SH
• Kim JH
• Shinn JM
• Kim Y
• Kim S
• Hwang S

• KMID: 2165747
• DOI: http://doi.org/10.5535/arm.2014.38.3.310

Abstract

OBJECTIVE
To evaluate the effects of functional electrical stimulation (FES) to ankle dorsiflexor (DF) and ankle plantarflexor (PF) on kinematic and kinetic parameters of hemiplegic gait.
METHODS
Fourteen post-stroke hemiplegic patients were considered in this study. Electrical stimulation was delivered to ankle DF during the swing phase and ankle PF during the stance phase via single foot switch. Kinematic and kinetic data were collected using a computerized motion analysis system with force plate. Data of no stimulation (NS), DF stimulation only (DS), DF and PF stimulation (DPS) group were compared among each other.
RESULTS
Peak ankle dorsiflexion angle during swing phase is significantly greater in DS group (-1.55degrees+/-9.10degrees) and DPS group (-2.23degrees+/-9.64degrees), compared with NS group (-6.71degrees+/-11.73degrees) (p<0.05), although there was no statistically significant difference between DS and DPS groups. Ankle plantarflexion angle at toe-off did not show significant differences among NS, DS, and DPS groups. Peak knee flexion in DPS group (34.12degrees+/-13.77degrees) during swing phase was significantly greater than that of NS group (30.78degrees+/-13.64degrees), or DS group (32.83degrees+/-13.07degrees) (p<0.05).
CONCLUSION
In addition to the usual FES application stimulating ankle DF during the swing phase, stimulation of ankle PF during stance phase can help to increase peak knee flexion during the swing phase. This study shows the advantages of stimulating the ankle DF and PF using single foot switch for post-stroke gait.

Keyword

Electrical stimulation; Hemiplegia; Gait; Kinematics

MeSH Terms

Ankle*
Biomechanical Phenomena
Electric Stimulation*
Foot*
Gait
Gait Disorders, Neurologic
Hemiplegia*
Humans
Knee
Stroke*

Figure

• 

  Fig. 1 Performed total of three test sessions: 1) patient was asked to ambulate on test way without any stimulation (NS); 2) patient ambulated with ankle DF stimulation during the swing phase (DS), 3) patient ambulated with additive ankle PF stimulation during the stance phase (DPS), which is composed of 5 trials each, these were performed with 10-minute intersession break and a 3-minute inter-trial break to avoid fatigue. DF, dorsiflexor; PF, plantarflexor; NS, no stimulation; DS, DF stimulation only; DPS, DF and PF stimulation.

• 

  Fig. 2 Swing phase peak ankle dorsiflexion angle was significantly greater in dorsiflexor stimulation only group (DS, -1.55°±9.10°) and dorsiflexor and plantarflexor stimulation group (DPS, -2.23°±9.64°), compared with no stimulation group (NS, -6.71°±11.73°) (p<0.05), although there was no statistically significant difference between DS and DPS groups. a)p<0.05, significant difference from no stimulation.

• 

  Fig. 3 Initial contact ankle dorsiflexion angle was still significantly greater continuing to swing phase (Fig. 2) in dorsiflexor stimulation only group (DS, -4.53°±2.73°) and dorsiflexor and plantarflexor stimulation group (DPS, -5.20°±3.01°), compared with no stimulation group (NS, -8.55°±3.93°). a)p<0.05, significant difference from no stimulation.

• 

  Fig. 4 Swing phase peak knee flexion was significantly greater in order of dorsiflexor and plantarflexor stimulation group (DPS, 34.12°±13.77°), dorsiflexor stimulation only group (DS, 32.83°±13.07°), and no stimulation group (NS, 30.78°±13.64°). a)p<0.05, significant difference from no stimulation. b)p<0.05, significant difference from dorsiflexor stimulation only.

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