J Korean Phys Ther.  2023 Oct;35(5):145-150. 10.18857/jkpt.2023.35.5.145.

Effects of Ankle Control Training Using Neuromuscular Electrical Stimulation on Leg Muscle Activation and Balance in Patients with Stroke

Affiliations
  • 1Department of Physical Therapy, Severance Rehabilitation Hospital, Yonsei University, Seoul, Republic of Korea
  • 2Department of Physical Therapy, Daejeon Rehabilitation Hospital, Daejeon, Republic of Korea
  • 3Department of Physical Therapy, Seoul Seonam Metropolitan Hospital, Seoul, Republic of Korea

Abstract

Purpose
This study examined the effects of ankle control training using neuromuscular electrical stimulation (NMES), leg muscle activation, and balance in stroke patients.
Methods
Thirty-one stroke patients diagnosed with cerebral infarction and cerebral hemorrhage were selected for the study. The experimental group underwent ankle control training using NMES, while the control group applied NMES to the paretic tibialis anterior muscle for 30 minutes per session, five times a week for four weeks. The muscle activity changes were measured using surface electromyography, and balance parameters were evaluated using a functional reach test (FRT).
Results
The intra-group comparison of the concentric muscle activity revealed improvements in the experimental group, including paretic tibialis anterior (TA) muscle (p<0.05), medial gastrocnemius muscle (MG) (p<0.01), and lateral gastrocnemius muscle (LG) (p<0.05), as well as MG (p<0.05), LG (p<0.05), soleus muscle (p<0.05) of the non-paretic side, and soleus muscle symmetry index (p<0.05). The intra-group comparison of the eccentric muscle activity showed improvements in the experimental group, including MG (p<0.01) and LG (p<0.01) of the paretic side, as well as MG (p<0.01), LG (p<0.01) of the non-paretic side, and LG symmetry index (p<0.01). The intra-group comparison of the functional reach test revealed significant differences in the test results in the experimental and control groups (p<0.05).
Conclusion
Ankle control training using NMES had a positive effect on the changes in muscle activation and improved balance in patients with stroke.

Keyword

Ankle; Balance; Electromyography; Gait; NMES
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