Functional electrical stimulation of ankle plantarflexor and dorsiflexor muscles: effects on poststroke gait.
Functional electrical stimulation of ankle plantarflexor and dorsiflexor muscles: effects on poststroke gait.
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DOI：
10.1161/strokeaha.109.560375
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发表时间：
2009-12
期刊：
影响因子：
8.3
通讯作者：
Binder-Macleod SA
中科院分区：
文献类型：
--
作者：
Kesar TM;Perumal R;Reisman DS;Jancosko A;Rudolph KS;Higginson JS;Binder-Macleod SA
功能性电刺激（FES）是一种流行的脑卒中后步态康复干预措施。虽然中风导致多关节步态缺陷，但FES通常仅用于校正摆动相足下垂。踝跖屈肌在步态中起着重要的作用。本研究的目的是测试将FES输送到踝跖屈肌和背屈肌对中风后步态的即时影响。对患有慢性中风后轻偏瘫的受试者（N=13）在使用和不使用FES的情况下以自选步行速度行走时进行步态分析。与在摆动阶段仅将FES递送至踝背屈肌相比，在末端站立期间将FES递送至麻痹的踝跖屈肌和在摆动阶段将FES递送至背屈肌两者提供了更大的摆动阶段膝关节屈曲、脚趾离地时更大的踝跖屈角度和更大的向前推进的优点。虽然FES的背屈肌和跖屈肌改善摆动阶段踝关节背屈相比，noFES，改善是小于观察到的单独刺激背屈肌，这表明需要进一步优化刺激参数和时间的背屈肌在步态。与仅在摆动阶段期间刺激踝背屈肌的典型FES方法相比，将FES递送至跖屈肌和背屈肌两者可以有助于在步态的摆动和站立阶段两者期间校正多个关节（踝和膝）处的中风后步态缺陷。我们的研究显示了在FES中刺激踝跖屈肌用于中风后步态的可行性和优势。
Functional electrical stimulation (FES) is a popular post-stroke gait rehabilitation intervention. Although stroke causes multi-joint 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 is to test the immediate effects of delivering FES to both ankle plantarflexors and dorsiflexors on post-stroke gait. Gait analysis was performed as subjects (N=13) with chronic post-stroke hemiparesis walked at their self-selected walking speeds during walking with and without FES. Compared to 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 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 dorsi- and plantar-flexor muscles improved swing phase ankle dorsiflexion compared to 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 only stimulating ankle dorsiflexor muscles during the swing phase, delivering FES to both the plantar- and dorsi-flexor muscles can help to correct post-stroke 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 post-stroke gait.