Chou C-H, Hwang Y-S, Chen C-C, Chen S-C, Lai C-H, Chen Y-L
Department of Electronic Engineering, National Taipei University of Technology, Taipei, Taiwan.
Department of Management Information System, Hwa Hsia University of Technology, Taipei, Taiwan.
Technol Health Care. 2014;22(5):751-8. doi: 10.3233/THC-140836.
Hemiplegia can cause accidental falls, as the patients place their arms in front of their chests or next to the hips when they walk. This is due to limitations in the ability to swing their arms during walking.
This study proposes a functional electrical stimulator approach in order to improve the foot drop and abnormal movement of the upper limbs during walking. The goal of this study is to verify the feasibility of improving the foot drop and arm swing problems of hemiplegic patients using electrical stimulators in a clinical trial.
The present study utilizes a functional electrical stimulator found on the market. The stimulator is controlling the gait and arm swing of the patient while the patient is walking. It can help him or her restore regular gait cycles and arm swings. The FES device can also train the patient to walk safely and regain control of his or her arm swing. After the four-week training, the subjects had to walk 10 meters without the FES system. The step length, step time, and joint goniograms were recorded in order to determine whether there was any improvement.
After the four-week training was concluded, the three post-stroke patients showed an improvement in arm swing angle when walking. The improvement was found to be 7.16% in the first patient, 43.06% in the second, and 54.66% in the third. These results are all statistically significant. The t-test had a p-value 0.012 (p< 0.05), which demonstrated that the method used in the present study had the potential to significantly improve the arm swing of post-stroke patients.
The present study showed that a traditional foot drop functional electrical stimulator providing stimulation also to the patient's upper limbs, while being triggered by a foot switch under his or her heel, can help the patient to swing the arms and reduce the foot drop. The method has significant effect on traditional foot drop therapy. The subjects' high degree of acceptance and willingness to commit to long-term use showed that the method is indeed worthy of further research.
偏瘫会导致意外跌倒，因为患者行走时会将手臂置于胸前或髋部旁边。这是由于行走时摆动手臂的能力受限所致。
本研究提出一种功能性电刺激器方法，以改善行走过程中的足下垂和上肢异常运动。本研究的目的是在临床试验中验证使用电刺激器改善偏瘫患者足下垂和手臂摆动问题的可行性。
本研究使用市场上找到的一种功能性电刺激器。当患者行走时，该刺激器控制患者的步态和手臂摆动。它可以帮助患者恢复正常的步态周期和手臂摆动。功能性电刺激（FES）设备还可以训练患者安全行走并重新控制其手臂摆动。经过四周的训练后，受试者必须在不使用FES系统的情况下行走10米。记录步长、步时和关节角度图，以确定是否有任何改善。
四周训练结束后，三名中风后患者行走时的手臂摆动角度有所改善。第一名患者的改善率为7.16%，第二名患者为43.06%，第三名患者为54.66%。这些结果均具有统计学意义。t检验的p值为0.012（p<0.05），这表明本研究中使用的方法有可能显著改善中风后患者的手臂摆动。
本研究表明，一种传统的足下垂功能性电刺激器，在患者足跟下的脚踏开关触发时也向患者的上肢提供刺激，可以帮助患者摆动手臂并减少足下垂。该方法对传统的足下垂治疗有显著效果。受试者的高度接受度和长期使用的意愿表明该方法确实值得进一步研究。
