Araki Sota, Kawada Masayuki, Miyazaki Takasuke, Nakai Yuki, Takeshita Yasufumi, Matsuzawa Yuta, Yamaguchi Yuya, Ohwatashi Akihiko, Tojo Ryuji, Nakamura Toshihiro, Nakatsuji Shintaro, Kiyama Ryoji
Doctoral Program, Graduate School of Health Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima 890-8544, Japan.
Department of Rehabilitation, Acras Central Hospital, 1-121-5 Takeoka, Kagoshima City, Kagoshima 890-0031, Japan.
Biomed Res Int. 2020 Nov 19;2020:8659845. doi: 10.1155/2020/8659845. eCollection 2020.
Many stroke patients rely on cane or ankle-foot orthosis during gait rehabilitation. The purpose of this study was to investigate the immediate effect of functional electrical stimulation (FES) to the gluteus medius (GMed) and tibialis anterior (TA) on gait performance in stroke patients, including those who needed assistive devices. Fourteen stroke patients were enrolled in this study (mean poststroke duration: 194.9 ± 189.6 d; mean age: 72.8 ± 10.7 y). Participants walked 14 m at a comfortable velocity with and without FES to the GMed and TA. After an adaptation period, lower-limb motion was measured using magnetic inertial measurement units attached to the pelvis and the lower limb of the affected side. Motion range of angle of the affected thigh and shank segments in the sagittal plane, motion range of the affected hip and knee extension-flexion angle, step time, and stride time were calculated from inertial measurement units during the middle ten walking strides. Gait velocity, cadence, and stride length were also calculated. These gait indicators, both with and without FES, were compared. Gait velocity was significantly faster with FES ( = 0.035). Similarly, stride length and motion range of the shank of the affected side were significantly greater with FES (stride length: = 0.018; motion range of the shank: = 0.026). Meanwhile, cadence showed no significant difference ( = 0.238) in gait with or without FES. Similarly, range of motion of the affected hip joint, knee joint, and thigh did not differ significantly depending on FES condition ( = 0.115-0.529). FES to the GMed and TA during gait produced an improvement in gait velocity, stride length, and motion range of the shank. Our results will allow therapists to use FES on stroke patients with varying conditions.
许多中风患者在步态康复过程中依靠拐杖或踝足矫形器。本研究的目的是调查对中风患者(包括那些需要辅助器械的患者)的臀中肌(GMed)和胫前肌(TA)进行功能性电刺激(FES)对步态表现的即时影响。本研究纳入了14名中风患者(中风后平均病程:194.9±189.6天;平均年龄:72.8±10.7岁)。参与者在有和没有对GMed和TA进行FES的情况下,以舒适的速度行走14米。在适应期后,使用附着在骨盆和患侧下肢的磁惯性测量单元测量下肢运动。在中间的十个步行步幅期间,根据惯性测量单元计算患侧大腿和小腿节段在矢状面的角度运动范围、患侧髋关节和膝关节屈伸角度的运动范围、步时和步幅时间。还计算了步态速度、步频和步幅长度。比较了有和没有FES时的这些步态指标。有FES时步态速度明显更快(P = 0.035)。同样,有FES时患侧小腿的步幅长度和运动范围明显更大(步幅长度:P = 0.018;小腿运动范围:P = 0.026)。同时,有和没有FES时的步频在步态中没有显著差异(P = 0.238)。同样,根据FES情况,患侧髋关节、膝关节和大腿的运动范围没有显著差异(P = 0.115 - 0.529)。步态期间对GMed和TA进行FES可改善步态速度、步幅长度和小腿运动范围。我们的结果将使治疗师能够对不同情况的中风患者使用FES。