He Ruxin, Dong Yiqun, Li You, Zheng Manxu, Peng Shenghui, Tong Raymond Kai-Yu, Song Rong
Guangdong Provincial Key Laboratory of Sensor Technology and Biomedical Instrument, School of Biomedical Engineering, Shenzhen Campus of Sun Yat-Sen University, Shenzhen, 518107, Guangdong, China.
Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China.
J Neuroeng Rehabil. 2025 Mar 18;22(1):62. doi: 10.1186/s12984-025-01577-0.
In recent years, functional electrical stimulation (FES) has become a common intervention for stroke survivors to correct foot drop and improve gait biomechanics. While the orthotic effects of adaptive FES systems were well-documented, the center of pressure (COP) symmetry has been largely neglected. Furthermore, the long-term therapeutic effects of adaptive FES systems on gait biomechanics have received less attention. METHODS : This study applied a timing- and intensity-adaptive functional electrical stimulation system for evaluation and training tests to address these limitations. In the evaluation test, eight participants with chronic stroke walked under three FES conditions: no stimulation (NS), adaptive FES to the tibialis anterior (SA-ILC SCS), and hybrid adaptive FES to the tibialis anterior and the gastrocnemius (SA-ILC DCS). Nine healthy subjects walked under the NS condition as the control group. In the training test, two participants with stroke took part in a 21-day training session under the SA-ILC DCS condition.
The results showed that the COP symmetry of participants with stroke in the SA-ILC SCS condition tended to improve compared to the NS condition, while the SA-ILC DCS condition showed significant improvement, approaching that of healthy subjects. After the 21-day treatment period, there was a tendency for improvement in the knee-ankle angle, anterior ground reaction force, and COP symmetry of both participants with stroke without assistance.
The observed improvements can be attributed to the hybrid adaptive FES targeting the tibialis anterior and gastrocnemius muscles. This study demonstrates that the adaptive FES system offers promising walking assistance capabilities and significant clinical therapeutic potential.
Ethics Committee of Zhujiang Hospital, Southern Medical University, 2022-KY-149-01. Registered 29 September 2022.
近年来，功能性电刺激（FES）已成为中风幸存者纠正足下垂和改善步态生物力学的常用干预措施。虽然自适应FES系统的矫正效果已有充分记录，但压力中心（COP）对称性在很大程度上被忽视了。此外，自适应FES系统对步态生物力学的长期治疗效果也较少受到关注。
本研究应用了一种时间和强度自适应功能性电刺激系统进行评估和训练测试，以解决这些局限性。在评估测试中，八名慢性中风患者在三种FES条件下行走：无刺激（NS）、对胫前肌的自适应FES（SA-ILC SCS）以及对胫前肌和腓肠肌的混合自适应FES（SA-ILC DCS）。九名健康受试者在NS条件下行走作为对照组。在训练测试中，两名中风患者在SA-ILC DCS条件下参加了为期21天的训练课程。
结果表明，与NS条件相比，中风患者在SA-ILC SCS条件下的COP对称性有改善趋势，而SA-ILC DCS条件下则有显著改善，接近健康受试者。在21天的治疗期后，两名中风患者在无辅助情况下的膝-踝角度、地面反作用力和COP对称性都有改善趋势。
观察到的改善可归因于针对胫前肌和腓肠肌的混合自适应FES。本研究表明，自适应FES系统具有良好的步行辅助能力和显著的临床治疗潜力。
南方医科大学珠江医院伦理委员会，2022-KY-149-01。2022年9月29日注册。
