Covarrubias-Escudero Felipe, Appelgren-Gonzalez Juan Pablo, Nuñez-Saavedra Gustavo, Urrea-Baeza Denisse, Varas-Diaz Gonzalo
Translational Research Unit, Trainfes Center, Santiago, Chile.
Departamento de Kinesiología, Facultad de Arte y Educación Física, Universidad Metropolitana Ciencias de la Educación (UMCE), Ñuñoa, Chile.
Physiother Res Int. 2025 Jul;30(3):e70080. doi: 10.1002/pri.70080.
Stroke often causes muscle weakness, reduced motor control, and gait abnormalities, such as foot drop and propulsion deficits, which impair weight transfer and walking efficiency. Traditional interventions such as ankle-foot orthoses and botulinum toxin address these impairments but often fail to activate the muscles involved in propulsion. Functional electrical stimulation (FES) has shown potential to enhance muscle activation and gait speed, but its effects on biomechanical parameters, particularly on step-to-step transitions, remain insufficiently explored.
A randomized crossover design included 18 individuals with stroke who walked with and without functional electrical stimulation (FES). Kinematic data and ground reaction forces (GRF) were recorded to evaluate step-to-step transitions. Outcome measures included the minimum vertical velocity (Vvmin) of the center of mass (CoM) and the force ratio (FRatio) between the back foot (Fback) and front foot (Ffront).
FES significantly reduced the force ratio (FRatio) (p < 0.001), indicating improved force distribution toward the back foot. The minimum vertical velocity (Vvmin) of the center of mass (CoM) occurred earlier with FES (0.470 ± 0.032) compared with No FES (0.513 ± 0.033; p < 0.001), demonstrating enhanced control of CoM redirection during gait.
FES applied to specific lower limb muscles improved critical biomechanical gait parameters, including enhanced force distribution and better control of the center of mass (CoM). These findings suggest that FES can optimize gait mechanics, particularly during step-to-step transitions, and improve walking efficiency in individuals with stroke. Further research is needed to assess its long-term effects and explore its integration into rehabilitation protocols.
The study was registered with Clinical Trials.gov (NCT06237972).
中风常导致肌肉无力、运动控制能力下降以及步态异常，如足下垂和推进力不足，这会损害体重转移和步行效率。传统干预措施，如踝足矫形器和肉毒杆菌毒素，可解决这些损伤问题，但往往无法激活参与推进的肌肉。功能性电刺激（FES）已显示出增强肌肉激活和提高步态速度的潜力，但其对生物力学参数的影响，特别是对步间转换的影响，仍未得到充分探索。
一项随机交叉设计纳入了18名中风患者，他们分别在有和没有功能性电刺激（FES）的情况下行走。记录运动学数据和地面反作用力（GRF）以评估步间转换。结果测量指标包括质心（CoM）的最小垂直速度（Vvmin）以及后脚（Fback）和前脚（Ffront）之间的力比（FRatio）。
FES显著降低了力比（FRatio）（p < 0.001），表明向后脚的力分布得到改善。与无FES（0.513 ± 0.033；p < 0.001）相比，使用FES时质心（CoM）的最小垂直速度（Vvmin）出现得更早（0.470 ± 0.032），这表明在步态过程中对CoM重定向的控制得到增强。
对特定下肢肌肉施加FES可改善关键的生物力学步态参数，包括增强力分布和更好地控制质心（CoM）。这些发现表明，FES可优化步态力学，特别是在步间转换期间，并提高中风患者的步行效率。需要进一步研究来评估其长期效果，并探索将其纳入康复方案。
该研究已在ClinicalTrials.gov（NCT06237972）注册。
