The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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Functional Electrical Stimulation with Augmented Feedback Training Improves Gait and Functional Performance in Individuals with Chronic Stroke: A Randomized Controlled Trial

  • Yu, Kyung-Hoon (Department of Physical Therapy, Division of Health Science, Baekseok University) ;
  • Kang, Kwon-Young (Department of Physical Therapy, Division of Health Welfare, Wonkwang Health Science University)
  • Received : 2017.02.28
  • Accepted : 2017.04.30
  • Published : 2017.04.30
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Abstract

Purpose: The purpose of this study was to compare the effects of the FES-gait with augmented feedback training to the FES alone on the gait and functional performance in individuals with chronic stroke. Methods: This study used a pretest and posttest randomized control design. The subjects who signed the agreement were randomly divided into 12 experimental groups and 12 control groups. The experimental groups performed two types of augmented feedback training (knowledge of performance and knowledge of results) together with FES, and the control group performed FES on the TA and GM without augmented feedback and then walked for 30 minutes for 40 meters. Both the experimental groups and the control groups received training five times a week for four weeks. Results: The groups that received the FES with augmented feedback training significantly showed a greater improvement in single limb support (SLS) and gait velocity than the groups that received FES alone. In addition, timed up and go (TUG) test and six minute walk test (6MWT) showed a significant improvement in the groups that received FES with augmented feedback compared to the groups that received FES alone. Conclusion: Compared with the existing FES gait training, augmented feedback showed improvements in gait parameters, walking ability, and dynamic balance. The augmented feedback will be an important method that can provide motivation for motor learning to stroke patients.

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References

  1. Schmid A, Duncan PW, Studenski S et al. Improvements in speed-based gait classifications are meaningful. Stroke. 2007;38(7):2096-100. https://doi.org/10.1161/STROKEAHA.106.475921
  2. Kim SH, Choi JD. The effect of gait training of progressive increasing in body weight support and gait speed on stroke patients. J Korean Soc Phys Ther. 2013:25(5):252-9.
  3. Nadeau S, Gravel D, Arsenault AB et al. Plantarflexor weakness as a limiting factor of gait speed in stroke subjects and the compensating role of hip flexors. Clin Biomech. 1999;14:125-35. https://doi.org/10.1016/S0268-0033(98)00062-X
  4. Howlett OA, Lannin NA, Ada L et al. Functional electrical stimulation improves activity after stroke: A systematic review with meta-analysis. Arch Phys Med Rehabil. 2015;96(5):934-43. https://doi.org/10.1016/j.apmr.2015.01.013
  5. An SH, Lee YM, Yang KH. Effectiveness of gait training using an electromechanical gait trainer combined with simultaneous functional electrical stimulation in chronic stroke patients. J Koren Soc Phys Ther. 2008; 20(1):41-7.
  6. Robbins SM, Houghton PE, Woodbury MG et al. The therapeutic effect of functional and transcutaneous electric stimulation on improving gait speed in stroke patients: A meta-analysis. Arch Phys Med Rehabil. 2006; 87:853-9. https://doi.org/10.1016/j.apmr.2006.02.026
  7. Pereira S, Mehta S, McIntyre A et al. Functional electrical stimulation for improving gait in persons with chronic stroke. Top stroke rehabil. 2012; 19(6):491-8. https://doi.org/10.1310/tsr1906-491
  8. Kim JH, Chung Y, Kim Y et al. Functional electrical stimulation applied to gluteus medius and tibialis anterior corresponding gait cycle for stroke. Gait posture. 2012;36(1):65-7. https://doi.org/10.1016/j.gaitpost.2012.01.006
  9. Chung Y, Kim JH, Cha Y et al. Therapeutic effect of functional electrical stimulation-triggered gait training corresponding gait cycle for stroke. Gait posture. 2014;40(3):471-5. https://doi.org/10.1016/j.gaitpost.2014.06.002
  10. Van Vliet PM, Gabriele W. Extrinsic feedback for motor learning after stroke: what is the evidence? 2006;28:831-40. https://doi.org/10.1080/09638280500534937
  11. Seo DK, Oh DW, Lee SH. Effectiveness of ankle visuoperceptual-feedback training on balance and gait functions in hemiparetic patients. J Kor Soc Phys Ther. 2010;22(4):35-41. https://doi.org/10.1589/jpts.22.35
  12. Winstein CJ, Pohl PS, Cardinale C et al. Learning a partial-weight-bearing skill: effectiveness of two forms of feedback. Phy Ther. 1996;76(9): 985-93. https://doi.org/10.1093/ptj/76.9.985
  13. Chen YL, Li YC, Kuo TS et al. The development of a closed-loop controlled functional electrical stimulation (FES) in gait training. J Med Eng Technol. 2001;25(2):41-8. https://doi.org/10.1080/03091900110043612
  14. Krishnamoorthy V, Hsu WL, Kesar TM et al. Gait training after stroke: A pilot study combining a gravity-balanced orthosis, functional electrical stimulation, and visual feedback. J Neurol PhysThe. 2008;32(4):192-202.
  15. Auchstaetter N, Luc J, Lukye S et al. Physical therapists' use of functional electrical stimulation for clients with stroke: Frequency, barriers, and facilitators. Phys Ther. 2016;96:995-1005. https://doi.org/10.2522/ptj.20150464
  16. Fitts PM and Posner MI. Human performance. Belmont, CA. Brooks/Cole. 1967
  17. O'Dell MW, Dunning K, Kluding P et al. Response and prediction of improvement in gait speed from functional electrical stimulation in persons with poststroke drop foot. PMR 2014;6:587-601.
  18. Lienhard K, Schneider D, Maffiuletti NA. Validity of the Optogait photoelectric system for the assessment of spatiotemporal gait parameters. Med Eng Phys. 2013;35(4):500-4. https://doi.org/10.1016/j.medengphy.2012.06.015
  19. Lee M, Song C, Lee K et al. Agreement between the spatio-temporal gait parameters from treadmill-based photoelectric cell and the instrumented treadmill system in healthy young adults and stroke patients. Med Sci Monit. 2014;20:1210-9. https://doi.org/10.12659/MSM.890658
  20. Ng SS, Hui-Chan CW. The timed up & go test: Its reliability and association with lower-limb impairments and locomotor capacities in people with chronic stroke. Arch Phys Med Rehabil. 2005;86(8):1641-7. https://doi.org/10.1016/j.apmr.2005.01.011
  21. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39:142-8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  22. Butland RJ, Pang J, Gross ER et al. Two-, six-, and twelve-minute walk tests in respiratory disease. BMJ (Clinical research ed). 1982;284:1607-8. https://doi.org/10.1136/bmj.284.6329.1607
  23. Kelly JO, Kilbreath SL, Davis GM, et al. Cardiorespiratory fitness and walking ability in subacute stroke patients. Arch Phys Med Rehabil. 2003;84:1780-5. https://doi.org/10.1016/S0003-9993(03)00376-9
  24. Gladstone DJ, Danells CJ, Black SE. The Fugl-Meyer assessment of motor recovery after stroke: A critical review of its measurement properties. Neurorehabil Neural Repair. 2002;16(3):232-40. https://doi.org/10.1177/154596802401105171
  25. Sanford J, Moreland J, Swanson LR et al. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phy Ther. 1993;73:447-54. https://doi.org/10.1093/ptj/73.7.447
  26. McNevin NH, Shea CH, Wulf G. Increasing the distance of an external focus of attention enhances learning. Psycholog Res. 2003;67:22-9.
  27. Lin PY, Yang YR, Cheng SJ et al. The relation between ankle impairments and gait velocity and symmetry in people with stroke. Arch Phys Med Rehabil. 2006;87:562-8. https://doi.org/10.1016/j.apmr.2005.12.042
  28. Kim JH. Relationship between gait symmetry and functional balance, walking performance in subjects with stroke. J Korean Soc Phys Ther. 2014;26(1):1-8.
  29. Kottink AI, Hermens HJ, Nene AV et al. A randomized controlled trial of an implantable 2-channel peroneal nerve stimulator on walking speed and activity in poststroke hemiplegia. Arch Phys Med Rehabil. 2007; 88(8):971-8. https://doi.org/10.1016/j.apmr.2007.05.002
  30. Bethoux F, Rogers HL, Nolan KJ et al. The effects of peroneal nerve functional electrical stimulation versus ankle-foot orthosis in patients with chronic stroke: A randomized controlled trial. Neurorehabil Neural Repair. 2014;28(7):688-97. https://doi.org/10.1177/1545968314521007
  31. Sabut SK, Sikdar C, Kumar R et al. Functional electrical stimulation of dorsiflexor muscle: Effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients. NeuroRehabilitation. 2011; 29(4):393-400.
  32. Embrey DG, Holtz SL, Alon G, et al. Functional electrical stimulation to dorsiflexors and plantar flexors during gait to improve walking in adults with chronic hemiplegia. Arch Phys Med Rehabil. 2010;91:687-96. https://doi.org/10.1016/j.apmr.2009.12.024
  33. Kluding PM, Dunning K, O'Dell MW, et al. Foot drop stimulation versus ankle foot orthosis after stroke 30-week outcomes. Stroke. 2013; 44(6):1660-9. https://doi.org/10.1161/STROKEAHA.111.000334

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