Browse > Article
http://dx.doi.org/10.14474/ptrs.2021.10.1.32

The Effects of Stair Climbing Training with Functional Electrical Stimulation on Muscle Strength, Balance, and Gait in Patients with Chronic Stroke  

Koh, Sieun (Department of Physical Therapy, Graduate School of Sahmyook University)
Choi, Wonjae (Department of Physical Therapy, Joongbu University)
Lee, Seungwon (Department of Physical Therapy, College of Health and welfare, Sahmyook University)
Publication Information
Physical Therapy Rehabilitation Science / v.10, no.1, 2021 , pp. 32-39 More about this Journal
Abstract
Objective: The weakness of muscle strength due to stroke affects the posture control and gait in the patients with stroke. Stroke This study examined the effects of the stair climbing training with functional electrical stimulation on muscle strength, dynamic balance, and gait in individuals with chronic stroke. Design: Randomized controlled trial. Methods: Total forty-eight patients were randomly assigned to the 3 groups. Participants randomly divided to stair climbing training with functional electrical stimulation group (SCT+FES group, n=16), stair climbing training group (SCT group, n=16) and control group (n=16). Subjects in the SCT+FES group and SCT group performed stair walking training with and without functional electrical stimulation for 30 minutes, 3 sessions per week for 4 weeks and all subjects received conventional physical therapy for 30 minutes with 5 sessions per week for 4 weeks. Outcome measurements were assessed using the sit-to stand Test for strength, timed up and go test and modified-timed up and go test for dynamic balance, and 10m walk test and GaitRite system for gait. Results: In the SCT+FES group, subjects have been shown the significant increase in lower extremity strength (p<0.05), significantly improve in dynamic balance (p<0.05), and significantly improve in their temporal gait parameter (p<0.05). The SCT+FES group was significantly better than other groups in all parameters (p<0.05). Conclusions: This result suggested that the SCT+FES may be effective strategy to improve muscle strength, dynamic balance, and gait for individuals with chronic stroke.
Keywords
Electric stimulation therapy; Stroke; Muscle strength; Postural balance; Gait;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Farhat F, Hsairi I, Baati H, Smits-Engelsman BC, Masmoudi K, McHirgui R, et al. The effect of a motor skills training program in the improvement of practiced and non-practiced tasks performance in children with developmental coordination disorder (DCD). Hum Mov Sci. 2016;46:10-22.   DOI
2 Danielsson A, Willen C, Sunnerhagen KS. Measurement of energy cost by the physiological cost index in walking after stroke. Arch Phys Med Rehabil. 2007;88: 1298-303.   DOI
3 You SH, Jang SH, Kim YH, Hallett M, Ahn SH, Kwon YH, et al. Virtual reality-induced cortical reorganization and associated locomotor recovery in chronic stroke: an experimenter-blind randomized study. Stroke. 2005;36:1166-71.   DOI
4 Rushton D. Functional electrical stimulation and rehabilitation-an hypothesis. Med Eng Phys. 2003; 25:75-8.   DOI
5 Kesar TM, Perumal R, Reisman DS, Jancosko A, Rudolph KS, Higginson JS, et al. Functional electrical stimulation of ankle plantarflexor and dorsiflexor muscles: effects on poststroke gait. Stroke. 2009;40:3821-7.   DOI
6 Lyons GM, Sinkjaer T, Burridge JH, Wilcox DJ. A review of portable FES-based neural orthoses for the correction of drop foot. IEEE Trans Neural Syst Rehabil Eng. 2002;10:260-79.   DOI
7 Robbins SM, Houghton PE, Woodbury MG, Brown JL. 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.   DOI
8 Ikai T, Kamikubo T, Takehara I, Nishi M, Miyano S. Dynamic postural control in patients with hemiparesis. Am J Phys Med Rehabil. 2003;82:463-9; quiz 70-2, 84.   DOI
9 Saunders DH, Greig CA, Young A, Mead GE. Association of activity limitations and lower-limb explosive extensor power in ambulatory people with stroke. Arch Phys Med Rehabil. 2008;89:677-83.   DOI
10 Eng JJ, Chu KS. Reliability and comparison of weight-bearing ability during standing tasks for individuals with chronic stroke. Arch Phys Med Rehabil. 2002;83:1138-44.   DOI
11 Alzahrani MA, Dean CM, Ada L. Ability to negotiate stairs predicts free-living physical activity in community-dwelling people with stroke: an observational study. Aust J Physiother. 2009;55:277-81.   DOI
12 Kim YS. Muscle Activation Patterns of Stair Gait in Hemiparetic Patients Using Surface Electromyography. Journal of adapted physical activity and exercise. 2006;14:1-15.
13 Aruin AS, Hanke T, Chaudhuri G, Harvey R, Rao N. Compelled weightbearing in persons with hemiparesis following stroke: the effect of a lift insert and goal-directed balance exercise. J Rehabil Res Dev. 2000;37:65-72.
14 Srivastava A, Taly AB, Gupta A, Kumar S, Murali T. Bodyweight-supported treadmill training for retraining gait among chronic stroke survivors: A randomized controlled study. Ann Phys Rehabil Med. 2016;59:235-41.   DOI
15 Riener R, Rabuffetti M, Frigo C. Stair ascent and descent at different inclinations. Gait posture. 2002;15: 32-44.   DOI
16 Protopapadaki A, Drechsler WI, Cramp MC, Coutts FJ, Scott OM. Hip, knee, ankle kinematics and kinetics during stair ascent and descent in healthy young individuals. Clin Biomech (Bristol, Avon). 2007;22:203-10.   DOI
17 Mitsutake T, Sakamoto M, Horikawa E. The effects of electromyography-triggered neuromuscular electrical stimulation plus tilt sensor functional electrical stimulation training on gait performance in patients with subacute stroke: a randomized controlled pilot trial. Int J Rehabil Res. 2019;42:358-64.   DOI
18 Sabut SK, Sikdar C, Kumar R, Mahadevappa M. Functional electrical stimulation of dorsiflexor muscle: effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients. NeuroRehabilitation. 2011;29:393-400.   DOI
19 Mustafaoglu R, Erhan B, Yeldan I, Gunduz B, Tarakci E. Does robot-assisted gait training improve mobility, activities of daily living and quality of life in stroke? A single-blinded, randomized controlled trial. Acta Neurol Belg. 2020;120:335-44.   DOI
20 Lee D, Lee G. Effect of afferent electrical stimulation with mirror therapy on motor function, balance, and gait in chronic stroke survivors: a randomized controlled trial. Eur J Phys Rehabil Med. 2019;55:442-9.
21 Flansbjer UB, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005;37:75-82.   DOI
22 Campbell FM, Ashburn AM, Pickering RM, Burnett M. Head and pelvic movements during a dynamic reaching task in sitting: implications for physical therapists. Arch Phys Med Rehabil. 2001;82:1655-60.   DOI
23 Kim CM, Eng JJ. The relationship of lower-extremity muscle torque to locomotor performance in people with stroke. Phys Ther. 2003;83:49-57.   DOI
24 Blazevich AJ, Cannavan D, Coleman DR, Horne S. Influence of concentric and eccentric resistance training on architectural adaptation in human quadriceps muscles. J Appl Physiol (1985). 2007;103: 1565-75.   DOI
25 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.   DOI
26 Samuel D, Rowe P, Hood V, Nicol A. The biomechanical functional demand placed on knee and hip muscles of older adults during stair ascent and descent. Gait posture. 2011;34:239-44.   DOI
27 Hesse S, Tomelleri C, Bardeleben A, Werner C, Waldner A. Robot-assisted practice of gait and stair climbing in nonambulatory stroke patients. Rehabil Res Dev. 2012;49:613-22.   DOI
28 Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in community-residing older adults. Res Q Exerc Sport. 1999; 70:113-9.   DOI
29 Broderick P, Horgan F, Blake C, Ehrensberger M, Simpson D, Monaghan K. Mirror therapy and treadmill training for patients with chronic stroke: a pilot randomized controlled trial. Top Stroke Rehabil. 2019;26:163-72.   DOI
30 Yang YR, Wang RY, Chen YC, Kao MJ. Dual-task exercise improves walking ability in chronic stroke: a randomized controlled trial. Arch Phys Med Rehabil. 2007;88:1236-40.   DOI
31 Lamberti N, Straudi S, Malagoni AM, Argiro M, Felisatti M, Nardini E, et al. Effects of low-intensity endurance and resistance training on mobility in chronic stroke survivors: a pilot randomized controlled study. Eur J Phys Rehabil Med. 2017;53:228-39.
32 Ng MF, Tong RK, Li LS. A pilot study of randomized clinical controlled trial of gait training in subacute stroke patients with partial body-weight support electromechanical gait trainer and functional electrical stimulation: six-month follow-up. Stroke. 2008;39:154-60.   DOI
33 Engardt M, Knutsson E, Jonsson M, Sternhag M. Dynamic muscle strength training in stroke patients: effects on knee extension torque, electromyographic activity, and motor function. Arch Phys Med Rehabil. 1995;76:419-25.   DOI
34 Scianni A, Teixeira-Salmela LF, Ada L. Effect of strengthening exercise in addition to task-specific gait training after stroke: a randomised trial. Int J Stroke. 2010;5:329-35.   DOI