The development of a closed-loop controlled functional electrical stimulation (FES) in gait training

Background. Many stroke survivors suffer from leg muscle paresis, resulting in asymmetrical gait patterns, negatively affecting balance control and energy cost. Interventions targeting asymmetry early after stroke may enhance recovery of walking. Objective. To determine the feasibility and preliminary efficacy of up to 10 weeks of gait training assisted by multichannel functional electrical stimulation (MFES gait training) applied to the peroneal nerve and knee flexor or extensor muscle on the recovery of gait symmetry and walking capacity in patients starting in the subacute phase after stroke. Methods. Forty inpatient participants (≤31 days after stroke) were randomized to MFES gait training (experimental group) or conventional gait training (control group). Gait training was delivered in 30-minute sessions each workday. Feasibility was determined by adherence (≥75% sessions) and satisfaction with gait training (score ≥7 out of 10). Primary outcome for efficacy was step length symmetry. Secondary outcomes included other spatiotemporal gait parameters and walking capacity (Functional Gait Assessment and 10-Meter Walk Test). Linear mixed models estimated treatment effect postintervention and at 3-month follow-up. Results. Thirty-seven participants completed the study protocol (19 experimental group participants). Feasibility was confirmed by good adherence (90% of the participants) and participant satisfaction (median score 8). Both groups improved on all outcomes over time. No significant group differences in recovery were found for any outcome. Conclusions. MFES gait training is feasible early after stroke, but MFES efficacy for improving step length symmetry, other spatiotemporal gait parameters, or walking capacity could not be demonstrated. Trial Registration. Netherlands Trial Register (NTR4762).

Download Full-text

Effects of Gait Training Using Functional Electrical Stimulation of the Tibialis Anterior Muscle on the Gait Pattern of Convalescent Hemiplegic Stroke Patients

Rigakuryoho Kagaku ◽

10.1589/rika.36.119 ◽

2021 ◽

Vol 36 (1) ◽

pp. 119-123

Author(s):

Mizuho OTA ◽

Jun AOKI ◽

Chihiro FUJII ◽

Tatsuki YAMADA ◽

Makoto TAMARI

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Tibialis Anterior ◽

Tibialis Anterior Muscle ◽

Gait Training ◽

Gait Pattern ◽

Stroke Patients ◽

Stimulation Of

Download Full-text

Effects of Integrating Transcutaneous Electrical Nerve Stimulation into Treadmill Gait Training Applying Functional Electrical Stimulation on Spasticity, Balance and Gait Ability in Stroke Patients: A Randomized Controlled Trial

Journal of the Korean Society of Physical Medicine ◽

10.13066/kspm.2020.15.2.39 ◽

2020 ◽

Vol 15 (2) ◽

pp. 39-48

Author(s):

Mun-Su Lee ◽

Myung-Mo Lee

Keyword(s):

Randomized Controlled Trial ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Nerve Stimulation ◽

Transcutaneous Electrical Nerve Stimulation ◽

Controlled Trial ◽

Gait Training ◽

Stroke Patients ◽

Electrical Nerve Stimulation ◽

Randomized Controlled

Download Full-text

Mechanomyography Based Closed-Loop Functional Electrical Stimulation Cycling System

2018 7th IEEE International Conference on Biomedical Robotics and Biomechatronics (Biorob) ◽

10.1109/biorob.2018.8487941 ◽

2018 ◽

Author(s):

Billy Woods ◽

Mahendran Subramanian ◽

Ali Shafti ◽

A. Aldo Faisal

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Closed Loop ◽

Cycling System

Download Full-text

EVALUATION OF CLOSED-LOOP CONTROL SYSTEM FOR RESTORING STANDING AND SITTING FUNCTIONS BY FUNCTIONAL ELECTRICAL STIMULATION

Biomedical Engineering Applications Basis and Communications ◽

10.4015/s1016237205000044 ◽

2005 ◽

Vol 17 (01) ◽

pp. 19-26 ◽

Cited By ~ 1

Author(s):

CHENG-LIANG LIU ◽

CHUNG-HUANG YU ◽

SHIH-CHING CHEN ◽

CHANG-HUNG CHEN

Keyword(s):

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Closed Loop ◽

Spinal Cord Injuries ◽

Control Method ◽

Control Strategies ◽

Evaluation Process ◽

Closed Loop Control ◽

Loop Control ◽

Loop Control System

Functional electrical stimulation (FES) is a method for restoring the functional movements of paraplegic or patients with spinal cord injuries. However, the selection of parameters that control the restoration of standing up and sitting functions has not been extensively investigated. This work provides a method for choosing the four main items involved in evaluating the strategies for sit-stand-sit movements with the aid of a modified walker. The control method uses the arm-supported force and the angles of the legs as feedback signals to change the intensity of the electrical stimulation of the leg muscles. The control parameters, Ki and Kp, are vary for different control strategies. Four items are collected through questionnaires and used for evaluation. They are the maximum reactions of the two hands, the average reaction of the two hands, largest absolute angular velocity of the knee joints, and the sit-stand-sit duration time. The experimental data are normalized to facilitate comparison. Weighting factors are obtained and analyzed from questionnaires answered by experts and are added to evaluation process for manipulation. The results show that the best strategy is the closed-loop control with parameters Ki=0.5 and Kp=0.

Download Full-text