scholarly journals Bilateral Contralaterally Controlled Functional Electrical Stimulation Reveals New Insights Into the Interhemispheric Competition Model in Chronic Stroke

2019 ◽  
Vol 33 (9) ◽  
pp. 707-717 ◽  
Author(s):  
David A. Cunningham ◽  
Jayme S. Knutson ◽  
Vishwanath Sankarasubramanian ◽  
Kelsey A. Potter-Baker ◽  
Andre G. Machado ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Repeated Measures ◽  
Neuromuscular Electrical Stimulation ◽  
Chronic Stroke ◽  
Motor Impairments ◽  
Repeated Measures Design ◽  
Interhemispheric Competition ◽  
Wide Range

Background. Upper-limb chronic stroke hemiplegia was once thought to persist because of disproportionate amounts of inhibition imposed from the contralesional on the ipsilesional hemisphere. Thus, one rehabilitation strategy involves discouraging engagement of the contralesional hemisphere by only engaging the impaired upper limb with intensive unilateral activities. However, this premise has recently been debated and has been shown to be task specific and/or apply only to a subset of the stroke population. Bilateral rehabilitation, conversely, engages both hemispheres and has been shown to benefit motor recovery. To determine what neurophysiological strategies bilateral therapies may engage, we compared the effects of a bilateral and unilateral based therapy using transcranial magnetic stimulation. Methods. We adopted a peripheral electrical stimulation paradigm where participants received 1 session of bilateral contralaterally controlled functional electrical stimulation (CCFES) and 1 session of unilateral cyclic neuromuscular electrical stimulation (cNMES) in a repeated-measures design. In all, 15 chronic stroke participants with a wide range of motor impairments (upper extremity Fugl-Meyer score: 15 [severe] to 63 [mild]) underwent single 1-hour sessions of CCFES and cNMES. We measured whether CCFES and cNMES produced different effects on interhemispheric inhibition (IHI) to the ipsilesional hemisphere, ipsilesional corticospinal output, and ipsilateral corticospinal output originating from the contralesional hemisphere. Results. CCFES reduced IHI and maintained ipsilesional output when compared with cNMES. We found no effect on ipsilateral output for either condition. Finally, the less-impaired participants demonstrated a greater increase in ipsilesional output following CCFES. Conclusions. Our results suggest that bilateral therapies are capable of alleviating inhibition on the ipsilesional hemisphere and enhancing output to the paretic limb.

scholarly journals Novel Patterns of Functional Electrical Stimulation Have an Immediate Effect on Dorsiflexor Muscle Function During Gait for People Poststroke

2010 ◽  
Vol 90 (1) ◽  
pp. 55-66 ◽  
Author(s):  
Trisha M. Kesar ◽  
Ramu Perumal ◽  
Angela Jancosko ◽  
Darcy S. Reisman ◽  
Katherine S. Rudolph ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Repeated Measures ◽  
Plantar Flexion ◽  
Swing Phase ◽  
Ankle Dorsiflexion ◽  
Muscle Performance ◽  
Foot Drop ◽  
Repeated Measures Design ◽  
Ankle Dorsiflexor

Background Foot drop is a common gait impairment after stroke. Functional electrical stimulation (FES) of the ankle dorsiflexor muscles during the swing phase of gait can help correct foot drop. Compared with constant-frequency trains (CFTs), which typically are used during FES, novel stimulation patterns called variable-frequency trains (VFTs) have been shown to enhance isometric and nonisometric muscle performance. However, VFTs have never been used for FES during gait. Objective The purpose of this study was to compare knee and ankle kinematics during the swing phase of gait when FES was delivered to the ankle dorsiflexor muscles using VFTs versus CFTs. Design A repeated-measures design was used in this study. Participants Thirteen individuals with hemiparesis following stroke (9 men, 4 women; age=46–72 years) participated in the study. Methods Participants completed 20- to 40-second bouts of walking at their self-selected walking speeds. Three walking conditions were compared: walking without FES, walking with dorsiflexor muscle FES using CFTs, and walking with dorsiflexor FES using VFTs. Results Functional electrical stimulation using both CFTs and VFTs improved ankle dorsiflexion angles during the swing phase of gait compared with walking without FES (X̅±SE=−2.9°±1.2°). Greater ankle dorsiflexion in the swing phase was generated during walking with FES using VFTs (X̅±SE=2.1°±1.5°) versus CFTs (X̅±SE=0.3±1.3°). Surprisingly, dorsiflexor FES resulted in reduced knee flexion during the swing phase and reduced ankle plantar flexion at toe-off. Conclusions The findings suggest that novel FES systems capable of delivering VFTs during gait can produce enhanced correction of foot drop compared with traditional FES systems that deliver CFTs. The results also suggest that the timing of delivery of FES during gait is critical and merits further investigation.

scholarly journals Effectiveness of Contralaterally Controlled Functional Electrical Stimulation versus Neuromuscular Electrical Stimulation on Upper Limb Motor Functional Recovery in Subacute Stroke Patients: A Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Songhua Huang ◽  
Peile Liu ◽  
Yinglun Chen ◽  
Beiyao Gao ◽  
Yingying Li ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Electrical Stimulation ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Controlled Trial ◽  
Neuromuscular Electrical Stimulation ◽  
Stroke Patients ◽  
Randomized Controlled ◽  
Subacute Stroke ◽  
Extensor Carpi Radialis

Purpose. To compare the effectiveness of contralaterally controlled functional electrical stimulation (CCFES) versus neuromuscular electrical stimulation (NMES) on motor recovery of the upper limb in subacute stroke patients. Materials and Methods. Fifty patients within six months poststroke were randomly assigned to the CCFES group ( n = 25 ) and the NMES group ( n = 25 ). Both groups underwent routine rehabilitation plus 20-minute stimulation on wrist extensors per day, five days a week, for 3 weeks. Fugl-Meyer Assessment of upper extremity (FMA-UE), action research arm test (ARAT), Barthel Index (BI), and surface electromyography (sEMG) were assessed at baseline and end of intervention. Results. After a 3-week intervention, FMA-UE and BI increased in both groups ( p < 0.05 ). ARAT increased significantly only in the CCFES group ( p < 0.05 ). The changes of FMA-UE, ARAT, and BI in the CCFES group were not greater than those in the NMES group. The improvement in sEMG response of extensor carpi radialis by CCFES was greater than that by NMES ( p = 0.026 ). The cocontraction ratio (CCR) of flexor carpi radialis did not decrease in both groups. Conclusions. CCFES improved upper limb motor function, but did not show better treatment effect than NMES. CCFES significantly enhanced the sEMG response of paretic extensor carpi radialis compared with NMES, but did not decrease the cocontraction of antagonist.

scholarly journals Effect of Functional Electrical Stimulation on Upper Limb Motor Functions in Patient with Chronic Stroke - A Case Report

2021 ◽  
pp. 199-203
Author(s):  
Rupa Zanwar ◽  
Pooja Motar ◽  
Minal Holani
Keyword(s):  
Electrical Stimulation ◽  
Ischemic Stroke ◽  
Case Report ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Chronic Stroke ◽  
Post Intervention ◽  
Motor Functions ◽  
Chronic Stage ◽  
Hand Muscles

Background: Literature shows that intensive Functional Electrical Stimulation facilitates upper limb motor recovery after Stroke. Aim: To assess the effects of 4 weeks of FES therapy on right upper limb motor functions in patient with Chronic Stroke. Materials and Methods: The participant was thirty year old male Right Hemiparesis who had experienced Chronic Ischemic Stroke. FES therapy was given for forty five minutes per session, three sessions a week for complete four weeks. The pre and post intervention score were measured with Fugl Meyer Assessment, Voluntary Control Grading and MAS. Results: The Fugl Meyer Assessment score for right upper limb showed improvement with progression in stage of VCG for right upper limb and hand. Also improved MAS score was noted for right shoulder, elbow and hand muscles. Conclusion: The current study confirms that application of FES therapy improves upper limb motor functions in Chronic stage of Stroke after 4 weeks.

scholarly journals The Performance of Aerobic Exercising by Spinal Cord Injury Patients Through the Application of Functional Electrical Stimulation

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Camellia Srikanthan ◽  
Dr. Sukhendu Dutta
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
Exercise Training ◽  
Functional Electrical Stimulation ◽  
Repeated Measures ◽  
Case Series ◽  
Rank Test ◽  
Repeated Measures Design ◽  
Cord Injury

Evoking a muscular response using Functional Electrical Stimulation onto paralyzed muscles will allow patients with spinal cord damage at the level of C4-L1 to perform aerobic and strengthening exercise training. The provoked activity will improve body strength, body composition, mitigate disuse atrophy, and enhance cardiopulmonary function. The study designs included case report, case control, case series, pre-clinical and post-clinical intervention and outcomes measure, clinical trial, prospective cohort study, cross-sectional, and longitudinal repeated measures design. The statistical methods and methods of data analysis used were ANOVA, ASIA impairment scores, ? level and p-value, mean ± standard error, r2, Student paired t-test, PASW statistics, Spearman rank correlation coefficient, Mann-Whitney U test, regression analysis, and Wilcoxon signed-rank test. The outcome of the study showed an increase in muscle thickness, strength, and lean muscle mass. There was improvement in oxygen consumption, positive effect on cardiorespiratory functioning, metabolic activity, and a slight increase in bone density. Subjects were able to perform more intense exercising as the training regime had progressed. The significance of these findings shows a potential way to improve the health of subjects with spinal cord injury, but also to recover and eventually regain the use of the muscles that were once paralyzed. Functional electrical stimulation therapy will introduce physical activity to a population that is normally found to be inactive.   Keywords: Functional electrical stimulation, spinal cord injury, FES-cycling, FES-rowing, rehabilitation, exercise training

Effects of Mirror Therapy Combined With EMG-triggered Functional Electrical Stimulation to Improve on Upper Extremity Function in Patient with Chronic Stroke

2020 ◽  
Author(s):  
Joo Yeol Jung ◽  
Pong Sub Youn ◽  
Dong Hoon Kim
Keyword(s):  
Electrical Stimulation ◽  
Physical Therapy ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Functional Electrical Stimulation ◽  
Chronic Stroke ◽  
Mirror Therapy ◽  
Extremity Function ◽  
Upper Extremity Function

AbstractThis study was performed to evaluate the effects of Mirror therapy combined with EMG-triggered Functional Electrical Stimulation on upper extremity function in patient with Chronic Stroke. A total of 24 chronic stroke patients were divided into 3 groups. Group I (n=8) was given with traditional physical therapy (TPT), group II (n=7) was given with traditional physical therapy and mirror therapy (MT), and group III (n=9) was given with traditional physical therapy and mirror therapy in conjunction with EMG-triggered Functional Electrical Stimulation (EMGFES-MT). Each group performed one hour a day 5 times a week for 6 weeks.We obtained the following result between before and after treatments about changes of elbow flexion muscle strength (EFMS), elbow extension muscle strength (EEMS), wrist flexion muscle strength (WFMS), wrist extension muscle strength (WEMS), elbow flexion range of motion (EFROM), elbow extension range of motion (EEROM), wrist flexion range of motion (WFROM), wrist extension range of motion (WEROM), grip strength (GS) and upper extremity function.Each group showed a significant difference in EFMS, EEMS, WFMS, WEMS, EFROM, EEROM, WFROM, WEROM, GS and upper extremity function (p<0.05) EMFES-MT group revealed significant differences in EEMS, WEROM, grip strength and upper extremity function as compared to the other groups (p<0.05). No difference was found in the change of spasticity among the 3 groups.Our results showed that EMFES-MT was more effective on elbow, WFMS, WEMS, AROM, grip strength and upper extremity function in patients with chronic stroke. We suggest that this study will be able to be used as an intervention data for recovering upper extremity function in chronic stroke patients

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