scholarly journals Functional Electrical Stimulation for Physiotherapy Management of Neurological Conditions: An Evidence Based Study

2021 ◽  
Vol 6 (3) ◽  
pp. 422-430
Author(s):  
Dhruva J. Kanojiya ◽  
Karishma Jagad
Keyword(s):  
Electrical Stimulation ◽  
Motor Neurons ◽  
Functional Electrical Stimulation ◽  
Gait Training ◽  
Rehabilitation Program ◽  
Foot Drop ◽  
Cord Injury ◽  
Long Time ◽  
Neurological Conditions ◽  
Muscle Groups

Functional Electrical Stimulation is the electrical stimulation of motor neurons such that muscle groups are stimulated to contract & create a moment about a joint. In recent years, FES is relatively used as a new therapeutic tool in rehabilitation program of different neurological conditions. Although FES has been used for long time for treating foot drop, there are many studies which supports the beneficiary effect to improve upper and lower extremity’s function, spasticity, subluxation, respiration, balance, gait training, activities of daily living, quality of life. Multiple databases were searched for relevant articles. The purpose of this study is to evaluate the effectiveness of FES in different neurological condition and to collect the existing literature dealing with FES in a single article to analyze the result & to finally reach the overall conclusion. Keywords: FES, Stroke, Spinal Cord Injury, Multiple Sclerosis, Parkinsonism, etc.

CLINICAL USE OF FUNCTIONAL ELECTRICAL STIMULATION FOR CORRECTION OF FOOT DROP: A COMPARISON BETWEEN SUBACUTE AND CHRONIC STROKE PATIENTS

2011 ◽  
Vol 11 (05) ◽  
pp. 1165-1177 ◽  
Author(s):  
SUKANTA K. SABUT ◽  
CHHANDA SIKDAR ◽  
RATNESH KUMAR ◽  
MANJUNATHA MAHADEVAPPA
Keyword(s):  
Electrical Stimulation ◽  
Lower Extremity ◽  
Functional Electrical Stimulation ◽  
Rehabilitation Program ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Calf Muscle ◽  
Foot Drop ◽  
Stroke Patients ◽  
Muscle Spasticity

Functional electrical stimulation (FES) allows active exercises for correction of foot drop in stroke patients. Our objective is to evaluate and compare the effects of FES therapy in walking ability, calf muscle spasticity, and lower-extremity motor recovery between subacute and chronic stroke patients. Twenty consecutive hemiplegic patients having foot drop were assigned either to subacute or chronic group. Both group subjects were treated with conventional rehabilitation program combined with FES therapy for 12 weeks. All subjects received the electrical stimulation to the peroneal nerve of paretic limb for 15–30 min while walking.After being treated with FES-based rehabilitation program, subacute subjects showed a mean increase in walking speed of 31.3% and chronic subjects of 19.1% and the physiological cost index (PCI), with a reduction of 66.7% in subacute subjects and 46.4% in chronic subjects between the beginning and end of the trial. Improvement was also measured in gait parameters such as cadence, step and stride lengths, ankle joint range of motion (ROM), calf muscle spasticity, and lower-extremity motor recovery assessed by Fugl-Meyer score in both group subjects, but subacute subjects improved better compared with chronic subjects. In conclusion, early and intensive interventions of FES therapy combine with conventional rehabilitation program could significantly improve the waking ability and recovery of lower-extremity motor functions in stroke survivors.

Functional electrical stimulation using microstimulators to correct foot drop: a case study

2004 ◽  
Vol 82 (8-9) ◽  
pp. 784-792 ◽  
Author(s):  
D J Weber ◽  
R B Stein ◽  
K M Chan ◽  
G E Loeb ◽  
F J.R Richmond ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Peroneal Nerve ◽  
Walking Speed ◽  
Common Peroneal Nerve ◽  
Foot Drop ◽  
Cost Index ◽  
Cord Injury ◽  
Stimulation Of

This paper presents a case study that tested the feasibility and efficacy of using injectable microstimulators (BIONs®) in a functional electrical stimulation (FES) device to correct foot drop. Compared with surface stimulation of the common peroneal nerve, stimulation with BIONs provides more selective activation of specific muscles. For example, stimulation of the tibialis anterior (TA) and extensor digitorum longus (EDL) muscles with BIONs produces ankle flexion without excessive inversion or eversion of the foot (i.e., balanced flexion). Efficacy was assessed using a 3-dimensional motion analysis of the ankle and foot trajectories during walking with and without stimulation. Without stimulation, the toe on the affected leg drags across the ground. BION stimulation of the TA muscle and deep peroneal nerve (which innervates TA and EDL) elevates the foot such that the toe clears the ground by 3 cm, which is equivalent to the toe clearance in the less affected leg. The physiological cost index (PCI) measured effort during walking. The PCI equals the change in heart rate (from rest to activity) divided by the walking speed; units are beats per metre. The PCI is high without stimulation (2.29 ± 0.37, mean ± SD) and greatly reduced with surface (1.29 ± 0.10) and BIONic stimulation (1.46 ± 0.24). Also, walking speed increased from 9.4 ± 0.4 m/min without stimulation to 19.6 ± 2.0 m/min with surface and 17.8 ± 0.7 m/min with BIONic stimulation. These results suggest that FES delivered by a BION is an alternative to surface stimulation and provides selective control of muscle activation.Key words: FES, BION, foot drop, stroke, spinal cord injury.

scholarly journals Functional electrical stimulation with surface electrodes

2008 ◽  
Vol 18 (2) ◽  
pp. 3-9 ◽  
Author(s):  
Tadej Bajd ◽  
Marincek Crt ◽  
Marko Munih
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Gait Training ◽  
Upper Extremities ◽  
Gait Velocity ◽  
Walking Ability ◽  
Surface Electrodes ◽  
Weight Support ◽  
Cord Injury ◽  
Electrical Stimulator

The review investigates the objective evidences of benefits derived from surface functional electrical stimulation (FES) of lower and upper extremities for people after incomplete spinal cord injury (SCI) and stroke. FES can offer noticeable benefits in walking ability. It can be efficiently combined with treadmill and body weight support. Voluntary muscle strength and endurance gain can be achieved through FES assisted gait training together with increased gait velocity in absence of electrical stimulator. Cyclic FES, FES augmented by biofeedback, and FES used in various daily activities can result in substantial improvements of the voluntary control of upper extremities.

An Adaptive Block Backstepping Control Design for Functional Electrical Stimulation of Agonist-Antagonist Muscles

2011 ◽  
Author(s):  
Bonsung Koo ◽  
Alexander Leonessa
Keyword(s):  
Electrical Stimulation ◽  
Motor Neurons ◽  
Functional Electrical Stimulation ◽  
Nonlinear Controller ◽  
Control Field ◽  
Antagonist Muscles ◽  
Cord Injury ◽  
Backstepping Controller ◽  
The 1960S ◽  
Stimulation Of

In this paper, an adaptive block backstepping controller is developed for stimulation of agonist-antagonist muscles by using Functional Electrical Stimulation (FES). FES is an alternative method that stimulates a paralyzed muscle in lieu of inactive motor neurons, which was first implemented in the 1960s ([1]). However, many challenges need to be addressed before clinical trials with Spinal Cord Injury (SCI) patients can be performed, which include designing a controller, modeling muscles, developing interface equipment, just to mention a few. To contribute to the FES control field, a nonlinear controller and its evaluation through a computer simulation are presented.

Feasibility and Preliminary Efficacy of Gait Training Assisted by Multichannel Functional Electrical Stimulation in Early Stroke Rehabilitation: A Pilot Randomized Controlled Trial

2021 ◽  
Vol 35 (2) ◽  
pp. 131-144
Author(s):  
Maijke van Bloemendaal ◽  
Sicco A. Bus ◽  
Frans Nollet ◽  
Alexander C. H. Geurts ◽  
Anita Beelen
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Step Length ◽  
Gait Training ◽  
Control Group ◽  
Significant Group ◽  
Gait Symmetry ◽  
Gait Parameters ◽  
Walking Capacity ◽  
Experimental Group

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).

scholarly journals Evaluation of Individualized Functional Electrical Stimulation-Induced Acute Changes during Walking: A Case Series in Children with Cerebral Palsy

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4452
Author(s):  
Nicole Zahradka ◽  
Ahad Behboodi ◽  
Ashwini Sansare ◽  
Samuel C. K. Lee
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Case Series ◽  
Phase Detection ◽  
Lower Extremity Muscle ◽  
Children With Cerebral Palsy ◽  
Muscle Groups

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

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