Citation

Gervasoni E, Parelli R, Uszynski M, Crippa A, Marzegan A, Montesano A, Cattaneo D. PM R 2016; 9(4): 339-347.e1.

Affiliation

LaRiCE: Gait and Balance Disorders Laboratory Department of Neurorehabilitation; Don Gnocchi Foundation I.R.C.C.S. Via Capecelatro 66 - 20148 Milano, ITALY. Electronic address: dcattaneo@dongnocchi.it.

Copyright

(Copyright © 2016, American Academy of Physical Medicine and Rehabilitation, Publisher Elsevier Publishing)

DOI

10.1016/j.pmrj.2016.10.019

PMID

27825837

Abstract

BACKGROUND: Loss of neuromuscular control of the ankle joint is a common impairment in neurological conditions, leading to abnormal gait and a higher risk of falling. However, limited information is available on the effectiveness of Functional Electrical Stimulation (FES) on reducing falls, and no studies have investigated its usefulness in improving lower limbs kinematics related to foot clearance and energy recovery. SETTING: Clinical setting. STUDY DESIGN: Longitudinal study. PARTICIPANTS: Twenty-four subjects, 14 people with multiple sclerosis (mean age ± standard deviation 50.93 ± 8.72 years) and 10 people with stroke (55.38 ±14.55 years).

METHODS: The number of falls was assessed at baseline and after 8 weeks, and a clinical assessment was assessed at the baseline, 4-week and 8-week time points. A subsample of the 24 subjects comprised of 5 people with multiple sclerosis, and five people with stroke performed a gait analysis assessment at baseline and after 4-weeks. After receiving the equipment and the training schedule, subjects performed daily home walking training using FES for 8 weeks. MAIN OUTCOME MEASUREMENTS: The main outcomes were 1) the number of falls, 2) foot clearance, and 3) energy recovery.

RESULTS: A reduction in the number of falls was observed from baseline (n=10) to the 8-week assessment (n=2), p=.02. Foot clearance increased (+ 5.26 mm, p=.04) between the baseline without FES and at 4 weeks with FES (total effect). No statistically significant differences were found in energy recovery between baseline and 4 weeks.

CONCLUSIONS: The use of FES had an impact on gait, specifically reducing the number of falls and improving walking. A specific effect at the ankle joint was observed, increasing foot clearance during the swing phase of gait. This effect was not accompanied with a reduction in the energetic expenditure during walking in subjects with multiple sclerosis and stroke.

Copyright © 2016 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Language: en