on December 1, 2005
Published online before print December 1, 2005, doi: 10.1161/01.STR.0000195129.95220.77
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Submitted on September 29, 2005
From the Department of Neurology (J.J.D., R.L.R.), Case Western Reserve University, School of Medicine, Cleveland, Ohio; Research Service and FES Center of Excellence (J.J.D., K.R., J.M.R., K.B., J.G., J.M., E.F., E.B.M., R.L.R.), Cleveland Veterans Affairs Medical Center, Ohio; and Department of Mathematics and Statistics (J.H.), Cleveland State University, Ohio. * To whom correspondence should be addressed. E-mail: jjd17{at}case.edu.
Background and Purpose--Conventional therapies fail to restore normal gait to many patients after stroke. The study purpose was to test response to coordination exercise, overground gait training, and weight-supported treadmill training, both with and without functional neuromuscular stimulation (FNS) using intramuscular (IM) electrodes (FNS-IM). Methods--In a randomized controlled trial, 32 subjects (>1 year after stroke) were assigned to 1 of 2 groups: FNS-IM or No-FNS. Inclusion criteria included ability to walk independently but inability to execute a normal swing or stance phase. All subjects were treated 4 times per week for 12 weeks. The primary outcome measure, obtained by a blinded evaluator, was gait component execution, according to the Tinetti gait scale. Secondary measures were coordination, balance, and 6-minute walking distance. Results--Before treatment, there were no significant differences between the 2 groups for age, time since stroke, stroke severity, and each study measure. FNS-IM produced a statistically significant greater gain versus No-FNS for gait component execution (P=0.003; parameter estimate 2.9; 95% CI, 1.2 to 4.6) and knee flexion coordination (P=0.049). Conclusion--FNS-IM can have a significant advantage versus No-FNS in improving gait components and knee flexion coordination after stroke.
Accepted on October 18, 2005
A Randomized Controlled Trial of Functional Neuromuscular Stimulation in Chronic Stroke Subjects
Janis J. Daly PhD, MS*;
Key words: exercise • gait • rehabilitation
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