Functional electrical stimulation of dorsiflexor muscle: Effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients

摘要

Objective:To evaluate the therapeutic effects of Functional Electrical Stimulation (FES) of the tibialis anterior muscleon plantarflexor spasticity, dorsiflexor strength, voluntary ankle dorsiflexion, and lower extremity motor recovery with strokesurvivors.Design:We conducted a prospective interventional study.Setting:Rehabilitation ward, physiotherapy unit and gait analysis laboratory.Participants:Fifty-one patients with foot drop resulting from stroke.Intervention:The functional electrical stimulation (FES) group (n=27) received 20–30 minutes of electrical stimulation to theperoneal nerve and anterior tibial muscle of the paretic limb along with conventional rehabilitation program (CRP). The controlgroup (n=24) treated with CRP only. The subjects were treated 1 hr per day, 5 days a week, for 12 weeks.Main outcome measures:Plantarflexor spasticity measured by modified ashworth scale (MAS), dorsiflexion strength measuredby manual muscle test (MMT), active/passive ankle joint dorsiflexion range of motion, and lower-extremity motor recovery byFugl-Meyer assessment (FMA) scale.Results:After 12 weeks of treatment, there was a significant reduction in a plantarflexor spasticity by 38.3% in the FES groupand 21.2% in control group (P<0.05), between the beginning and end of the trial. Dorsiflexor muscle strength was increasedsignificantly by 56.6% and 27.7% in the FES group and control group, respectively. Similarly, voluntary ankle dorsiflexion andlower-extremity motor function improved significantly in both the groups. No significant differences were found in the baselinemeasurements among groups. When compared with control group, a significant improvement (p<0.05) was measured in allassessed parameters in the FES group at post-treatment assessment, thus FES therapy has better effect on recovery process inpost-stroke rehabilitation.Conclusions:Therapy combining FES and conventional rehabilitation program was superior to a conventional rehabilitationprogram alone, in terms of reducing spasticity, improving dorsiflexor strength and lower extremity motor recovery in strokepatients