The use of functional electrical stimulation as a treatment intervention to improve walking ability in a sub-acute stroke population

Abstract

To date, few authors have explored whether Functional Electrical Stimulation (FES) of the lower limb, can lead to improvements in gait parameters in a sub-acute stroke population using a randomised controlled study design. Addressing the limitations of previous studies and building on the current evidence to date, this study aims to explore the feasibility of conducting a two week gait training programme combined with FES (targeted to glutei and/or ankle dorsiflexor and evertor muscles) for people with sub-acute stroke, to inform the methodology of a larger randomised control trial. Fifteen medically stable sub-acute stroke survivors were randomised into one of two groups; in addition to routine therapy one group received one hour of gait training four times a week for two weeks (n=7), and the other group received gait training at an identical level of intensity but combined with FES targeted to glutei and/or ankle dorsiflexor and evertor muscles (n=8). Outcome measures, including gait speed and quality of walking pattern, were measured prior to and post gait training intervention, and at six week follow-up. All fifteen participants received the intended intensity of therapy and completed the trial. There were no drop outs during treatment or at follow-up. There was a significant improvement in gait speed and the quality of walking pattern between baseline assessment and immediately following both gait training programmes (week two). These improvements were maintained at six week follow-up. However, no trends were found in favour of either group. The current methodological process proved a feasible approach and sub-acute stroke patients were able to tolerate the gait training interventions however, modifications to the protocol to enhance the success of a follow-on randomised controlled trial are suggested.

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