Volume 41 Number
6A, November/December 2004
Pages 807 — 820
Response of sagittal plane gait kinematics to weight-supported treadmill training and functional neuromuscular stimulation following stroke
Janis J. Daly, PhD, MS; Kristen L. Roenigk, BME; Kristen M. Butler, MSPT;
Jennifer L. Gansen, MSPT; Eric Fredrickson, MD; E. Byron Marsolais,
MD, PhD; Jean Rogers, PT; Robert L. Ruff, MD, PhD
Department of Neurology and Department of Orthopedics, Case Western Reserve University School of Medicine, Cleveland, OH; Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Research Service, Functional Electrical Stimulation Center of Excellence, Cleveland, OH
Abstract — After stroke, persistent gait deficits cause debilitating falls and poor functional mobility. Gait restoration can preclude these outcomes. Sixteen subjects (>12 months poststroke) were randomized to two gait training groups. Group 1 received 12 weeks of treatment, 4 times a week, 90 min per session, including 30 min strengthening and coordination, 30 min over-ground gait training, and 30 min weight-supported treadmill training. Group 2 received the same treatment, but also used functional neuromuscular stimulation (FNS) with intramuscular (IM) electrodes (FNS-IM) for each aspect of treatment. Outcome measures were kinematics of gait swing phase. Both groups showed no significant pre-/posttreatment gains in peak swing hip flexion. Group 1 (no FNS) had no significant gains in other gait components at posttreatment or at follow-up. Group 2 (FNS-IM) had significant gains in peak swing knee flexion and mid-swing ankle dorsiflexion (p < 0.05) that were maintained for 6 months.
Key words: brain ischemia, electrical stimulation therapy, gait, gait disorders, kinematics, motor learning, neurologic, rehabilitation, treadmill training.