scholarly journals Gait Training of Patients After Stroke Using an Electromechanical Gait Trainer Combined With Simultaneous Functional Electrical Stimulation

2006 ◽  
Vol 86 (9) ◽  
pp. 1282-1294 ◽  
Author(s):  
Raymond KY Tong ◽  
Maple FW Ng ◽  
Leonard SW Li ◽  
Elaine FM So
Keyword(s):  
Electrical Stimulation ◽  
Case Report ◽  
Functional Electrical Stimulation ◽  
Gait Training ◽  
Berg Balance Scale ◽  
Functional Activities ◽  
Performance Functional ◽  
Gait Trainer

AbstractBackground and Purpose. This case report describes the implementation of gait training intervention that used an electromechanical gait trainer with simultaneous functional electrical stimulation (FES) for 2 patients with acute ischemic stroke. Case Descriptions. Two individuals with post-stroke hemiplegia of less than 6 weeks' duration participated in a 4-week gait training program as an adjunct to physical therapy received at a hospital. After the 4-week intervention, both patients were discharged from the hospital, and they returned after 6 months for a follow-up evaluation. Outcomes. By the end of the 4-week intervention, both patients had shown improvements in scores on the Barthel Index, Berg Balance Scale, Functional Ambulation Categories Scale, 5-m timed walking test, and Motricity Index. In the 6-month follow-up evaluation, both patients continued to have improvements in all outcome measures. Discussion. This case report shows that, following the use of an electromechanical gait trainer simultaneously with FES, patients after acute stroke had improvements in gait performance, functional activities, balance, and motor control in the long term.

Functional electrical stimulation as a promising intervention for polymyositis-related weakness: a case report

2021 ◽  
Vol 28 (5) ◽  
pp. 1-8
Author(s):  
Marie Vazquez Morgan ◽  
Suzanne Tinsley ◽  
Rachael Henderson
Keyword(s):  
Electrical Stimulation ◽  
Case Report ◽  
Functional Electrical Stimulation ◽  
Berg Balance Scale ◽  
Functional Mobility ◽  
Walk Test ◽  
Timed Up And Go ◽  
Balance Confidence ◽  
Minute Walk ◽  
Confidence Scale

Background/aims Polymyositis is an inflammatory myopathy characterised by chronic and progressive muscle weakness. This case report discusses a 61-year-old African-American man with polymyositis. Even though pharmacological and physical therapy interventions had previously been prescribed, they had not been beneficial. This case report examined the effects of a functional electric stimulation-assisted exercise programme. Methods The patient was treated in an outpatient clinic two times a week and performed exercises three times a week on alternating days for 36 weeks. In the clinic, he received functional electrical stimulation-assisted strengthening to quadriceps, hamstrings and gluteus maximus while performing activities such as sit to stand, squats, bridging and cycling. For endurance training, he ambulated on the clinic track with a neuroprosthetic to assist with dorsiflexion in the swing phase of gait. At home, he performed lower extremity and core strengthening exercises. Measures to evaluate the intervention included the Manual Muscle Test, functional mobility (Timed Up and Go Test), balance (Berg Balance Scale, Activities of Balance Confidence Scale), endurance (Six-Minute Walk Test with a modified Borg scale) and gait speed (10-Metre Walk Test). Results After 36 weeks of treatment, the patient had made gains in strength in all muscle groups in his bilateral lower extremities except hip extensors. Timed Up and Go time decreased by 14.01 seconds. The patient changed from a medium fall risk to low fall risk on the Berg Balance Scale and his confidence increased by 46.2% on the Activities of Balance Confidence Scale. Furthermore, he gained endurance as exhibited by his increased distance of 289 feet on the Six-Minute Walk Test and his modified Borg score decreased from 4 out of 10 to 2 out of 10. The patient made subjective and objective gains in gait speed, increasing from 0.18 metres per second at his initial examination to 0.50 metres per second. Conclusions This case study demonstrates that functional electrical stimulation-assisted exercise, conducted in an outpatient setting, can improve strength and functional mobility in an individual with polymyositis without detrimental effects.

scholarly journals Cortical re-organization after traumatic brain injury elicited using functional electrical stimulation therapy: A case report

2020 ◽  
Author(s):  
Matija Milosevic ◽  
Tomoya Nakanishi ◽  
Atsushi Sasaki ◽  
Akiko Yamaguchi ◽  
Milos R. Popovic ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Electrical Stimulation ◽  
Brain Injury ◽  
Motor Function ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Short Term ◽  
Electrical Stimulation Therapy

AbstractFunctional electrical stimulation therapy (FEST) can improve motor function after neurological injuries. However, little is known about cortical re-organization after FEST and weather it can improve upper-limb motor function after traumatic brain injury (TBI). Therefore, our study examined cortical and motor changes in a single male participant with chronic TBI suffering from mild motor impairment during 3-months of FEST and at 3-months follow-up. FEST was applied to enable upper-limb grasping and reaching movements during each session, which was performed for 45-60 min, 3 days per week, over 12-weeks. Short-term assessments were examined before and after each session, while long-term assessments were performed at baseline, after 6- and 12-weeks of FEST, and during follow-up 6- and 12-weeks after completing FEST. Short-term assessments carried out using transcranial magnetic stimulation (TMS) showed reduced cortical silent period (CSP), which is related to cortical and/or subcortical inhibition. At the same time, no changes in motor evoked potentials (MEP) were observed, suggesting corticospinal excitability was unaffected. Long-term assessments indicate increased MEP corticospinal excitability after 12-weeks of FEST, which remained during both follow-ups, while no changes in CSP were observed. Similarly, long-term assessments using TMS mapping showed larger hand MEP area in the primary motor cortex (M1) after 12-weeks of FEST as well as during both follow-ups. Corroborating TMS results, fMRI imaging data showed M1, as well as sensory, premotor, parietal area, and supplementary motor area activations increased after 12-weeks of FEST and during both follow-ups. While clinical scores did not change considerably, writing test performance indicates mild improvements after FEST. Our results suggest that FEST can effectively increase cortical activations, while writing tests confirmed functional improvements in fine motor function even after chronic TBI. These results demonstrated long-term recovery mechanisms of FEST, which include cortical re-organization or neuroplasticity to improve motors function after neurological injury.

scholarly journals Neuroprosthesis Peroneal Functional Electrical Stimulation in the Acute Inpatient Rehabilitation Setting: A Case Series

2009 ◽  
Vol 89 (5) ◽  
pp. 499-506 ◽  
Author(s):  
Kari Dunning ◽  
Kristy Black ◽  
Andrea Harrison ◽  
Keith McBride ◽  
Susan Israel
Keyword(s):  
Electrical Stimulation ◽  
Case Report ◽  
Functional Electrical Stimulation ◽  
Case Series ◽  
Inpatient Rehabilitation ◽  
Gait Training ◽  
Stroke Recovery ◽  
Gait Symmetry ◽  
The Difference ◽  
Test Distance

Background and Purpose Studies have suggested that peroneal nerve functional electrical stimulation (peroneal FES) during walking improves gait in patients with chronic stroke. The effect of peroneal FES during the acute stages of stroke recovery is not known. The purposes of this case report are: (1) to describe differences between walking with and without a neuroprosthesis during the first few weeks after stroke, (2) to offer a clinical perspective on decision making for the use of peroneal FES during acute rehabilitation, and (3) to determine the feasibility of rehabilitation with peroneal FES neuroprostheses during the acute phases of stroke recovery. Case Description This case report describes 2 patients with different clinical presentations but both receiving inpatient rehabilitation less than 2 weeks after stroke. Each patient received peroneal FES via a neuroprothesis as tolerated while gait training in therapy. Outcomes One patient immediately increased gait speed (128%) and decreased time to perform the Timed “Up & Go” Test (40%) using the neuroprothesis. Both patients immediately increased the 6-Minute Walk Test distance using the neuroprothesis (121% and 101%). The patient who underwent testing with the instrumented walking system also demonstrated improved gait symmetry. After 1 to 3 weeks of using the neuroprothesis, the difference between outcomes with and without the neuroprothesis decreased. Discussion It is possible that peroneal FES delivered through a neuroprosthesis during acute stroke recovery may improve gait outcomes. Research is needed to determine proper duration and timing.

scholarly journals CLINICAL EVALUATION OF FUNCTIONAL ELECTRICAL STIMULATION EFFECTIVENESS OF ANTAGONISTIC MUSCLE GROUPS AT WRIST AND ANKLE IN PATIENTS AFTER ISCHEMIC STROKE IN LONG TERM FOLLOW UP

2021 ◽  
Vol 35 (35) ◽  
pp. 51-60
Author(s):  
Katarzyna Kaczmarek ◽  
Juliusz Huber
Keyword(s):  
Electrical Stimulation ◽  
Ischemic Stroke ◽  
Muscle Strength ◽  
Clinical Evaluation ◽  
Functional Electrical Stimulation ◽  
Post Stroke ◽  
Home Based ◽  
Proprioceptive Neuromuscular Facilitation

Introduction So far, no detailed evaluation of the results of neuromuscular therapy with functional electrical stimulation combined with kinesiotherapy in long-term observation with clinical methods assessing the scale of post-stroke deficits, muscle strength and the severity of the spasticity symptom on the more paresis side has been performed. Aim The aim of this study was to compare results of neuromuscular functional electrical stimulation algorithm (NMFES) associated with a uniform system of kinesiotherapy based mainly on proprioceptive neuromuscular facilitation (PNF) procedures versus the same system of applied kinesiotherapy alone in home-based treatment of ischemic stroke patients in two months follow up. Material and methods The same set of clinical studies has been applied to a group of 25 healthy volunteers once as well as three times (T0- at hospital ward up to 7 days after an incident, T1- after 21 days of treatment at a hospital ward, T2-after 62 days of home-based treatment) to the 50 patients after ischemic stroke divided into two groups, 25 subjects each (NMFES+K and K groups). Evaluation of treatment effects in two groups of patients was performed with NIHSS scale, Lovett’s scale and Ashworth’s scale. Results After 60 days of applied treatment, only patients of the NMFES+K group represented a statistically significant decrease of NIHSS scale score, indicating the retirement of stroke symptoms. The symptom of increased muscle tension evaluated in the Ashwort’s scale in patients of the NMFES+K group significantly decreased but not in patients of K group. The muscle force of extensor muscles of upper and lower extremities significantly increased only in patients of the NMFES+K group. In general, patients from both groups did not present significant abnormalities in sensory perception within dermatomes C5-C7 and L5-S1 on the more paretic side. Conclusions The proposed personalized, safe and controlled in use a NMFES electrostimulation algorithm gives better, and long-lasting functional effects than previously used as a standard, making it a targeted treatment method. In patients after an ischemic stroke, this treatment reduces post-stroke deficits, increases muscle strength, and reduces the severity of the spasticity symptom on the more paralyzed side. Keywords: ischemic stroke, rehabilitation, functional neuromuscular stimulation, proprioceptive neuromuscular facilitation, clinical evaluation

Implanted functional electrical stimulation system for mobility in paraplegia: a follow-up case report

1999 ◽  
Vol 7 (4) ◽  
pp. 390-398 ◽  
Author(s):  
R. Kobetic ◽  
M. Sharma ◽  
R.J. Triolo ◽  
J.P. Uhlir ◽  
C. Bieri ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Case Report ◽  
Functional Electrical Stimulation ◽  
Stimulation System

scholarly journals Brain Abscess Caused by Nocardia: Case Report and Literature Review

2020 ◽  
Author(s):  
Guilherme Finger ◽  
Maria Eduarda Conte Gripa ◽  
Tiago Paczko Bozko Cecchini ◽  
Tobias Ludwig do Nascimento
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Clinical Signs ◽  
Occipital Lobe ◽  
High Morbidity ◽  
Rare Clinical Entity ◽  
Brain Abscesses

AbstractNocardia brain abscess is a rare clinical entity, accounting for 2% of all brain abscesses, associated with high morbidity and a mortality rate 3 times higher than brain abscesses caused by other bacteria. Proper investigation and treatment, characterized by a long-term antibiotic therapy, play an important role on the outcome of the patient. The authors describe a case of a patient without neurological comorbidities who developed clinical signs of right occipital lobe impairment and seizures, whose investigation demonstrated brain abscess caused by Nocardia spp. The patient was treated surgically followed by antibiotic therapy with a great outcome after 1 year of follow-up.

Feasibility and Preliminary Efficacy of Gait Training Assisted by Multichannel Functional Electrical Stimulation in Early Stroke Rehabilitation: A Pilot Randomized Controlled Trial

2021 ◽  
Vol 35 (2) ◽  
pp. 131-144
Author(s):  
Maijke van Bloemendaal ◽  
Sicco A. Bus ◽  
Frans Nollet ◽  
Alexander C. H. Geurts ◽  
Anita Beelen
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Step Length ◽  
Gait Training ◽  
Control Group ◽  
Significant Group ◽  
Gait Symmetry ◽  
Gait Parameters ◽  
Walking Capacity ◽  
Experimental Group

Background. Many stroke survivors suffer from leg muscle paresis, resulting in asymmetrical gait patterns, negatively affecting balance control and energy cost. Interventions targeting asymmetry early after stroke may enhance recovery of walking. Objective. To determine the feasibility and preliminary efficacy of up to 10 weeks of gait training assisted by multichannel functional electrical stimulation (MFES gait training) applied to the peroneal nerve and knee flexor or extensor muscle on the recovery of gait symmetry and walking capacity in patients starting in the subacute phase after stroke. Methods. Forty inpatient participants (≤31 days after stroke) were randomized to MFES gait training (experimental group) or conventional gait training (control group). Gait training was delivered in 30-minute sessions each workday. Feasibility was determined by adherence (≥75% sessions) and satisfaction with gait training (score ≥7 out of 10). Primary outcome for efficacy was step length symmetry. Secondary outcomes included other spatiotemporal gait parameters and walking capacity (Functional Gait Assessment and 10-Meter Walk Test). Linear mixed models estimated treatment effect postintervention and at 3-month follow-up. Results. Thirty-seven participants completed the study protocol (19 experimental group participants). Feasibility was confirmed by good adherence (90% of the participants) and participant satisfaction (median score 8). Both groups improved on all outcomes over time. No significant group differences in recovery were found for any outcome. Conclusions. MFES gait training is feasible early after stroke, but MFES efficacy for improving step length symmetry, other spatiotemporal gait parameters, or walking capacity could not be demonstrated. Trial Registration. Netherlands Trial Register (NTR4762).

scholarly journals Functional electrical stimulation‐assisted cycle ergometry-based progressive mobility programme for mechanically ventilated patients: randomised controlled trial with 6 months follow-up

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-215755
Author(s):  
Petr Waldauf ◽  
Natália Hrušková ◽  
Barbora Blahutova ◽  
Jan Gojda ◽  
Tomáš Urban ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Randomised Controlled Trial ◽  
Functional Electrical Stimulation ◽  
Controlled Trial ◽  
Cycle Ergometry ◽  
Control Group ◽  
Mechanically Ventilated ◽  
Icu Discharge ◽  
Randomised Controlled

PurposeFunctional electrical stimulation-assisted cycle ergometry (FESCE) enables in-bed leg exercise independently of patients’ volition. We hypothesised that early use of FESCE-based progressive mobility programme improves physical function in survivors of critical care after 6 months.MethodsWe enrolled mechanically ventilated adults estimated to need >7 days of intensive care unit (ICU) stay into an assessor-blinded single centre randomised controlled trial to receive either FESCE-based protocolised or standard rehabilitation that continued up to day 28 or ICU discharge.ResultsWe randomised in 1:1 ratio 150 patients (age 61±15 years, Acute Physiology and Chronic Health Evaluation II 21±7) at a median of 21 (IQR 19–43) hours after admission to ICU. Mean rehabilitation duration of rehabilitation delivered to intervention versus control group was 82 (IQR 66–97) versus 53 (IQR 50–57) min per treatment day, p<0.001. At 6 months 42 (56%) and 46 (61%) patients in interventional and control groups, respectively, were alive and available to follow-up (81.5% of prespecified sample size). Their Physical Component Summary of SF-36 (primary outcome) was not different at 6 months (50 (IQR 21–69) vs 49 (IQR 26–77); p=0.26). At ICU discharge, there were no differences in the ICU length of stay, functional performance, rectus femoris cross-sectional diameter or muscle power despite the daily nitrogen balance was being 0.6 (95% CI 0.2 to 1.0; p=0.004) gN/m2 less negative in the intervention group.ConclusionEarly delivery of FESCE-based protocolised rehabilitation to ICU patients does not improve physical functioning at 6 months in survivors.Trial registration numberNCT02864745.

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