title: A randomized controlled trial of functional neuromuscular stimulation in chronic stroke subjects.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  FNS-IM can have a significant advantage versus No-FNS in improving gait components and knee flexion coordination after stroke.
authors.affiliation: Department of Neurology, Case Western Reserve University, School of Medicine, Cleveland, Ohio, USA. jjd17@case.edu
authors.forename: Janis J
authors.initials: JJ
authors.lastname: Daly
authors.forename: Kristen
authors.initials: K
authors.lastname: Roenigk
authors.forename: John
authors.initials: J
authors.lastname: Holcomb
authors.forename: Jean M
authors.initials: JM
authors.lastname: Rogers
authors.forename: Kristen
authors.initials: K
authors.lastname: Butler
authors.forename: Jennifer
authors.initials: J
authors.lastname: Gansen
authors.forename: Jessica
authors.initials: J
authors.lastname: McCabe
authors.forename: Eric
authors.initials: E
authors.lastname: Fredrickson
authors.forename: E Byron
authors.initials: EB
authors.lastname: Marsolais
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ruff
mesh_terms: D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D004566:Electrodes; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000534:rehabilitation / Q000628:therapy; D026741:Physical Therapy Modalities; D020521:Stroke / Q000628:therapy; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome