Functional electrical stimulation of dorsiflexor muscle: effects on dorsiflexor strength, plantarflexor spasticity, and motor recovery in stroke patients.
OBJECTIVE
To evaluate the therapeutic effects of Functional Electrical Stimulation (FES) of the tibialis anterior muscle on plantarflexor spasticity, dorsiflexor strength, voluntary ankle dorsiflexion, and lower extremity motor recovery with stroke survivors.


METHODS
We conducted a prospective interventional study.


METHODS
Rehabilitation ward, physiotherapy unit and gait analysis laboratory.


METHODS
Fifty-one patients with foot drop resulting from stroke.


METHODS
The functional electrical stimulation (FES) group (n=27) received 20-30 minutes of electrical stimulation to the peroneal nerve and anterior tibial muscle of the paretic limb along with conventional rehabilitation program (CRP). The control group (n=24) treated with CRP only. The subjects were treated 1 hr per day, 5 days a week, for 12 weeks.


METHODS
Plantarflexor spasticity measured by modified ashworth scale (MAS), dorsiflexion strength measured by manual muscle test (MMT), active/passive ankle joint dorsiflexion range of motion, and lower-extremity motor recovery by Fugl-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 group and 21.2% in control group (P< 0.05), between the beginning and end of the trial. Dorsiflexor muscle strength was increased significantly by 56.6% and 27.7% in the FES group and control group, respectively. Similarly, voluntary ankle dorsiflexion and lower-extremity motor function improved significantly in both the groups. No significant differences were found in the baseline measurements among groups. When compared with control group, a significant improvement (p< 0.05) was measured in all assessed parameters in the FES group at post-treatment assessment, thus FES therapy has better effect on recovery process in post-stroke rehabilitation.


CONCLUSIONS
Therapy combining FES and conventional rehabilitation program was superior to a conventional rehabilitation program alone, in terms of reducing spasticity, improving dorsiflexor strength and lower extremity motor recovery in stroke patients.
School of Medical Science & Technology, Indian Institute of Technology, Kharagpur, India. ssabut@iitkgp.ac.in
Sukanta K
SK
Sabut
Chhanda
C
Sikdar
Ratnesh
R
Kumar
Manjunatha
M
Mahadevappa
D000328:Adult; D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000628:therapy*; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000628:therapy*; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D011446:Prospective Studies; D020127:Recovery of Function; D020521:Stroke / Q000628:therapy*; D016896:Treatment Outcome