Article

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. DESIGN: We conducted a prospective interventional
study. SETTING: Rehabilitation ward, physiotherapy unit and gait analysis
laboratory. PARTICIPANTS: Fifty-one patients with foot drop resulting from
stroke. Intervention: 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. MAIN OUTCOME MEASURES:
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.

Langue : ANGLAIS