Article

Loss of neuromuscular control of the ankle joint is a common
impairment in neurologic conditions, leading to abnormal gait and a greater risk
of falling. Limited information, however, is available on the effectiveness of
functional electrical stimulation (FES) on reducing falls, and no studies have
investigated its usefulness in improving lower limbs kinematics related to foot
clearance and energy recovery. SETTING: Clinical setting.
STUDY DESIGN:
Prospective longitudinal study. PARTICIPANTS: Twenty-four subjects, 14 people
with multiple sclerosis (mean age +/- standard deviation 50.93 +/- 8.72 years)
and 10 people with stroke (55.38 +/- 14.55 years). METHODS: The number of falls
was assessed at baseline and after 8 weeks, and a clinical assessment was
performed at the baseline, 4-week, and 8-week time points. A subsample of the 24
subjects comprising 5 people with multiple sclerosis and 5 people with stroke
performed a gait analysis assessment at baseline and after 4 weeks. After
receiving the equipment and the training schedule, subjects performed daily home
walking training using FES for 8 weeks. MAIN OUTCOME MEASUREMENTS: The main
outcomes were (1) the number of falls, (2) foot clearance, and (3) energy
recovery. RESULTS: A reduction in the number of falls was observed from baseline
(n = 10) to the 8-week assessment (n = 2), P = .02. Foot clearance increased
(+5.26 mm, P = .04) between the baseline without FES and at 4 weeks with FES
(total effect). No statistically significant differences were found in energy
recovery between baseline and 4 weeks. CONCLUSIONS: The use of FES had an impact
on gait, specifically reducing the number of falls and improving walking. A
specific effect at the ankle joint was observed, increasing foot clearance during
the swing phase of gait. This effect was not accompanied with a reduction in the
energetic expenditure during walking in subjects with multiple sclerosis and
stroke.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS