FES for abnormal movement of upper limb during walking in post-stroke subjects

Article type: Research Article

Authors: Chou, C.-H.^a | Hwang, Y.-S.^{a; 1} | Chen, C.-C.^{b; 1} | Chen, S.-C.^{c; 1} | Lai, C.-H.^{c; 1} | Chen, Y.-L.^{d; e; *}

Affiliations: [a] Department of Electronic Engineering, National Taipei University of Technology, Taipei, Taiwan | [b] Department of Management Information System, Hwa Hsia University of Technology, Taipei, Taiwan | [c] Department of Physical Medicine & Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan | [d] Department of Digital Technology Design, National Taipei University of Education, Taipei, Taiwan | [e] Department of Information Management, Nursing and Management College, Yilan, Taiwan

Correspondence: [*] Correspondence author: Y.-L. Chen, No.134, Sec.2, Heping E. Rd., Da-an District, Taipei City 106, Taiwan. Tel.: +886 2 2732 1104; Fax: +886 2 6639 6688; E-mail: allen@tea.ntue.edu.tw.

Note: [1] These authors contributed equally to this study and should all be considered first authors.

Abstract: Background:Hemiplegia can cause accidental falls, as the patients place their arms in front of their chests or next to the hips when they walk. This is due to limitations in the ability to swing their arms during walking. Objective:This study proposes a functional electrical stimulator approach in order to improve the foot drop and abnormal movement of the upper limbs during walking. The goal of this study is to verify the feasibility of improving the foot drop and arm swing problems of hemiplegic patients using electrical stimulators in a clinical trial. Methods:The present study utilizes a functional electrical stimulator found on the market. The stimulator is controlling the gait and arm swing of the patient while the patient is walking. It can help him or her restore regular gait cycles and arm swings. The FES device can also train the patient to walk safely and regain control of his or her arm swing. After the four-week training, the subjects had to walk 10 meters without the FES system. The step length, step time, and joint goniograms were recorded in order to determine whether there was any improvement. Results:After the four-week training was concluded, the three post-stroke patients showed an improvement in arm swing angle when walking. The improvement was found to be 7.16% in the first patient, 43.06% in the second, and 54.66% in the third. These results are all statistically significant. The t-test had a p-value 0.012 (p < 0.05), which demonstrated that the method used in the present study had the potential to significantly improve the arm swing of post-stroke patients. Conclusions:The present study showed that a traditional foot drop functional electrical stimulator providing stimulation also to the patient's upper limbs, while being triggered by a foot switch under his or her heel, can help the patient to swing the arms and reduce the foot drop. The method has significant effect on traditional foot drop therapy. The subjects' high degree of acceptance and willingness to commit to long-term use showed that the method is indeed worthy of further research.

Keywords: Functional electrical stimulation, gait analysis, drop foot, hemiplegia, goniometter

DOI: 10.3233/THC-140836

Journal: Technology and Health Care, vol. 22, no. 5, pp. 751-758, 2014