Affiliations: [a] Institute for Information Transmission Problems of RAS, Moscow, Russia | [b] Russian Medical State University, Moscow, Russia | [c] Central Clinical Hospital of RAS, Moscow, Russia | [d] IRCCS Fondazione Santa Lucia, Rome, Italy
Correspondence:
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Corresponding author: Dr. Irina Solopova, Laboratory of Neurobiology of Motor Control, Institute for Information Transmission Problems, Russian Academy of Science, Bolshoy Karetny 19, Moscow 127994, Russia. Tel.: +7 495 650 2895; Fax: +7 495 650 0579; E-mail: solopova@iitp.ru
Abstract: Objective:Here we developed and tested a novel system for early motor rehabilitation in acute stroke when patients are unable to stand and walk without assistance. Stepping performance may be largely facilitated by providing treatment in the supine position on a tilt table using step-synchronized functional electrical stimulation (FES) with assisted leg movements and progressive limb loading. Methods:Sixty-one individuals with acute stroke were randomly assigned to two groups, experimental and control. The first group received both a conventional therapy and FES-therapy combined with progressive limb loading, whereas the control group received a conventional therapy only. Changes after treatment were assessed using clinical scores and neurophysiological measurements of movement performance. Results:After treatment, there was an improvement of the clinical scores, muscle forces and everyday life activity performance in both groups, however, significantly higher in the experimental group. Active rhythmic movements of the non paretic leg often provoked muscle activity in the paretic leg as well as there was a reduction of the contralateral leg muscle contraction during paretic leg movements. Conclusion:The developed FES and leg displacement-assisted therapy facilitates a smooth transition to walking in the vertical position and increases the patient’s functional abilities and the effectiveness of rehabilitation.
Keywords: Neuromotor rehabilitation, locomotor movements, EMG patterns, functional electrical stimulation, acute period of stroke
