Functional Electrical Therapy (FET) of the paretic leg in post-stroke hemiplegics

The inability to walk after stroke is a major limiting factor for normal life. Studies on walking patterns in hemiplegics showed deviations in spatio-temporal, kinematic and kinetic characteristics of walking when compared to able-bodied subjects. Functional Electrical Stimulation could be used to restore the lost functional movements and correct the abnormal gait pattern. We hypothesize that the FET applied in acute post-stroke hemiplegic patients will result in better walking symmetry, faster walking, longer stride, and ability to cover longer distances when compared with conventional walking if applied in acute hemiplegic subjects. FET relates to multichannel surface electrical stimulation of prime movers of hip, knee, and ankle joints of the paretic leg that is timed to match the appropriate phases of the gait cycle during over-ground walking. The objective of this study is to study the effects of FET on the walking abilities of hemiplegic subjects in the acute phase after stroke. The FET comprises multi-channel patterned stimulation of main hip, knee, and ankle movers of the paretic leg. The pattern of stimulation would be controlled so to generate functional movements that contribute to better walking. The pre-programmed sequence of stimulation will be sensory driven in order to allow integration of the stimulation pattern into the modified walking pattern of the user. The walking performance will be compared with the control subjects who receive conventional post-stroke gait training. The FET sessions will be applied five days a week during four consecutive weeks and they will last for 30 minutes, and minimum of 20 minutes of walking. The control group will receive the same number of equal length sessions of over-ground walking. The effects of the FET will be established pre- and post-treatment. The outcome measures are the following: 1) walking speed, 2) energy consumption, and 3) temporal characteristics of paretic and non-paretic leg.