Effects of dorsiflexor functional electrical stimulation compared to an ankle/foot orthosis on stroke-related genu recurvatum gait.

[Purpose] We evaluated the effects of functional electrical stimulation (FES) and an ankle/foot orthosis (AFO) in hemiplegic patients exhibiting excessive plantar flexion during the stance phase, associated with genu recurvatum. [Participants and Methods] In total, 12 stroke patients were recruited. We measured changes in knee and ankle joint angles, gait speed, and step and stride length during the gait cycle during barefoot walking, walking while wearing an AFO, and walking after FES application; we used a three dimensional gait analysis system. [Results] In terms of kinematic variables, FES walking was associated with significant increases in peak ankle dorsiflexion during swing, dorsiflexion angle at initial contact, peak ankle dorsiflexion during stance, knee angle at initial contact, and peak knee flexion in the loading response compared to AFO and barefoot walking. AFO walking was associated with a significant difference in peak ankle dorsiflexion during swing compared to barefoot walking. [Conclusion] FES afforded kinematic advantages to the ankle and knee joints compared to AFO in hemiplegic patients with a genu recurvatum gait.

Effects of non-paretic arm movements during bridge exercises on trunk muscle activity in stroke patients.

[Purpose] The purpose of this study was to determine the effects of non-paretic arm movement during the bridge exercise on trunk muscle activity in stroke patients. [Participants and Methods] In total, 18 stroke patients were recruited. Surface EMG electrodes were attached over the trunk muscles (rectus abdominis, RA; internal oblique, IO; erector spinae, ES), and three kinds of bridge exercises were performed: 1) 'standard' bridge, 2) bridge with unilateral isometric arm flexion, and 3) bridge with unilateral isometric arm horizontal abduction. [Results] According to the activity of the trunk muscles measured during bridge exercises, only the IO and ES showed significantly greater muscle activity during bridges with isometric arm horizontal abduction and flexion than during the standard bridge. Additionally, comparison of the paretic and non-paretic sides showed that muscle activity was higher on the paretic side. [Conclusion] This study showed that, as an exercise to heighten the activity of the trunk muscles in stroke patients, bridge exercises with accompanying non-paretic arm flexion and horizontal abduction were more effective clinically than a standard bridge.