Combined user-driven treadmill control and functional electrical stimulation increases walking speeds poststroke.
J Biomech
; 124: 110480, 2021 07 19.
Article
em En
| MEDLINE
| ID: mdl-34126560
ABSTRACT
The variety of poststroke impairments and compensatory mechanisms necessitate adaptive and subject-specific approaches to locomotor rehabilitation. To implement subject-specific, adaptive training to treadmill-based gait training, we developed a user-driven treadmill (UDTM) control algorithm that adjusts the user's speed in real-time. This study examines the response of individuals poststroke to the combination of UDTM control and electrical stimulation of the paretic ankle musculature to augment forward propulsion during walking. Sixteen individuals poststroke performed a randomized series of walking tasks on an instrumented split-belt treadmill at their self-selected speeds 1) with fixed speed treadmill (FSTM) control only, 2) FSTM control and paretic limb functional electrical stimulation (FES), 3) UDTM control only, and 4) UDTM control and FES. With UDTM control and FES, participants selected speeds that were 0.13 m/s faster than their speeds with fixed speed control only. This instantaneous increase is comparable to the gains in SS speed seen after 12 weeks of training with FES and fast walking with fixed speed treadmill control by Kesar and colleagues (Δ = 0.18 m/s). However, we saw no significant differences in the corresponding push-off forces or trailing limb position. Since individuals can use a variety of strategies to change their walking speeds, it is likely that the differences among individual responses obscured trends in the group average changes in mechanics. Ultimately, the combination of UDTM control and functional electrical stimulation (FES) allows individuals to increase speeds after a short exposure and may be a beneficial addition to poststroke gait training programs.
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Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Acidente Vascular Cerebral
/
Reabilitação do Acidente Vascular Cerebral
Tipo de estudo:
Clinical_trials
Limite:
Humans
Idioma:
En
Revista:
J Biomech
Ano de publicação:
2021
Tipo de documento:
Article