Article

OBJECTIVE: To determine whether functional electrical stimulation (FES)-assisted
active cycling is more effective than active cycling without FES concerning
walking and balance. Specifically, walking ability was classified as to the
amount of personal assistance needed to be able to walk and balance was evaluated
for static and dynamic balance tasks. DESIGN: Monocentric, randomized,
single-blinded, controlled trial. SETTING: Neurologic rehabilitation hospital.
PARTICIPANTS: Patients with severe hemiparesis due to stroke (N=40).
INTERVENTIONS: Twenty minutes of active leg cycling with or without FES applied
to the paretic vastus medialis and rectus femoris of quadriceps and to the biceps
femoris and semitendinosus muscles, 3 times/wk for 4 weeks. MAIN OUTCOME
MEASURES: Functional ambulation classification (FAC) and performance-oriented
mobility assessment (POMA) were the primary outcome measures. The leg subscale of
the motricity index (MI) and the modified Ashworth scale were the secondary
outcome measures. Evaluation was done before and after the intervention period
and after an additional 2 weeks. RESULTS: After the intervention, the FAC, POMA,
and the MI (P<.016) for both intervention groups improved significantly. The FAC
of the control group increased by a median of 1 category and that of the FES
group by 2 categories. The median change in POMA was 2 and 4 points for the
control group and the FES group, respectively. The Mann-Whitney U test
between-group comparisons revealed that these gains were significantly better in
the FES group for both the FAC (U=90; z=-2.58; P=.013; r=-.42) and the POMA
(U=60; z=-3.43; P<.0004; r=-.56). Because of missing data and slightly decreased
effect sizes during the follow-up phase (FAC, r=-.33; POMA, r=-.41), differences
did not reach statistically significant P values. The MI leg subscale showed
significant improvements in both groups. However, there were no significant
differences between the groups at any time. No changes were observed on the
modified Ashworth scale. CONCLUSIONS: FES-assisted active cycling seems to be a
promising intervention during rehabilitation in patients with stroke.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS