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Influence of functional electrical stimulation of the hamstrings on knee kinematics in stroke survivors walking with stiff knee gait

OBJECTIVE: To explore whether functional electrical stimulation of the hamstrings
results in improved knee kinematics in chronic stroke survivors walking with a
stiff knee gait. DESIGN: Quasi-experimental. SUBJECTS:
Sixteen adult chronic
stroke survivors. METHODS: Survivors received functional electrical stimulation
of the hamstrings, 3 times a week for 1 h during a period of 5 weeks. 3D
kinematics was calculated before the training period and after 5 weeks of
training. Knee kinematics of walking without stimulation before the training
period was compared with walking with stimulation after 5 weeks of training.
(intervention effect). In addition, knee kinematics of walking without
stimulation before the training period was compared with walking without
stimulation after the training period (therapeutic effect). RESULTS: The
intervention effect showed a significant increase, of mean 8.7 degrees (standard
deviation (SD) 8.3, p = 0.001), in peak knee flexion. The therapeutic effect
showed a significant increase in peak knee flexion, of mean 3.1 degrees (SD 4.7,
p = 0.021) Conclusion: The results of this exploratory study suggest an increase
in knee kinematics in swing after functional electrical stimulation of the
hamstrings in stroke survivors walking with a stiff knee gait. The largest
improvement in peak knee flexion in swing was seen when participants walked with
hamstring stimulation. Participants with low neurological impairment responded
better to hamstring stimulation, and there are indications that the effect of
hamstring stimulation can be predicted during a single session. The effect of
functional electrical stimulation is comparable to that of more invasive
treatment options, such as botulinum toxin or soft-tissue surgery. This makes
functional electrical stimulation a feasible treatment option for daily clinical practice.

Langue : ANGLAIS

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