Effects of Combination of Functional Electric Stimulation and Robotic Leg Movement Using Dynamic Tilt Table on Walking Characteristics in Post-Stroke Patients with Spastic Hemiplegia: A Randomized Crossover-Controlled Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Research Design
2.2. Study Participants
2.3. Study Protocol
2.4. Intervention
2.5. Measured Variables
2.6. Sample Size Estimates
2.7. Statistical Analysis
3. Results
3.1. Participant Flowchart
3.2. Results of 10 m Walking Test
3.3. Changes in Range of Motion, Fugl–Meyer Assessment Score, and Modified Ashworth Scale
3.4. Current Intensity
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
References
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Factor | Overall (n = 20) | A (n = 9) | B (n = 11) |
---|---|---|---|
Age (years) | 73 [31, 89] | 72 [31, 84] | 74 [55, 89] |
Sex: Male, Female | 8, 12 | 4, 5 | 4, 7 |
Body height (m) | 1.53 [1.39, 1.74] | 1.57 [1.41, 1.74] | 1.52 [1.39, 1.73] |
Body weight (kg) | 51.85 [43, 80] | 51.80 [44.5, 80] | 53.80 [43, 77.7] |
Affected side: Right, Left | 10, 10 | 4, 5 | 6, 5 |
Lesion: Hemorrhagic, Ischemic | 12, 8 | 6, 3 | 6, 5 |
Use of orthotics (%) | 8 (40.0) | 4 (44.4) | 4 (36.4) |
mRS score | 2.00 [1, 4] | 2.00 [1, 3] | 2.00 [1, 4] |
MAS score on affected side (0/1/1+/2/3/4) | |||
Knee extension | 17/2/1/0/0/0 | 6/2/1/0/0/0 | 11/0/0/0/0/0 |
Knee flexion | 10/3/7/0/0/0 | 4/1/4/0/0/0 | 6/2/3/0/0/0 |
Ankle dorsiflexion | 0/1/10/5/4/0 | 0/1/2/3/3/0 | 0/0/8/2/1/0 |
Ankle plantar flexion | 19/0/0/1/0/0 | 8/0/0/1/0/0 | 11/0/0/0/0/0 |
Stepping + FES Group | Stepping Group | Mixed Effect Model | ||||
---|---|---|---|---|---|---|
Mean [95%CIs] | p-Value | Mean [95%CIs] | p-Value | Coeff [95%CIs] | p-Value | |
10 m walking time (s) | −1.35 [−0.59, −2.12] | 0.001 | −0.59 [0.62, −1.80] | 0.318 | −0.68 [0.57, −1.88] | 0.306 |
10 m walking steps (step) | −1.02 [0.00, −2.05] | 0.05 | 0.17 [1.48, −1.13] | 0.783 | −1.18 [−0.09, −2.18] | 0.026 |
10 m walking speed (m/s) | 0.10 [0.14, 0.06] | <0.001 | 0.08 [0.12, 0.04] | <0.001 | −0.02 [−0.04, 0.00] | 0.048 |
Cadence (step/min) | 6.69 [3.05, 10.32] | 0.001 | 7.84 [4.72, 10.97] | <0.001 | −1.38 [2.35, −5.08] | 0.461 |
Stepping + FES Group | Stepping Group | Mixed Effect Model | ||||||
---|---|---|---|---|---|---|---|---|
Before | After | p Value | Before | After | p Value | 95%Coefficient Interval | p Value | |
ROM (degree) | ||||||||
Knee extension | 2.75 ± 3.02 | 3.75 ± 3.19 | 0.042 | 2.00 ± 4.10 | 3.00 ± 4.10 | 0.214 | 0.16 [1.51, −1.15] | 0.817 |
Knee flexion | 148.5 ± 9.1 | 148.8 ± 9.2 | 0.666 | 147.5 ± 8.4 | 149.2 ± 7.8 | 0.015 | −1.50 [0.13, −3.38] | 0.089 |
Ankle dorsiflexion (knee extension position) | 4.25 ± 7.12 | 10.25 ± 8.03 | <0.001 | 4.75 ± 5.50 | 10.25 ± 5.95 | <0.001 | 0.34 [2.39, −1.86] | 0.748 |
Ankle dorsiflexion (knee flexion position) | 17.25 ± 9.52 | 24.25 ± 8.63 | <0.001 | 16.00 ± 7.88 | 22.00 ± 8.01 | <0.001 | 1.22 [3.75, −1.25] | 0.343 |
Ankle plantar flexion | 58.75 ± 11.68 | 61.75 ± 7.48 | 0.062 | 60.25 ± 7.16 | 63.00 ± 7.68 | 0.001 | −0.18 [2.50, −2.71] | 0.892 |
Ankle inversion | 48.25 ± 11.84 | 53.50 ± 8.44 | 0.007 | 45.25 ± 10.94 | 45.75 ± 9.22 | 0.776 | 6.39 [9.86, 2.69] | <0.001 |
Ankle eversion | 4.75 ± 10.19 | 9.00 ± 8.37 | 0.009 | 4.50 ± 6.26 | 8.25 ± 5.20 | 0.001 | 0.74 [3.59, −1.92] | 0.612 |
FMA Score | 23.90 ± 4.68 | 25.65 ± 4.74 | 0.001 | 24.20 ± 5.34 | 26.10 ± 4.42 | 0.001 | −0.11 [0.94, −1.17] | 0.834 |
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Ueda, K.; Umemoto, Y.; Kamijo, Y.-i.; Sakurai, Y.; Araki, S.; Ise, M.; Yoshioka, I.; Banno, M.; Mochida, S.; Iwahashi, T.; et al. Effects of Combination of Functional Electric Stimulation and Robotic Leg Movement Using Dynamic Tilt Table on Walking Characteristics in Post-Stroke Patients with Spastic Hemiplegia: A Randomized Crossover-Controlled Trial. J. Clin. Med. 2022, 11, 6911. https://doi.org/10.3390/jcm11236911
Ueda K, Umemoto Y, Kamijo Y-i, Sakurai Y, Araki S, Ise M, Yoshioka I, Banno M, Mochida S, Iwahashi T, et al. Effects of Combination of Functional Electric Stimulation and Robotic Leg Movement Using Dynamic Tilt Table on Walking Characteristics in Post-Stroke Patients with Spastic Hemiplegia: A Randomized Crossover-Controlled Trial. Journal of Clinical Medicine. 2022; 11(23):6911. https://doi.org/10.3390/jcm11236911
Chicago/Turabian StyleUeda, Koki, Yasunori Umemoto, Yoshi-ichiro Kamijo, Yuta Sakurai, Shohei Araki, Masato Ise, Izumi Yoshioka, Motohiko Banno, Satoshi Mochida, Takaya Iwahashi, and et al. 2022. "Effects of Combination of Functional Electric Stimulation and Robotic Leg Movement Using Dynamic Tilt Table on Walking Characteristics in Post-Stroke Patients with Spastic Hemiplegia: A Randomized Crossover-Controlled Trial" Journal of Clinical Medicine 11, no. 23: 6911. https://doi.org/10.3390/jcm11236911