A Randomized Controlled Trial of Functional Neuromuscular Stimulation in Chronic Stroke Subjects

<p> <p id="x-x-p-1"> <strong> <em> Background and Purpose&mdash; </em> </strong> Conventional therapies fail to restore normal gait to many patients after stroke. The study purpose was to test response to coordination exercise, overground gait training, and weight-supported treadmill training, both with and without functional neuromuscular stimulation (FNS) using intramuscular (IM) electrodes (FNS-IM). <p id="x-x-p-2"> <strong> <em> Methods&mdash; </em> </strong> In a randomized controlled trial, 32 subjects (&gt;1 year after stroke) were assigned to 1 of 2 groups: FNS-IM or No-FNS. Inclusion criteria included ability to walk independently but inability to execute a normal swing or stance phase. All subjects were treated 4 times per week for 12 weeks. The primary outcome measure, obtained by a blinded evaluator, was gait component execution, according to the Tinetti gait scale. Secondary measures were coordination, balance, and 6-minute walking distance. <p id="x-x-p-3"> <strong> <em> Results&mdash; </em> </strong> Before treatment, there were no significant differences between the 2 groups for age, time since stroke, stroke severity, and each study measure. FNS-IM produced a statistically significant greater gain versus No-FNS for gait component execution ( <em> P </em> =0.003; parameter estimate 2.9; 95% CI, 1.2 to 4.6) and knee flexion coordination ( <em> P </em> =0.049). <p id="x-x-p-4"> <strong> <em> Conclusion&mdash; </em> </strong> FNS-IM can have a significant advantage versus No-FNS in improving gait components and knee flexion coordination after stroke. </p> </p> </p> </p></p>