The effect of electromechanical gait trainer combined with functional electrical stimulation for persons in the subacute stage of stroke

Abstract

The purpose of this study was to investigate the effect of electromechanical gait trainer combined with functional electrical stimulation (FES) for persons in the subacute stage of recovery from stroke. The study was a randomized controlled trial design with repeated measures. The dependent variables for this study were: motor strength, mobility, balance, functional ambulation, gait speed, activities of daily living and disability. Fifty-four participants suffered from stroke were recruited for this study. All participants were randomly assigned to the two treatment groups and one control group. Participants in the treatment groups (GT, GT-FES) experienced walking on an electromechanical gait trainer, with or without FES for 20 minutes for 20 sessions, totally 4 weeks. Three repeated measures on the motor and functional limitation were performed before, at the end of training period as well as 6 months follow-up. Data was entered into version 14 of Statistical Package for Social Sciences (SPSS) for analysis. Repeated measure ANOVA showed that no difference was found between the demographic variables for the groups. Significant differences were found between the 'gait trainer' and 'control' groups at the end of the training period in terms of mobility identified on the Elderly Mobility Scale (EMS), functional walking ability identified on the Functional Ambulatory Category (FAC) and gait speed. Improvement in all variables was found across time with an interaction between time and the variables. The FES with gait trainer group has showed better improvement than without FES, but no significant difference could be shown. The effects on both groups could be carried over to six weeks after interventions stopped. This study is the first step in investigating interaction between two known-to-be effective therapeutic modalities for persons recovering from stroke, in a targeted intervention. Future study on large scale and blinded measurement was warranted to further understanding on the ambulatory recovery of stroke patients using an electromechanical gait trainer combined with FES.