Résumé
Functional Electrical Stimulation (FES) facilitates ambulatory function after paralysis by activating the muscles of the lower extremities. The FES-assisted stepping can either be triggered by a heel-switch, or by an electromyogram (EMG)-based gait event detector. A group of six chronic (>6 months post-stroke) hemiplegic stroke survivors underwent transcutaneous FES-assisted training for 1 hour on stepping task with EMG biofeedback from paretic tibialis anterior (TA) and medial gastrocnemius (GM) muscles, where the stimulation of the paretic TA or GM was triggered with surface EMG from the same muscle. During the baseline, post-intervention, and 2-day-post-intervention assessments, a total of 5 minutes of surface EMG was recorded from paretic GM and TA muscles during volitional treadmill walking. Two-way ANOVA showed significant effects in terms of p-values for the 6 stroke subjects, 0.002, the 3 assessments, 0, and the interaction between subjects and assessments, 6.21e-19. The study showed a significant improvement from baseline in paretic GM and TA muscle coordination during volitional treadmill walking. The observational gait analysis showed improvement in ankle plantarflexion during late stance, knee flexion and ground clearance of the foot during swing phase.