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The Bilateral Effect of FES on Hemiplegic Gait

May 03, 2019

Slow, inefficient gait with abnormal gait parameters are common findings when assessing walking post stroke. While loss of affected limb foot strike angle is a common finding we may additionally see compensatory change where foot strike angle in the non affected limb is similarly abnormal.

Example 2 graph (grey area= normal range)  illustrates the bilateral change in foot strike angle in a hemiplegic subject where, on initial assessment, the non affected limb is similar to the affected (far left column set). With application of FES, (column sets 2,3,4) foot strike angle of affected & non affected  limb improves and approaches normal  (grey area on graph).

Withdrawal of FES (far right column set) shows the immediate carry over effect from FES with decreased but improved foot strike angle bilaterally.

This example illustrates a valuable outcome of gait retraining with FES where non-affected limb as well as affected limb kinematics are improved & where a carry over effect when walking without FES is also seen.  FES should be considered for its potential to normalize gait parameters bilaterally during application & for its potential to additionally improve gait symmetry & parameters post application..

 

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