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Igarashi T, Tani Y, Hayashi S, Asakura T. Short-term effects of pedaling exercise combined with integrated volitional control electrical stimulation in an older patient hospitalized for subacute stroke: ABA single-case design. J Phys Ther Sci 2023; 35:82-87. [PMID: 36628143 PMCID: PMC9822830 DOI: 10.1589/jpts.35.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/03/2022] [Indexed: 01/01/2023] Open
Abstract
[Purpose] The purpose of this study was to examine effects on gait indices produced by a short-term intervention of pedaling combined with integrated volitional control electric stimulation in an older patient with stroke. [Participant and Methods] This study was a single-case ABA (A-control, B-treatment) design. Each phase lasted four consecutive days (12 days total). Ten minutes of pedaling were performed daily. In Phase B, pedaling was combined with integrated volitional control electric stimulator on the rectus femoris of the affected side. The primary outcomes were the coefficient of variation, a measure of stride time homogeneity during gait; and the root mean square, a measure of trunk sway in the triaxial direction (mediolateral, vertical, anteroposterior) during gait. Assessments were measured before the intervention (day 0) and after the end of each phase (days 4, 8, and 12). [Results] Changes from the previous coefficient of variation were +1.13%, -3.95%, and +0.82% in Phases A, B, and A', respectively, with the greatest improvement occurring after Phase B. The root mean square improved the most with -5.13 for mediolateral after Phase B, -3.33 for vertical, and -6.99 for anteroposterior after Phase A. [Conclusion] A short-term intervention consisting of pedaling combined with integrated volitional control electric stimulation may contribute to the improvement of gait abnormalities.
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Affiliation(s)
- Tatsuya Igarashi
- Physical Therapy Division, Department of Rehabilitation,
Numata Neurosurgery and Cardiovascular Hospital: 8 Sakaemachi, Numata-shi, Gunma 378-0014,
Japan,Corresponding author. Tatsuya Igarashi (E-mail: )
| | - Yuta Tani
- Physical Therapy Division, Department of Rehabilitation,
Numata Neurosurgery and Cardiovascular Hospital: 8 Sakaemachi, Numata-shi, Gunma 378-0014,
Japan
| | - Shota Hayashi
- School of Physical Therapy, Faculty of Health Science,
Gunma Paz College, Japan
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Frazão M, Werlang LA, Azevedo C, Kunz A, Peltz M. Metabolic, ventilatory and cardiovascular responses to FES-cycling: A comparison to NMES and passive cycling. Technol Health Care 2021; 30:909-918. [PMID: 34744034 DOI: 10.3233/thc-213220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cyclergometry with functional electrical stimulation (FES-cycling) is a feasible method for rehabilitation. The concept is to promote exercise induced by depolarization of the motoneuron and muscular contraction. OBJECTIVE To measure acute physiological responses to FES-cycling. METHODS Retrospective study of data from ten healthy volunteers who performed FES-cycling, passive cycling and neuromuscular electrical stimulation (NMES) alone. Metabolic, ventilatory and cardiovascular parameters were analyzed. RESULTS Oxygen uptake enhanced 97 ± 15% during FES-cycling, with medium effect size compared to NMES and large effect size compared to passive cycling. Energy expenditure enhanced 102 ± 15% during FES-cycling, with medium effect size compared to NMES and large effect size compared to passive cycling. Minute ventilation enhanced 115 ± 26% during FES-cycling, with small effect size compared to NMES and medium effect size compared to passive cycling. Cardiac output enhanced 21 ± 4% during FES-cycling, with medium effect size compared to NMES and passive cycling. Arterial - mixed venous oxygen content difference enhanced 60 ± 8% during FES-cycling, with a medium effect size compared to NMES and large effect size compared to passive cycling. CONCLUSIONS FES-cycling enhances metabolic, ventilatory and cardiovascular demands and the physiological responses are higher than NMES and passive cycling.
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Affiliation(s)
- Murillo Frazão
- Lauro Wanderley Hospital, Federal University of Paraíba, João Pessoa, PB, Brazil.,CLINAR Exercise Physiology, João Pessoa, PB, Brazil
| | | | - Cássio Azevedo
- INBRAMED Brazilian Medical Equipment Industry, Porto Alegre, RS, Brazil
| | - Adelar Kunz
- INBRAMED Brazilian Medical Equipment Industry, Porto Alegre, RS, Brazil
| | - Maikel Peltz
- INBRAMED Brazilian Medical Equipment Industry, Porto Alegre, RS, Brazil
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Shariat A, Nakhostin Ansari N, Honarpishe R, Moradi V, Hakakzadeh A, Cleland JA, Kordi R. Effect of cycling and functional electrical stimulation with linear and interval patterns of timing on gait parameters in patients after stroke: a randomized clinical trial. Disabil Rehabil 2021; 43:1890-1896. [PMID: 31707865 DOI: 10.1080/09638288.2019.1685600] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Patients in the chronic phase after a stroke are an underrepresented group in the literature. Therefore, the aim of this study was to compare the effects of cycling and functional electrical stimulation with linear versus interval patterns of timing on gait parameters in patients after stroke. DESIGN A double blinded, parallel, randomized clinical trial. SETTING Neuroscience Institute. PARTICIPANTS Patients with lower limb disability due to stroke (N = 30) with a stroke onset >6 months and <18 months. INTERVENTIONS Twenty-eight minutes of leg cycling with functional electrical stimulation with linear or interval patterns of timing applied to the peroneal and biceps femoris muscles, 3 times/week for 4 weeks. MAIN MEASURES Timed 10-Meter Walk Test and Functional Ambulation Classification were the primary outcome measures. The Modified Modified Ashworth scale, active range of motion, Timed Up and Go Test, and Single Leg Stance Test were the secondary outcome measures. Evaluation was performed at baseline, after 4, and after 8 weeks. RESULTS Thirty participants completed the 4-week intervention (interval group, n = 16; linear group, n = 14). The Functional Ambulation Classification, Timed 10-Meter Walk Test, and the Timed Up and Go Test improved significantly in both groups. The Modified Modified Ashworth scale scores for quadriceps and plantar flexion statistically decreased after 4-weeks in the interval group. Significant group-by-time interaction was shown for Timed Up and Go Test (p = 0.003, np2=0.228), knee flexion active range of motion (p < 0.001, np2=0.256) and dorsiflexion active range of motion (p < 0.001, np2=0.359). Modified Modified Ashworth scale and active range of motion in both the ankle and knee improved significantly in the interval group. CONCLUSIONS The functional electrical stimulation with cycling protocols improved the Functional Ambulation Classification, Timed 10-Meter Walk Test, active range of motion, Timed Up and Go Test, and Modified Modified Ashworth scale. An interval protocol of timing was more effective than the linear protocol in terms of spasticity and active range of motion.Implications for rehabilitationCycling + functional electrical stimulation training with an interval pattern of timing seems superior to cycling + functional electrical stimulation training with a linear pattern.Interval protocol has positive effects on spasticity and range of motion after 12 sessions in patients post stroke.Cycling + functional electrical stimulation improves functional mobility and speed in stroke survivors and the effects of this intervention lasted in follow-up assessment after one month.
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Affiliation(s)
- Ardalan Shariat
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Roshanak Honarpishe
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahideh Moradi
- Department of Orthotics and Prosthetics, Faculty of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
| | - Azadeh Hakakzadeh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ramin Kordi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ha SY, Han JH, Ko YJ, Sung YH. Ankle exercise with functional electrical stimulation affects spasticity and balance in stroke patients. J Exerc Rehabil 2020; 16:496-502. [PMID: 33457385 PMCID: PMC7788250 DOI: 10.12965/jer.2040780.390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/22/2020] [Indexed: 11/22/2022] Open
Abstract
Stroke patients have limited motor function due to ankle spasticity, and various interventions are applied to solve this problem. The purpose of this study was to investigate the effects of functional electrical stimulation (FES) with ankle exercise on spinal cord motor neuron excitability and balance in stroke patients. Twenty-five stroke patients were divided into the three groups. For the intervention, the control group applied general physiotherapy, the experimental group I applied a sham FES with ankle exercise, and the experimental group II applied a FES with ankle exercise. All groups applied the intervention for 30 min per session, 5 times a week, for a total of 8 weeks. The functional reaching test (FRT), Timed Up and Go test was used to measure balance ability, and H-reflex was used to measure spinal motor neuron excitability. All tests were measured before and after the intervention. In the ankle exercise with FES group, spinal motor neuron excitability significantly decreased (P<0.05), and FRT was significantly increased (P<0.05). Therefore, FES with ankle exercise for stroke patients could be suggested as an effective intervention for improving motor function.
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Affiliation(s)
- Sun-Young Ha
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea
| | - Jun-Ho Han
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea
| | - Young Jun Ko
- Major in Sport Service Practice, College of Welfare Covergence, Kangnam University, Yongin, Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon, Korea.,Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon, Korea
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Glue C, Haveron R, Smith ML, Thiagarajan P, Edwards H, Mulligan H, Wilkinson A. Six-minute walk test values for people with and without long-term conditions in relation to the Walk Score ®: a scoping review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1832719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Caitlin Glue
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Rowan Haveron
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Megan-Li Smith
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Pranav Thiagarajan
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Heather Edwards
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Hilda Mulligan
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Amanda Wilkinson
- Centre for Health, Activity, and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Functional Electrical Stimulation Cycling Exercise for People with Multiple Sclerosis. Curr Treat Options Neurol 2019; 21:54. [PMID: 31705304 DOI: 10.1007/s11940-019-0597-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW There has been substantial interest in the role of exercise for managing impairments, limitations, and disability progression among persons with multiple sclerosis (MS). Despite established benefits of exercise training for persons who have mild-to-moderate MS, the ability to deliver exercise to persons who experience higher disability remains challenging. One promising approach for exercise in this population is functional electrical stimulation (FES) cycling. This review provides a summary of the current evidence for FES cycling as an exercise training modality in persons with MS with respect to prescription, safety, tolerability, and acute and chronic effects. RECENT FINDINGS We searched the literature for studies involving FES cycling exercise in persons with MS published in English up until July 2019. Eight studies were retrieved: two studies examined acute effects, two studies examined chronic effects, and four studies reported on both acute and chronic effects of FES cycling exercise. The overall quality of the studies was low, with only one, small, randomized controlled trial (RCT). There is limited but promising evidence for the application of FES cycling exercise among persons with MS who have moderate-to-severe disability. Participants were capable of engaging in regular FES cycling exercise (~ 30 min, 2-3×/week), with few, mild adverse events experienced. Preliminary evidence from small, mostly uncontrolled trials supports the potential benefits of FES cycling on physiological fitness, walking mobility, and symptoms of fatigue and pain. High-quality RCTs of FES cycling exercise are necessary for providing recommendations for integrating exercise training in the management of advanced MS.
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Iyanaga T, Abe H, Oka T, Miura T, Iwasaki R, Takase M, Isatake M, Doi A. Recumbent cycling with integrated volitional control electrical stimulation improves gait speed during the recovery stage in stroke patients. J Exerc Rehabil 2019; 15:95-102. [PMID: 30899743 PMCID: PMC6416497 DOI: 10.12965/jer.1836500.250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/09/2018] [Indexed: 12/05/2022] Open
Abstract
The purpose of this study was to investigate the effect of recumbent cycling with integrated volitional control electrical stimulation (IVES) on gait ability in stroke patients. Six stroke patients (all male; average age, 55.7±8.3 years) participated. Recumbent cycling (R-cycling) was performed with and without IVES in the power assist (IVES-P) mode. The targeted muscle for electrostimulation was the tibialis anterior. Patients performed 10 min of IVES-P mode plus R-cycling (program A) or R-cycling alone (program B), once per day, 5 times per week. Patients completed two sets of each program, alternating between programs each week. Gait speed and the number of steps numbers on a 10-m walking test was assessed before and after each interventional session. Program A improved gait speed, but not the number of steps, to a greater extent than that in program B. Specifically, the combined intervention significantly improved gait speed in the first set, but not the second set of the intervention. R-cycling with IVES-P mode improved gait speed during the recovery stage in stroke patients to a greater extent than that achieved with R-cycling alone. Thus, this combined therapy has potential as a standardized treatment in the field of rehabilitation medicine.
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Affiliation(s)
- Takuya Iyanaga
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Hayata Abe
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Takashi Oka
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Tetsuya Miura
- Department of Rehabilitation, Tsutsumi Hospital, Fukuoka, Japan
| | - Rumiko Iwasaki
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Mai Takase
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Minoru Isatake
- Department of Rehabilitation, Fukuoka Seisyukai Hospital, Fukuoka, Japan.,Center of Advanced Rehabilitation "HOPE", Fukuoka Seisyukai Hospital, Fukuoka, Japan
| | - Atsushi Doi
- Department of Rehabilitation, Faculty of Health Science, Kumamoto Health Science University, Kumamoto, Japan.,Division of Health Sciences, Graduate School of Health Sciences, Kumamoto Health Science University, Kumamoto, Japan
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