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Rivista di Medicina Fisica e Riabilitativa dopo Eventi Patologici
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Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
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European Journal of Physical and Rehabilitation Medicine 2008 Giugno;44(2):159-67
Cycling induced by functional electrical stimulation improves the muscular strength and the motor control of individuals with post-acute stroke. Europa Medico-physica-SIMFER 2007 Award Winner
Ferrante S. 1, Pedrocchi A. 1, Ferrigno G. 1, Molteni F. 2
1 Neuroengineering and Medical Robotics Laboratory Bioengineering Department Politecnico of Milan, Milan, Italy
2 Villa Beretta Rehabilitation Centre, Valduce Hospital Costamasnaga, Lecco, Italy
Aim. The aim of this study was to investigate the effectiveness of cycling induced by functional electrical stimulation (FES) in patients with postacute stroke.
Methods. Twenty postacute inpatients were recruited and were randomly shared in a control group (56±9.2 years old, 50.8±24.5 days post-stroke) performing the standard rehabilitation (SR) and a FES group (51±12 years old, 56.1±22.8 days post-stroke) performing FES cycling in addition to SR. Both the groups performed 3 hours of rehabilitation per day for 4 weeks. The FES cycling was applied daily for 35 minutes and quadriceps, hamstring, gluteus maximus and tibialis anterior of both the legs were stimulated. The two groups were compared by the following outcome measurements before and after treatment: maximum isometric voluntary contraction (MVC) of quadriceps, walking and sit-to-stand ability, motricity index, upright motor control test and trunk control test.
Results. After the treatment, the U-Mann-Whitney test demonstrated that the FES group produced a significantly higher increase of the muscular force produced by both the quadriceps during MVC with respect to the control group (P<0.05). Seventy percent of FES patients learned how to perform the sit to stand movement with three different rising speeds while no control patients develop the ability to perform the task properly.
Conclusion. Rehabilitation including FES cycling was more effective in promoting muscle strength and motor recovery of the lower extremity than therapist-assisted SR alone. Tests on an enlarged number of patients are necessary for generalization before proposing FES cycling in the clinical rehabilitation of post-acute stroke patients.