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Sensory electrical stimulation improves foot placement during targeted stepping post-stroke. Exp Brain Res 2014 Apr;232(4):1137-43

Date

01/23/2014

Pubmed ID

24449007

Pubmed Central ID

PMC4448948

DOI

10.1007/s00221-014-3823-2

Abstract

Proper foot placement is vital for maintaining balance during walking, requiring the integration of multiple sensory signals with motor commands. Disruption of brain structures post-stroke likely alters the processing of sensory information by motor centers, interfering with precision control of foot placement and walking function for stroke survivors. In this study, we examined whether somatosensory stimulation, which improves functional movements of the paretic hand, could be used to improve foot placement of the paretic limb. Foot placement was evaluated before, during, and after application of somatosensory electrical stimulation to the paretic foot during a targeted stepping task. Starting from standing, twelve chronic stroke participants initiated movement with the non-paretic limb and stepped to one of five target locations projected onto the floor with distances normalized to the paretic stride length. Targeting error and lower extremity kinematics were used to assess changes in foot placement and limb control due to somatosensory stimulation. Significant reductions in placement error in the medial-lateral direction (p = 0.008) were observed during the stimulation and post-stimulation blocks. Seven participants, presenting with a hip circumduction walking pattern, had reductions (p = 0.008) in the magnitude and duration of hip abduction during swing with somatosensory stimulation. Reductions in circumduction correlated with both functional and clinical measures, with larger improvements observed in participants with greater impairment. The results of this study suggest that somatosensory stimulation of the paretic foot applied during movement can improve the precision control of foot placement.

Author List

Walker ER, Hyngstrom AS, Schmit BD

Authors

Allison Hyngstrom PhD Associate Professor in the Physical Therapy department at Marquette University
Brian Schmit PhD Professor in the Biomedical Engineering department at Marquette University




MESH terms used to index this publication - Major topics in bold

Electric Stimulation
Evoked Potentials, Somatosensory
Female
Foot
Gait
Humans
Male
Middle Aged
Recovery of Function
Stroke