Effectiveness of functional electrical stimulation on functional recovery of the lower extremity in subject with early stroke: a randomized controlled trial

Objective: To assess the efficacy of functional electrical stimulation (FES) in enhancing functional recovery of the lower extremity in subjects with acute stroke. Method: In a randomized controlled trial, 37 subjects with first stroke were randomly assigned into 2 groups: FES group or control group. The electrodes of the FES group(n=19) were applied on the motor point of the tibial muscle, peroneal muscle and peroneus brevis. The stimulation current intensity was set to produce full ankle extension with a duty cycle of 5 seconds on and 5 seconds off. The stimulus pulse was a symmetric biphasic waveform with amplitude ranging between 0 to 90mA, frequency 30Hz, pulse width of 200ms, and rise and fall time of 2s each. The current amplitude was adjusted to meet subject′s comfort. It lasted for 30 minutes per day, 5 days per week for 3 weeks. All subjects in the 2 groups received standard rehabilitation program. Measurements included composite spasticity scale(CSS) for the ankle planter flexors, Fugl-Meyer motor assessment(FMA) for the lower extremity, Postural Assessment Scale for Stroke patients(PASS) and Berg Balance Scale(BBS) for stability. Measurements were recorded before and after 2 and 3 weeks of treatment. Result: Before treatment, there were no significant differences between the two groups for age, time post-stroke, stroke severity, and the baseline of measurements. After 2 and 3 weeks of treatment, the percentage of CSS score in the FES group was 8.9%±23.2% and 10.4%±18.3%, which was significantly lower than the control group (36.3%±47.3% and 47.7%±56.4%).The percentage of FMA score in the FES group was 105.5%±75.7% and 127.1%±89.4%, significantly higher than the control group. Conclusion: Three weeks of FES to the affected lower extremity of subjects with early stroke improved their function recovery.