Acute biomechanical and physiological changes in the context of the immediate effect of peroneal functional electrical stimulation: a pilot study

Abstract

Background: Peroneal functional electrical stimulation (FES) is a commonly used method for compensating foot drop syndrome resulting from stroke. Beyond its immediate orthotic effect, FES is presumed to induce short-term neuromuscular and central adaptive processes that contribute to its long-term therapeutic effect. The aim of this pilot study was to evaluate the immediate effect of FES-assisted gait therapy and to compare our pilot observations with current evidence.

Participants: The pilot measurement included 10 post-stroke patients with hemiparetic gait and foot drop syndrome.

Methods: Gait kinematic parameters were assessed on a Zebris Rehawalk FDM-T treadmill before and immediately after FES application. FES therapy was performed for 20 minutes during treadmill walking. In addition to objective parameters, subjective perception of the therapy effect was evaluated.

Results: Significant improvements were observed mainly in the stance phase parameters of the non-paretic lower limb, indirectly indicating a prolongation of the swing phase of the stimulated paretic lower limb. Subjective evaluation of the immediate effect of FES was predominantly positive, particularly regarding the overall perceived gait quality.

Conclusions: Pilot observations suggest that FES can immediately influence gait biomechanical parameters, especially of the non-paretic limb, while simultaneously improving subjective perception of gait. Repeated summation of these immediate changes may represent a key mechanism underlying the long-term therapeutic effect of FES. Larger studies are needed to confirm these findings.