Background: Stroke rehabilitation often uses the motor relearning concept that require patients to perform active\npractice of skill-specific training and to receive feedback. Treadmill training augmented with real-time visualisation\nfeedback and functional electrical stimulation may have a beneficial synergistic effect on motor recovery. This study aims\nto determine the feasibility of this kind of enhanced treadmill training for gait rehabilitation among patients after stroke.\nMethods: A system for dynamic visualisation of lower-limb movement based on 3-dimentional motion capture and a\ncomputer timed functional electrical stimulation system was developed. Participants received up to 20-min enhanced\ntreadmill training instead of their over-ground gait training once or twice a week for 6 weeks at Coathill hospital,\nLanarkshire, United Kingdom. Number of training sessions attended, and training duration were used to assess feasibility.\nAnkle kinematics in the sagittal plane of walking with and without functional electrical stimulation support of the pretibial\nmuscles were also compared and used to confirm the functional electrical stimulation was triggered at the targeted\ntime.\nResults: Six patients after stroke participated in the study. The majority of participants were male (5/6) with a age range\nfrom 30 to 84 years and 4/6 had left hemiplegia. All participants suffered from brain infarction and were at least 3 months\nafter stroke. Number of training sessions attended ranged from 5 to 12. The duration of training sessions ranged from 11\nto 20 min. No serious adverse events were reported. The computerised functional electrical stimulation to the pre-tibial\nmuscles was able to reduce plantarflexion angle during the swing phase with statistical significance (p = 0.015 at 80%;\np = 0.008 at 90 and 100% of the gait cycle).\nConclusions: It is safe and feasible to use treadmill gait training augmented with real-time visual feedback and\ncomputer-controlled functional electrical stimulation with patients after stroke in routine clinical practice.
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