3. is a partial loss of motor
function
mainly caused of one side of the
body
hemorrhagic strokes
ischemic strokes
severe and
long-term
disability
4. Neurologicaltypically improve first
deficits weeks
beca after
use injury
brain plasticity
mechanisms of neuronal
reorganization pathways functionally
recruitment of
homologous
synaptogenesis
dendritic arborization
functionally silent synaptic
5. The understanding of the
mechanisms that improve
is
recovery
cruci
al
design of optimized
therapies
motor activity sensory feedback
fundamental
6. Several studies
afferent
stimulation with
beneficial
changes
in brain activity
repetition
functional goal-
directed activity
functional electrical
stimulation (FES)
7. Clinical evidence therapy
FES-
reduces motor
impairment
persons with
hemiparesis
poststroke
estoration of walking goal lower limb
main
rehabilitation
8. Since the 1990s
FES increasingly used
in
evide
poststroke gait
nce
rehabilitation
improving motor and walk
FES-induced gait training
use of FES synchronized to the
cycling movement
entails a coordinated activation of the
lower limb muscles
approximating the cyclic movements
of locomotion Hui-Chan CW et al.2005 SM et a
Yan T, Robbins
9. similarities between cycling and wa
hypothes
ized
FES-induced cycling applied in the
postacute phase
could play a crucial role in
promoting motor recovery and
improving locomotion.
10. The aim of
our study
investigate whether FES-
induced cycling was a more
effective intervention for
postacute
11.
12. Thirty-five patients, inpatients
All patients received an information sheet
and provided their written informed
consent. The research protocol was
approved by the medical ethics committee
of the Valduce Hospital.
13. 35 patients inpatients
Inclusion-stroke or TBI
-hemiparesis
criteria
-able to sit up to 30
Exclusion minutes
criteria -joint mobility ranges
that would
-cardiac pacemakers
not preclude pedaling
-allergy to electrodes
-low spasticity in the LE
-inability to tolerate
m. (MAS 2)
stimulation
Treatment
14.
15.
16. A current-controlled -
channel stimulator
surface electrodes: bipolar techni
Quadriceps
Hamstrings of both le
Gluteus
maximus
Tibialis
anterior
17.
18. current
• Rectangular
biphasic pulses
pulse
width • s
frequency • Hz
• set on each muscle at a
intensi tolerated value
ty • visibly good muscle
contractions
20. To promote a similar mental set
participants were informed
before treatment
might feel might not feel
the stimulation the stimulation
21. -minute warm-up of passive cyclin
1 - FES group: training of
minute FES cycling
Placebo group: placebo
-minute FES cyclingof passive cyc
cool-down
constant speed of rpm
throughout the training
22.
23. primary outcome
the leg subscale of the
Motricity Index (MI)
gait speed was measured by timing a
walk of 50 meters
24. the leg subscale of the
Motricity Index (MI)
evaluates motor power of
the paretic
lower extremity and ranges
from 0 as 100
was chosen to a
primary outcome
measure related to body
functions
25.
26.
27. gait speed activity dom
measured by timing a walk of 50 meters
with a stopwatch
using walking aids if necessary
chosen is representative of
because the typical indoor
a 50-meter walking need of
28. Secondary outcome
Upright Motor Control Test (UMCT)
Trunk Control Test (TCT)
The mean work produced by the paretic
and healthy legs
The pedaling unbalance
29. Upright Motor Control Test (U
scored from 0 to 6
assesses functional abilities
of
the impaired leg during single-
limb standing
31. The mean work
produced
by the paretic and
healthy legs
the work produced by each side
Was computed as the integral of the
active
torque profiles mapped as function of
the crank angle.
32. The pedaling unbalanc
U could range from 0% (identical work
produced by both legs)
to 100% (WPL negative or equal to 0)
44. The results of this study
demonstrated that 20 sessions
FES-induced cycling training
significantly
impairments TCT, U
MI,
reduc MCT
activity pedaling
ed limitations walki
unbalance
45. Motricity
Index (MI)
impairments
Trunk Control Test (TCT
Upright Motor Control Tes
46. significant
differences between groups
after training in favor of FES-
treated subjects and were
maintained at follow-up
significant improvement of the
whole kinetic chain, involving both
leg and trunk, as demonstrated by
MI and TCT and confirmed by
47. Trunk control
important prerequisite for
the control of more complex
limb activities
early rehabilitatio
48. significant
differences between groups
pedaling unbalance
FES cycling treatment may help in
“re- minding” subjects how to
perform a symmetrical pedaling
49. A strength of
the study
was the participants’ blindness to
treatment group
ensuring that all patients
received
the same extent of attention by
the therapists
50. A possible limitation of the stu
heterogeneous population
of participants
Although the optimal solution
would be
the definition of rehabilitative
methods
specific for each brain lesion
neurological
but affected by
etiology and location
patients similar
with different motor impairments
often undergo
51. results confirmed
hypothes
ized
FES-induced cycling applied in the
postacute phase
could play a crucial role in
promoting motor recovery and
improving locomotion.
facilitating and accelerating motor recovery in
54. 4-week treatment of FES-
induced cycling
impro
ves
motor recovery
walking ability
Improvements are maintained for at
ast 3 to 5 months after the end of the treatm
55. These improvements could be
explained by
increased sensorial
input
provided to the
brain by FES
help in relearning how
to
execute movements
56.
57. Neurologicaltypically improve first
deficits weeks
beca after
use injury
brain plasticity
mechanisms of neuronal
reorganization pathways functionally
recruitment of
homologous
synaptogenesis
dendritic arborization
functionally silent synaptic
