Neuromuscular electric stimulation effect on lower-extremity motor recovery and gait kinematics of patients with stroke: a randomized controlled trial

OBJECTIVE: To evaluate the effects of neuromuscular electric stimulation (NMES) of the tibialis anterior muscle on motor recovery and gait kinematics of patients with stroke. DESIGN: Randomized, controlled, assessor-blinded trial. SETTING: Rehabilitation ward and gait laboratory of a university hospital. PARTICIPANTS: A total of 25 consecutive inpatients with stroke (mean age, 55y), all within 6 months poststroke and without volitional ankle dorsiflexion. INTERVENTION: Both the NMES group (n=12) and the control group (n=13) participated in a conventional stroke rehabilitation program, 5 days a week for 4 weeks. The NMES group also received 10 minutes of NMES to the tibialis anterior muscle of the paretic limb. MAIN OUTCOME MEASURES: Brunnstrom stages of motor recovery and kinematic characteristics of gait. RESULTS: Brunnstrom stages improved significantly in both groups (P<.05). In total, 58% of the NMES group and 61% of the control group gained voluntary ankle dorsiflexion. Between-group difference of percentage change was not significant (P>.05). Gait kinematics was improved in both groups, but the difference between groups was not significant. CONCLUSIONS: NMES of the tibialis anterior muscle combined with a conventional stroke rehabilitation program was not superior to a conventional stroke rehabilitation program alone, in terms of lower-extremity motor recovery and gait kinematics.