下肢外骨骼康复机器人在膝关节活动受限康复治疗中的应用

背景:下肢外骨骼康复机器人以持续主被动活动联合为理论基础,通过模拟人体运动,刺激机体的自然复原力,发挥组织代偿作用。目的:动态观察并了解下肢外骨骼康复机器人在膝关节活动受限患者功能锻炼中的康复作用。方法:将20例术后早期膝关节活动受限患者随机等分为实验组与对照组,实验组采用下肢外骨骼康复机器人行肢体功能锻炼,对照组采用被动训练装置CPM机行功能锻炼,治疗间隙2组均采用心理疏导、低频脉冲电疗和红外线等物理治疗。结果与结论:治疗2个月后,实验组与对照组患者膝关节后屈、前伸活动度均较治疗前明显改善(P<0.01),同时实验组股四头肌肌力较治疗前明显改善(P<0.01)。2个月后的后续治疗,实验组患者膝关节后屈、前伸活动度有了进一步的改善(P<0.05),对照组上述指标无明显改善。说明早期采用下肢外骨骼康复机器人或CPM机配合心理疏导、低频脉冲电疗和红外线等治疗均能明显提高膝关节活动受限患者膝关节活动度,同时下肢外骨骼康复机器人具有恢复患者股四头肌肌力的作用。     

ELECTROMYOGRAPHY DURING PEDALING ON UPRIGHT AND RECUMBENT ERGOMETER

Background:

Ergometers are used during rehabilitation and fitness to restore range of motion, muscular strength, and cardiovascular fitness. The primary difference between upright and recumbent ergometers is that the seat and crank spindle are aligned nearly vertically on upright bicycles and nearly horizontally on recumbent ergometers. In addition, recumbent ergometers are characterized by large seats with backrests to provide support for the upper body and are low to the ground, permitting easier access for wheelchair users and individuals with mobility impairments. Despite the great utility of the recumbent bike, it has not been studied with regard to energy costs or muscular output. This is the first study to investigate the differences between two commercial ergometers by analyzing of lower limb EMG in participants who are not habitual cyclers.

Methods:

Ten non‐cyclist males with no history of musculoskeletal lower limb injury pedaled on standard recumbent and upright ergometers. EMG data were recorded from the volunteers’ lower limb muscles (rectus femoris, semitendinosus, tibialis anterior, and medial gastrocnemius muscles). EMG signals were normalized to the highest EMG signals recorded for the maximum voluntary isometric contractions (MVIC). The peak normalized EMG value of the studied muscles over the average of the 10 pedal cycles was analyzed.

Results:

The differences in average peak muscle activity were not statistically significant for any of the four muscles tested. Pedaling a recumbent ergometer resulted in greater activity in two (semitendinosus and tibialis anterior) of the four muscles studied. Only the rectus femoris muscle demonstrated greater activity during upright pedaling.

Conclusion:

There were no differences in the EMG activity of the muscles studied during pedaling on a standard recumbent and an upright stationary exercise ergometer at moderate workload. This increased understanding of muscle activity during pedaling may be useful in the development of new exercise protocols and therapeutic approaches.

Level of Evidence:

2c     

下肢外骨骼康复机器人在膝关节活动受限康复治疗中的应用

背景：下肢外骨骼康复机器人以持续主被动活动联合为理论基础,通过模拟人体运动,刺激机体的自然复原力,发挥组织代偿作用。目的：动态观察并了解下肢外骨骼康复机器人在膝关节活动受限患者功能锻炼中的康复作用。方法：将20例术后早期膝关节活动受限患者随机等分为实验组与对照组,实验组采用下肢外骨骼康复机器人行肢体功能锻炼,对照组采用被动训练装置CPM机行功能锻炼,治疗间隙2组均采用心理疏导、低频脉冲电疗和红外线等物理治疗。结果与结论：治疗2个月后,实验组与对照组患者膝关节后屈、前伸活动度均较治疗前明显改善（P〈0.01）,同时实验组股四头肌肌力较治疗前明显改善（P〈0.01）。2个月后的后续治疗,实验组患者膝关节后屈、前伸活动度有了进一步的改善（P〈0.05）,对照组上述指标无明显改善。说明早期采用下肢外骨骼康复机器人或CPM机配合心理疏导、低频脉冲电疗和红外线等治疗均能明显提高膝关节活动受限患者膝关节活动度,同时下肢外骨骼康复机器人具有恢复患者股四头肌肌力的作用。     

COMPARISON OF TRUNK AND LOWER EXTREMITY MUSCLE ACTIVITY AMONG FOUR STATIONARY EQUIPMENT DEVICES: UPRIGHT BIKE,RECUMBENT BIKE,TREADMILL, AND ELLIPTIGO?

Background

Stationary equipment devices are often used to improve fitness. The ElliptiGO® was recently developed that blends the elements of an elliptical trainer and bicycle, allowing reciprocal lower limb pedaling in an upright position. However, it is unknown whether the muscle activity used for the ElliptiGO® is similar to walking or cycling. To date, there is no information comparing muscle activity for exercise on the treadmill, stationary upright and recumbent bikes, and the ElliptiGO®.

Purpose/Hypothesis

The purpose of this study was to assess trunk and lower extremity muscle activity among treadmill walking, cycling (recumbent and upright) and the ElliptiGO® cycling. It was hypothesized that the ElliptiGO® and treadmill would elicit similar electromyographic muscle activity responses compared to the stationary bike and recumbent bike during an exercise session.

Study Design

Cohort, repeated measures

Methods

Twelve recreationally active volunteers participated in the study and were assigned a random order of exercise for each of the four devices (ElliptiGO®, stationary upright cycle ergometer, recumbent ergometer, and a treadmill). Two-dimensional video was used to monitor the start and stop of exercise and surface electromyography (SEMG) were used to assess muscle activity during two minutes of cycling or treadmill walking at 40-50% heart rate reserve (HRR). Eight muscles on the dominant limb were used for analysis: gluteus maximus (Gmax), gluteus medius (Gmed), biceps femoris (BF), lateral head of the gastrocnemius (LG), tibialis anterior (TA), rectus femoris (RF). Two trunk muscles were assessed on the same side; lumbar erector spinae at L3-4 level (LES) and rectus abdominus (RA). Maximal voluntary isometric contractions (MVIC) were determined for each muscle and SEMG data were expressed as %MVIC in order to normalize outputs.

Results

The %MVIC for RF during ElliptiGO® cycling was higher than recumbent cycling. The LG muscle activity was highest during upright cycling. The TA was higher during walking compared to recumbent cycling and ElliptiGO® cycling. No differences were found among the the LES and remaining lower limb musculature across devices.

Conclusion

ElliptiGO® cycling was found to elicit sufficient muscle activity to provide a strengthening stimulus for the RF muscle. The LES, RA, Gmax, Gmed, and BF activity were similar across all devices and ranged from low to moderate strength levels of muscle activation. The information gained from this study may assist clinicians in developing low to moderate strengthening exercise protocols when using these four devices.

Level of evidence

3     

Muscle synergies and joint linkages in sit-to-stand under two initial foot positions

OBJECTIVE: The purpose of this study was to investigate the activation pattern of six lower limb muscles during standing up from two initial foot positions and to examine relationships between the onsets of muscle activity and the dynamics of the action. In contrast to earlier studies, an algorithm was used to measure onsets and duration of muscle activity. METHOD: The activity of biceps femoris, rectus femoris, vastus lateralis, tibialis anterior, lateral gastrocnemius and medial soleus was studied as nine male subjects between the ages of 20 and 35 stood up from two initial foot positions (foot forward, foot back). Subjects sat on a height-adjustable seat with their right foot on a force platform and were videotaped as they stood up. RESULTS: When the feet were forward there were significant increases in movement duration, displacement and velocity of trunk segment flexion at the hips reflecting the increased distance the body mass must be moved forward. The sequence of onsets and the duration of muscle activity, however, were consistent across the two conditions. Onsets of extension at hip, knee and ankle, however, correlated with different muscle activity depending on the foot position. CONCLUSION: The results suggest that muscles working over different joints are temporally linked and that different muscle linkages may be utilised in the lower limb to coordinate the sit-to-stand action under different functional demands.     

Activation timing patterns of the abdominal and leg muscles during the sit-to-stand movement in individuals with chronic hemiparetic stroke

[Purpose] The purpose of this study was to determine the activation timing patterns of abdominal and leg muscles during the sit-to-stand movement in individuals with chronic hemiparetic stroke. [Subjects] Twenty adults with chronic hemiparetic stroke participated in this study. [Methods] Subjects performed five sit-to-stand movements at a self-selected velocity without using their hands. Surface electromyography was used to measure the reaction time of the bilateral transverse abdominis/internal oblique, rectus femoris, and tibialis anterior muscles during the sit-to-stand movement. [Results] There were significant differences in the reaction time between the affected and unaffected sides of the abdominal and leg muscles. Muscles on the unaffected side had faster reaction time than those on the affected side. Activation of the transverse abdominis/internal oblique muscles was delayed relative to activation of the tibialis anterior muscle during the sit-to-stand movement. [Conclusion] Our findings provide information that may aid clinicians in the examination and management of paretic muscles for transfers in individuals with chronic hemiparetic stroke.Key words: Reaction time, Sit-to-stand, Stroke     

Lower extremity general muscle moment patterns in healthy individuals during recumbent cycling

OBJECTIVE: The purpose of this study was to compare lower extremity generalized muscle moments across two workloads during recumbent bicycling in younger and older healthy adults. DESIGN: The study design was a comparative investigation of cycling patterns. BACKGROUND: Biomechanical data regarding muscle activation, kinematic, and kinetic patterns have been presented for upright cycling, but only a few studies have evaluated biomechanical patterns during the alternative configuration of recumbent cycling. METHODS: Twenty-four healthy adults, classified by age into two different groups, under 35 and over 50 years of age, rode a recumbent bicycle at a constant cadence (60-65 rpm) and at two different resistances (0.5 and 1.0 kg m) while kinematic and kinetic data were recorded. General muscle moments were calculated using joint kinematic and kinetic data via inverse dynamic equations. RESULTS: The ankle general muscle moment remained plantar flexor throughout the pedaling cycle; the knee general muscle moment remained flexor throughout the cycle, except during the power phase of the higher workload where an extensor general muscle moment was observed; and the hip general muscle moment was extensor with a transient flexor general muscle moment period during the recovery phase. Increased workload led to increases in ankle plantar flexor and knee extensor general muscle moment magnitudes, but no changes at the hip. Age had no effect on general muscle moment magnitudes or patterns. CONCLUSIONS: Configurational differences between the upright and recumbent bicycle do not affect patterns, but the total output requirements do affect the magnitudes of the general muscle moments. RELEVANCE: Based on previous studies, the recumbent bicycle appears to be a safe rehabilitation tool for post-cerebrovascular accident and cardiorespiratory patients, but in order to more properly and efficiently use the recumbent bicycle as a rehabilitation tool, normative biomechanical data are necessary. The current study is the first such investigation to report normative data of lower extremity general muscle moment patterns during recumbent cycling. Effects of age and workload were also demonstrated.     

Biomechanical analysis of the sit-to-stand motion in elderly persons.

The sit-to-stand motion of ten healthy subjects, 65 to 76 years old, was evaluated using kinematic, force plate, and electromyographic data to characterize the sit-to-stand motion. Kinematic data collected by video, muscle activity monitored by surface electromyography, and ground reaction forces analyzed by a piezoelectric force plate were used for analysis. Using these synchronized data, three phases of the sit-to-stand motion were identified--phase 1, weight shift; phase 2, transition; and phase 3, lift. A consistent pattern of trunk and lower extremity motion was observed, and two distinct upper extremity movement strategies were identified. The onset of muscle activity occurred in the following order: erector spinae, rectus femoris, and vastus medialis (phase 1); biceps femoris, gluteus maximus, and rectus abdominus (phase 2). This characterization of the sit-to-stand motion for a small population of healthy elderly subjects serves as a basis for identifying problems in elderly patients who demonstrate difficulty getting up from a chair.     

Progressive resistance muscle strength training of hospitalized frail elderly.

OBJECTIVE: To determine whether frail elderly patients recuperating from acute illnesses could safely participate in and gain appreciable improvement in muscle strength from progressive resistance muscle strength training. DESIGN: Muscle strength (one repetition maximum), functional abilities (sit-to-stand maneuver and 20-sec maximal safe gait speed), and body composition were measured before and at the conclusion of a 10-wk program of lower limb progressive resistance muscle strength training. The nonrandomized study was conducted in a 30-bed geriatric rehabilitation unit of a university-affiliated Veterans Affairs hospital and a 28-bed transitional care unit of a community nursing home. Participants included 19 recuperating elderly subjects (14 male, 5 female; 13 ambulatory, 6 nonambulatory) >64 yr (mean age, 82.8+/-7.9 yr). RESULTS: The one repetition maximum increased an average of 74%+/-49% (median, 70%; interquartile range, 38%-95%, and an average of 20+/-13 kg (P = 0.0001). Sit-to-stand maneuver times improved in 15 of 19 cases (79%). Maximum safe gait speeds improved in 10 of 19 cases (53%). Four of the six nonambulatory subjects progressed to ambulatory status. No subject experienced a complication. CONCLUSIONS: A carefully monitored program of progressive resistance muscle strength training to regain muscle strength is a safe and possibly effective method for frail elderly recuperating from acute illnesses. A randomized control study is needed to examine the degree to which progressive resistance muscle strength training offers advantages, if any, over routine posthospital care that includes traditional low-intensity physical therapy.     

The effects of progressive functional training on lower limb muscle architecture and motor function in children with spastic cerebral palsy

[Purpose] To investigate the effects of progressive functional training on lower limb muscle architecture and motor function of children with spastic cerebral palsy (CP). [Subjects] The subjects of this study were 26 children with spastic CP. [Methods] Thirteen subjects in the experimental group performed general neurodevelopmental treatment (NDT) and additional progressive functional trainings and 13 subjects in the control group performed only general NDT 3 times a week for 6 weeks. Ultrasonography, gross motor function measurement (GMFM) and the mobility questionnaire (MobQue) were evaluated. [Results] After the intervention, the muscle thickness of the quadriceps femoris (QF), cross-sectional area of the rectus femoris (RF), pennation angle of the gastrocnemius (GCM) and the MobQue score of the experimental group were significantly greater than those of the control group. The muscle thickness of QF correlated with the cross-sectional area (CSA) of RF and the pennation angle of GCM, and GMFM score correlated with the pennation angle of GCM. [Conclusion] Progressive functional training can increase muscle thickness, CSA, and the pennation angle of the lower limb muscles, and improve the mobility of spastic CP children making it useful as a practical adjunct to rehabilitation therapy.Key words: Cerebral palsy, Function, Ultrasonography     

集束化管理在重型颅脑损伤患者早期康复护理中的应用

正重型颅脑损伤(severe traumatic brain injury,STBI)是指颅脑损伤后格拉斯哥昏迷评分(Glasgow coma scale,GCS)3~8分,伤后昏迷时间6 h以上或在伤后24 h内意识恶化致再次昏迷6 h以上[1]。STBI的发病率逐年增加,脑外伤的原发性及继发性损伤对大脑造成的伤害会导致暂时和/或永久的功能障碍,限制患者的活     

血流量限制结合低强度抗阻训练对下肢骨科术后肌肉功能的影响

目的:探索血流量限制结合低强度抗阻训练对下肢骨科术后肌肉功能的影响.方法:选取下肢骨科术后4～12周患者39例,随机将患者分为观察组19例和对照组20例.2组患者均接受为期4周的康复训练,对照组根据渐进抗阻原则进行肌力训练,观察组使用血流量限制结合低强度抗阻肌力训练.等速伸膝峰力矩、超声下股四头肌肌肉形态、肢体围度、静...     

膝骨关节炎患者膝关节置换后下肢肌的表面肌电图变化

背景：膝骨关节炎患者膝关节置换后下肢肌功能恢复一直存在着争议。目的：评价膝骨关节炎患者膝关节置换手术后下肢肌肉功能。方法：应用TELEMYO2400RG2表面肌电图遥测仪对25例双膝骨关节炎单膝关节置换后患者在平常自然步态下进行双下肢股直肌、胫前肌、股二头肌和腓肠肌内侧的表面肌电信号测试。在肌电图测试前,对患者双膝关节功能进行美国特种外科医院膝关节评分。结果与结论：患者置换后美国特种外科医院膝关节评置换侧平均分91．44,其优良率达100％;未置换侧平均分54．52。置换侧在疼痛、关节功能方面有明显改善;膝关节置换后置换侧股直肌、胫前肌、股二头肌的肌电振幅、肌电积分、平均频率、中位频率的（平均值、最小值、最大值）与未置换侧相比差异无显著性意义（P〉0．05）;置换侧腓肠肌内侧肌电振幅值及肌电积分值显著大于未置换侧（P〈0．05）;置换侧腓肠肌内侧平均频率、中位频率与未置换侧相比差异无显著性意义（P〉0．05）。提示膝关节置换后置换侧的下肢肌没有恢复到正常的功能活动水平,因此膝关节置换后康复要特别重视患者的肌肉锻炼。     

正常青年人自然步态下肢肌的表面肌电图分析

背景:肌肉的生物电活动是人体的能动部分,可反映人体运动的功能。目的:观察和分析正常青年人在自然步态中下肢肌肉的表面肌电活动。方法:采用美国NORAXON公司生产的TELEMYO2400RG2表面肌电图仪对30例正常青年人在平地自然行走时,其双下肢股直肌、胫前肌、股二头肌和腓肠肌内侧进行测试,分析在正常步态中受试肌群表面肌电信号的变化规律。结果与结论:正常青年人平地自然步行中,其双下肢股直肌、胫前肌、股二头肌和腓肠肌内侧的肌电随步态周期呈活动与静止周期性变化,左右侧同名肌肉交替活动;平均肌电振幅、平均肌电积分、平均频率、中位频率值最大的是腓肠肌内侧,其余由大到小依次是胫前肌,股二头肌,股直肌,右左腿分布规律一致;右侧腓肠肌内侧平均肌电振幅、平均频率、中位频率值均明显低于左侧(P<0.05);受试肌的时域、频域值波动在一定范围。提示正常青年人自然步态中下肢肌群肌电活动呈节律性和右左侧交替活动;在受试肌中腓肠肌内侧的肌电活动最强;腓肠肌内侧的肌电活动存在着优势侧与非优势侧的轻度差别;下肢肌肌电活动的时域、频域值在一定范围波动。     

表面肌电在脑卒中患者双侧肢体训练中的应用

目的 采用表面肌电评定双侧肢体训练治疗脑卒中患者运动功能障碍的疗效。 方法 选取60例脑卒中偏瘫患者,按随机数字表法将其分为双侧组和单侧组,每组30例。两组患者均进行常规康复训练,双侧组在此基础上联合健侧肢体训练,共4周。治疗前及治疗4周后（治疗后）,利用Delsys表面肌电图仪测试患者三角肌、肱二头肌、肱三头肌、股直肌、股二头肌和胫前肌的相关指标,对其最大自主收缩（MVC）、随意收缩状态下的积分肌电值（iEMG）和均方根值（RMS）等指标进行比较,评估患者疗效。 结果 治疗前,2组患者三角肌、肱二头肌、肱三头肌、股直肌、股二头肌、胫前肌的MVC、iEMG、RMS比较,差异均无统计学意义（P>0.05）。2组患者治疗后三角肌、肱二头肌、肱三头肌、股直肌、股二头肌、胫前肌的MVC、iEMG、RMS均较组内治疗前提高,且双侧组MVC、iEMG、RMS较单侧组明显提高,差异有统计学意义（P<0.05）。 结论 双侧肢体训练较常规康复训练能更好地改善脑卒中患者的运动功能。     

前后方向水平姿势扰动对人体站立平衡响应的影响

目的:对比受试者在受到站立平台突然前移和后移两方向外部干扰下,姿势控制过程中运动学及相关肌肉动员表现,为平衡障碍人群的康复提供理论指导。方法:使用三维红外运动捕捉系统(100Hz)、无线表面肌电采集系统(4000Hz)采集13例男性青年受试者分别受到站立平台前、后两方向水平移动干扰刺激时,姿势控制过程中的肌电及运动学数据,对比研究下肢三关节及躯干的角度变化、身体质心前后方向位移及平衡恢复过程中各相关肌肉平均积分肌电值。结果:两方向水平刺激下身体质心位移方向相反,各关节表现出了方向相反的角度变化;在站立平台后移时,腓肠肌的活动强度要显著大于站立平台前移时(P0.05),而股直肌、胫骨前肌和腰段竖脊肌的肌电活动则表现为站立平台前移时显著较大(P0.05);除腹直肌和竖脊肌外,其他肌肉的激活时间无显著差异。结论:中枢神经系统会根据不同方向扰动自动调节人体的响应,通过协调主动肌与拮抗肌的活动强度,控制人体各主要环节的运动,从而将人体质心控制在支撑面内,维持机体的稳定。     

Ballism after stroke responds to standard physical therapeutic interventions

OBJECTIVE: To report the effects of noninvasive standard physical therapy (PT) interventions on an involuntary movement disorder after stroke. DESIGN: Single case with clinical follow-up over 2 years. SETTING: Inpatient stroke and rehabilitation services and outpatient clinic. PARTICIPANT: A man with acute bilateral ballism after unilateral subthalamic infarction. INTERVENTIONS: Rhythmic coordinated bilateral limb movements and firm tactile stimulation to the hand. MAIN OUTCOME MEASURES: We had not anticipated that dyskinesia itself would specifically improve during treatment. Consequently, we used qualitative clinical observations, including review of videotaped performance, and self-reported limb control. Hypotheses concerning treatment effects were developed after data collection. RESULTS: Involuntary movements recurrently improved within treatment sessions. CONCLUSIONS: PT may improve dyskinesia after stroke. The benefit may be adjunctive or alternative to current invasive treatments of movement disorders after brain injury and merits confirmation. The improvements are consistent with current research indicating that (1) intact cortical, subcortical, cerebellar, and spinal areas interact to generate bilateral rhythmic limb movements that can overcome dyskinesia and (2) tactile stimulation can improve motor deficits associated with basal ganglia disorders. Finally, because functional activities assessments improved our evaluation of ballism, these should be routinely used along with conventional neurologic examination to assess involuntary movement disorders.     

The efficacy of perturbation training in nonoperative anterior cruciate ligament rehabilitation programs for physical active individuals

BACKGROUND AND PURPOSE: Treatment techniques involving perturbations of support surfaces may induce compensatory muscle activity that could improve knee stability and increase the likelihood of returning patients to high-level physical activity. The purpose of this study was to determine the efficacy of augmenting standard nonoperative anterior cruciate ligament (ACL) rehabilitation programs with a perturbation training program. SUBJECTS: Twenty-six patients with acute ACL injury or ruptures of ACL grafts participated in the study. Subjects had to have a unilateral ACL injury, be free of concomitant multiple ligament or meniscal damage requiring surgical repair, and pass a screening examination designed to identify patients who had the potential to return to high-level physical activity with nonoperative treatments. Subjects also had to be regular participants in level I activities (eg, soccer, football, basketball) or level II activities (eg, racquet sports, skiing, construction work). METHODS: Subjects were randomly assigned to either a group that received a standard rehabilitation program (standard group) or a group that received the standard program augmented with a perturbation training program (perturbation group). Treatment outcome was determined from scores on the Knee Outcome Survey's Activities of Daily Living Scale (ADLS) and Sports Activity Scale, a global rating of knee function, scores on a series of single-limb hop tests, measurements of maximum isometric quadriceps femoris muscle force output, and the group frequency of unsuccessful rehabilitation. Unsuccessful rehabilitation was defined as the occurrence of an episode of giving way of the knee or failure to maintain the functional status of a rehabilitation candidate on retesting. RESULTS: More subjects had unsuccessful rehabilitation in the standard group compared with the perturbation group. There was a within-group x time interaction for the ADLS, global rating of knee function, and crossover hop test scores. These scores decreased from posttraining to the 6-month follow-up for the standard group. CONCLUSION AND DISCUSSION: Although both the standard program and the perturbation training program may allow subjects to return to high-level physical activity, the perturbation training program appears to reduce the risk of continued episodes of giving way of the knee during athletic participation and allows subjects to maintain their functional status for longer periods.     

Effects of a multichannel dynamic functional electrical stimulation system on hemiplegic gait and muscle forces

[Purpose] The purpose of the study was to design and implement a multichannel dynamic functional electrical stimulation system and investigate acute effects of functional electrical stimulation of the tibialis anterior and rectus femoris on ankle and knee sagittal-plane kinematics and related muscle forces of hemiplegic gait. [Subjects and Methods] A multichannel dynamic electrical stimulation system was developed with 8-channel low frequency current generators. Eight male hemiplegic patients were trained for 4 weeks with electric stimulation of the tibia anterior and rectus femoris muscles during walking, which was coupled with active contraction. Kinematic data were collected, and muscle forces of the tibialis anterior and rectus femoris of the affected limbs were analyzed using a musculoskelatal modeling approach before and after training. A paired sample t-test was used to detect the differences between before and after training. [Results] The step length of the affected limb significantly increased after the stimulation was applied. The maximum dorsiflexion angle and maximum knee flexion angle of the affected limb were both increased significantly during stimulation. The maximum muscle forces of both the tibia anterior and rectus femoris increased significantly during stimulation compared with before functional electrical stimulation was applied. [Conclusion] This study established a functional electrical stimulation strategy based on hemiplegic gait analysis and musculoskeletal modeling. The multichannel functional electrical stimulation system successfully corrected foot drop and altered circumduction hemiplegic gait pattern.Key words: Hemiplegia, Functional electrical stimulation, Gait