Effectiveness of EMS Versus TENS During Gait Training in Post Stroke Patients to Improve Gait and Quality of Life
Condition: Stroke, Anterior Cerebral Artery
MeSH terms: Stroke; Infarction, Anterior Cerebral Artery
Study type: Interventional

Summary: 
      The goal of this Randomized clinical trial was to compare effectiveness of EMS versus TENS
      during gait training in stroke patients to improve gait and quality of life. The main
      question it aims to answer was:

      • To compare effectiveness of EMS versus TENS during gait training in post stroke survivors
      to improve gait and quality of life Participants were given consent form and after subjects
      read and sign the informed consent, they were included in study according to eligibility
      criteria. 2 groups were included in study, one group received stimulation through TENS and
      other through EMS. Both groups received exercise protocol and stimulation would be provided
      only during gait training. Outcome was measured through different outcome measure tools.
    

Detailed description: 
      Patients with stroke experience gait disorders due to various causes, including sensory
      impairment and muscle weakness, spasticity, etc., and the primary goal of rehabilitation is
      to regain independent walking. The ankle plantar flexors tightly contract to maintain a
      standing posture and contribute to postural control through anticipatory contractions before
      changes in the center of mass. The plantar flexors in the ankle create most of the energy
      required for forward propulsion of body mass during walking. The strength of the ankle
      plantar flexors on the paretic side is related to the gait speed of patients with stroke. The
      peripheral sensory inputs via Electrical muscle stimulation enhanced the activities of
      circuits in the somatosensory cortex thus it can cause neuroplasticity to brain. Electrical
      stimulation on ankle dorsiflexors could be an effective management to enhance gait
      performance and ankle control during walking in chronic stroke patients. Neuromuscular
      electrical stimulation on ankle plantar flexors may improve gait symmetry. When neuromuscular
      stimulation combined with activity can enhance efficacy. Many previous studies conducted
      trials on effectiveness of muscle stimulation but this study aims to perform a clinical trial
      to enhance evidence about effectiveness.

      2 groups were included in study, one group received stimulation through TENS and other
      through EMS. Both groups received exercise protocol and stimulation was provided only during
      gait training. The outcome was measured through different outcome measure tools.

      Functional electrical stimulation device was used to improve dorsiflexion during walking, but
      it was somehow expensive treatment. To achieve same outcome during walking, it is aimed to
      see effect of EMS vs TENS. This would be an inexpensive alternate of FES device and could
      improve gait and quality of life if used during treatment protocol. So it was aimed to
      generate evidence about effectiveness of TENS vs EMS on lower limb during gait training to
      improve gait and quality of life.
    

Intervention name(s): TENS treatment protocol; EMS treatment protocol; Exercises
Intervention type(s): Other; Other; Other
Intervention description(s): The 2 sets of electrodes of TENS were placed over the common peroneal nerve as it passes over the head of fibula and the motor point of tibialis anterior to elicit dorsiflexion and eversion of foot.; The electrodes were placed over the common peroneal nerve as it passes over the head of fibula and the motor point of tibialis anterior to elicit dorsiflexion and eversion of foot. A portable comfy EMS channel was used to apply EMS protocol to set at threshold of muscle contraction level.; Patient were given 30 minutes treatment session, 10 minutes of supported walking 10 minutes of BWS treadmill training 10 minutes of Task-specific over ground locomotor training (LT) There was rest of 2 minutes The frequency of the sessions was five times a week for 12 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment