Effects Of Functional Electrical Stimulation At Different Sites Of Action On Walking Ability In Stroke Patients

Objective: To explore the effect of functional electrical stimulation at different action sites on the walking ability of stroke patients,and to provide an objective basis for the clinical treatment of stroke patients.Methods: A randomized controlled study method was used to select 116 stroke patients in the rehabilitation period from October 2020 to December 2021 in the Department of Rehabilitation Medicine,Dongguan Branch,Affiliated Hospital of Yan’an University as the research objects,and they were divided into three groups according to the random number table method.Nerve（CPN）group（n=41）,tibialis anterior（TA）group（n=33）and control group（n=42）.The general data,modified Ashworth classification and Brunnstrom staging were compared among the three groups before admission for treatment,and the lower extremity motor function（AROM,FMA-LE）,walking and balance ability（FAC,Fugl-Meyer balance）,mental state（MMSE）and comprehensive living ability（MBI）,were given routine rehabilitation treatment,including drug therapy and rehabilitation training.On the basis of routine rehabilitation,CPN group and TA group were given functional electrical stimulation（FES）therapy.In the CPN group,the main electrode patch was attached to the projection of the common peroneal nerve below the fibular head.In the TA group,the main electrode patch was attached to the motor point of the tibialis anterior muscle.The control group was given placebo electrical stimulation therapy.The treatment lasted for 8 weeks,once a day,15 min each time,5 times a week.Lower extremity motor function（AROM,FMA-LE）,walking and balance（FAC,Fugl-Meyer balance）,mental status（MMSE）,and general living ability（MBI）were reassessed after the 8-week course of treatment.The intra-group and inter-group indexes were compared between the three groups before and after treatment to evaluate the curative effect.All data were statistically analyzed using SPSS 26.0.Results: 1.The three groups of patients in this study were balanced and comparable in terms of gender,age,course of disease,type of stroke,history and classification of hypertension,hemiplegia,modified Ashworth classification,and Brunnstrom staging（P>0.05）.2.There was no significant difference in AROM,FMA-LE,FAC,Fugl-Meyer balance,MMSE and MBI among the three groups of patients before admission（P>0.05）.3.After 8 weeks of treatment,there were significant differences in lower limb motor function,walking and balance ability,mental state and comprehensive living ability among the three groups compared with those before treatment（P<0.001）.4.After 8 weeks of treatment,the CPN group and TA group had significant differences compared with the control group in lower limb motor function,walking and balance ability,mental state and comprehensive living ability（P<0.05）.5.In terms of lower extremity motor function,there were significant differences in AROM and FMA-LE scores between CPN group and TA group（P<0.05）,and the improvement in CPN group was more obvious.6.In terms of walking ability and balance,there were statistically significant differences in Fugl-Meyer balance score and functional walking classification FAC between CPN group and TA group（P<0.05）,and the improvement was more obvious in CPN group.7.In terms of mental state,there was no significant difference in the MMSE score between the CPN group and the TA group（P>0.05）,and there was no significant difference in the improvement effect between the two groups.8.In terms of comprehensive living ability,there was a statistically significant difference in MBI score between CPN group and TA group（P<0.05）,and the improvement in CPN group was more obvious.Conclusion: 1.Conventional rehabilitation therapy combined with FES can improve lower limb motor function,walking and balance ability,mental state and comprehensive living ability of stroke patients.2.Functional electrical stimulation CPN is more effective than TA in improving lower limb motor function,walking and balance function and comprehensive living ability in stroke patients,and it is worthy of clinical application.