Development and application of a novel electromyographic-driven multi-channel functional electrical stimulation for the management of homolateral limb synkinesis during post-stroke gait

Stroke often leads to various movement impairments, including upper limb Associated Reactions (ARs) during walking. ARs are defined as automatic activities which fix or alter the posture of a part or parts when some other part of the body is brought into action by either voluntary effort or reflex stimulation. Homolateral limb synkinesis (HLS) is considered a type of non-purposive AR and refers to the involuntary movement of the limb on the same side of the body when the corresponding unilateral limb performs a voluntary movement. HLS can negatively impact various aspects of functioning, such as walking, dynamic balance, upper limb movement, activities of daily living, and self-esteem. Additionally, keeping the paretic arm in a fixed position for prolonged periods can contribute to muscular tightness and hinder balance reactions in both the upper and lower limbs, ultimately compromising overall stability. Uncertainty about the key underlying impairments has resulted in a variety of treatment approaches for HLS, many of which are not evidence based.Functional Electrical Stimulation (FES) has become an increasingly prevalent therapeutic technique in stroke rehabilitation, aimed at restoring physical movement in stroke patients with motor impairments. Although a previous study has explored the effects of FES in improving arm swing in stroke patients, it incorporated a small sample size of three patients and delivered the FES only to triceps muscle of the affected upper limb using a preset intensity. Hence this before-after study aims to develop a multi-channel electromyographic (EMG) driven FES and to find out its effectiveness in reducing HLS during gait in post-stroke patients.

The study hypothesizes that the EMG driven FES device will aid in the reduction of HLS during gait in post-stroke patients.