THE EFFECTS OF FAST FES TRAINING ON OVER GROUND GAIT SPEED AND GAIT MECHANICS
IN A PERSON WITH HEMIPLEGIA. Michael Parlatore PT, DPT. Moss Rehab at Elkins Park. “2886
Joyce Road, Abington, PA 19001.”
Introduction: Functional electrical stimulation (FES) has traditionally been used to improve foot drop in
hemiplegic patients by stimulating the ankle dorsiflexors and everters. This type of FES is meant to
mimic an ankle-foot orthosis and improve a person’s safety when ambulating. Research has
demonstrated that by stimulating both the plantarflexors and dorsiflexors during gait training, you can
improve propulsion and assist in generating knee flexion during the pre-swing phase of gait. This case
demonstrates the effects of fast FES training on over ground gait speed and gait mechanics in a person
with hemiplegia.
Case description: The patient is a 59 year old male status post left pontine cerebral vascular accident
(CVA) that occurred 3 years ago. Previously, he received 4 courses of outpatient physical therapy with
limited success. He ambulates with a single point cane and a dual channel molded ankle foot orthosis
(MAFO) that allows 5 degrees of plantarflexion and neutral dorsiflexion. A “stiff knee gait” is present
along with decreased stance time on the right, and decreased gait speed. FES was applied to both the
dorsiflexors and plantarflexors while ambulating on a treadmill. A harness system was used to support the
patient over the treadmill for safety. Training with FES lasted 20-30 minutes per session with speeds
progressed from 1.5 to 3.0 miles per hour. During the start of training, the left hand was used for support.
As training continued, upper extremity support was removed. Performance of over ground gait training
without the MAFO occurred after every FES session for 10-15 minutes. Treatment occurred 2 times per
week for 12 weeks. Objective measures taken: 6 minute walk test, gait speed, stair climb test, single limb
stance time on the affected lower extremity, 5 timed sit to stand, and timed up and go. Gait symmetry
was measured by ambulating over a force plate. All objective measures were taken without FES and
without his MAFO. Substantial improvements were found in his gait speed (self selected and “fast”), 6
minute walk distance, and stair climbing ability.
parlatom@einstein.edu
Case Report/Poster Presentation
THE EFFECTS OF FAST FES TRAINING ON OVER GROUND GAIT SPEED AND GAIT MECHANICS
IN A PERSON WITH HEMIPLEGIA. Michael Parlatore PT, DPT. Moss Rehab at Elkins Park. “2886
Joyce Road, Abington, PA 19001.”
Discussion: In an individual who is 3 years post injury to his central nervous system, substantial changes
occurred in a number of objective measures. He is now ambulating with a more symmetrical gait pattern.
The changes have also taken place in less time than during his prior courses of care, which focused on
more conventional approaches towards improving gait.
parlatom@einstein.edu
Case Report/Poster Presentation