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Implanted multijoint functional electrical stimulation assistance improves walking efficiency after stroke: A case report

Published online by Cambridge University Press:  10 May 2018

Nathaniel Makowski
Affiliation:
Case Western Reserve University, Cleveland, OH, USA
Rudi Kobetic
Affiliation:
Case Western Reserve University, Cleveland, OH, USA
Lisa Lombardo
Affiliation:
Case Western Reserve University, Cleveland, OH, USA
Kevin Foglyano
Affiliation:
Case Western Reserve University, Cleveland, OH, USA
Gilles Pinault
Affiliation:
Case Western Reserve University, Cleveland, OH, USA
Stephen Selkirk
Affiliation:
Case Western Reserve University, Cleveland, OH, USA
Ronald Triolo
Affiliation:
Case Western Reserve University, Cleveland, OH, USA
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Abstract

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OBJECTIVES/SPECIFIC AIMS: Evaluate the effect of multijoint functional electrical stimulation (FES) on energy consumption during post-stroke walking. METHODS/STUDY POPULATION: A 67-year-old male with chronic stroke was implanted with an 8-channel implanted pulse generator to stimulate flexor and extensor muscles of the hip, knee, and ankle. Oxygen consumption was measured with a k2b4 portable pulmonary gas analyzer during walking with and without FES assistance. Data were analyzed during steady state oxygen consumption within the last 2 minutes of a 5 minute walk. Distance and walking speed were also measured. RESULTS/ANTICIPATED RESULTS: Electrical stimulation increased walking speed from 0.29 to 0.64 minute/second. Faster walking corresponded with increased oxygen consumption from 10.1 to 14.4 mL O2/kg per minute. Energy cost, consumption as a function of distance, decreased from 3.7 to 2.9 mL O2/kg per minute walking with stimulation compared with without. DISCUSSION/SIGNIFICANCE OF IMPACT: These preliminary data suggest improvements in walking speed with FES are accompanied by increased energy consumption and decreased energy cost. Oxygen consumption during FES assisted walking was <50% of the peak for able bodied individuals of similar age; patients may successfully use the system for community ambulation.

Type
Mechanistic Basic to Clinical
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Association for Clinical and Translational Science 2018