Treadmill training with tilt sensor functional electrical stimulation for improving balance, gait, and muscle architecture of tibialis anterior of survivors with chronic stroke: A randomized controlled trial

BACKGROUND: Gait training is important for stroke rehabilitation, such as using the treadmill training with functional electrical stimulation (FES). OBJECTIVE: This study was to investigate the effects of the treadmill training with tilt sensor FES on the balance, gait, and muscle architecture of the tibialis anterior in stroke survivors. METHODS: The study was a randomized controlled trial. Thirty-four stroke survivors were recruited and screened eligibility criteria. Thirty-two participants were randomly allocated to two groups using random allocation software: Treadmill training with Tilt Sensor FES (TTSF) group (n = 16) and Treadmill training with Placebo Tilt Sensor FES (TPTSF) group (n = 16). TTSF group performed gait training on treadmill with tilt sensor FES, and TPTSF group performed gait training on treadmill with placebo tilt sensor FES. Two participants were dropped during this study, and 30 participants were included at post-test. Balance and gait were measured using the timed up and go (TUG) test, berg balance scale (BBS), and 10 m walk test (10 mWT). Ultrasound imaging was used to measure the muscle architecture of the tibialis anterior. RESULTS: After intervention, there were significant improvements in the TUG, BBS, and 10 mWT compared to baseline in both groups ( p< 0.05). At follow-up, the TUG, BBS, 10 mWT, and muscle architecture of tibialis anterior on the paretic side showed significant improvements in the TTSF group compared to TPTSF group ( p< 0.05). CONCLUSIONS: The findings of this study suggest that TTSF can be an effective intervention for improving balance, gait ability, and muscle architecture of tibialis anterior of stroke survivors.