Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial

Abstract Background Transcutaneous spinal stimulation has been applied to gait rehabilitation for persons with neurological diseases. The authors developed electromyography-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation and called this system FAST walk. This study a...

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Main Authors: Mami Tani, Tomofumi Yamaguchi, Kaoru Honaga, Yoko Takahashi, Hidemi Kono, Yuhei Murakami, Reina Isayama, Koshiro Haruyama, Yuji Fujino, Tadamitsu Matsuda, Issei Fukunaga, Masaaki Hori, Akira Tanuma, Futoshi Wada, Kozo Hatori, Toshiyuki Fujiwara
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of NeuroEngineering and Rehabilitation
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Online Access:https://doi.org/10.1186/s12984-025-01690-0
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author Mami Tani
Tomofumi Yamaguchi
Kaoru Honaga
Yoko Takahashi
Hidemi Kono
Yuhei Murakami
Reina Isayama
Koshiro Haruyama
Yuji Fujino
Tadamitsu Matsuda
Issei Fukunaga
Masaaki Hori
Akira Tanuma
Futoshi Wada
Kozo Hatori
Toshiyuki Fujiwara
author_facet Mami Tani
Tomofumi Yamaguchi
Kaoru Honaga
Yoko Takahashi
Hidemi Kono
Yuhei Murakami
Reina Isayama
Koshiro Haruyama
Yuji Fujino
Tadamitsu Matsuda
Issei Fukunaga
Masaaki Hori
Akira Tanuma
Futoshi Wada
Kozo Hatori
Toshiyuki Fujiwara
author_sort Mami Tani
collection DOAJ
description Abstract Background Transcutaneous spinal stimulation has been applied to gait rehabilitation for persons with neurological diseases. The authors developed electromyography-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation and called this system FAST walk. This study aimed to assess the effect of FAST walk in a randomized, controlled trial. Methods All participants were randomly allocated to three groups: FAST walk combined with treadmill gait training (FAST walk); spinal stimulation combined with treadmill gait training (spinal stim); and treadmill gait training (treadmill). Participants performed two sets of 15-min treadmill gait training with 5-min intervals in the FAST walk, spinal stim, and treadmill groups. Gait training was performed twice weekly for a total of 10 sessions. The primary outcome was 10-m walking time. The secondary outcomes were the time symmetry index (TSI) with gait analysis and spinal reciprocal inhibition on the conditioned-test H reflex study. Results Twenty persons with chronic stroke participated in this study, and 17 persons completed this study. For the primary outcome, there was no significant interaction between time and intervention in 10-m walking time on two-way analysis of covariance (ANCOVA) (P = 0.382, η2 = 0.064). For the FAST walk group, 10-m walking time improved significantly at post and post-4w (P = 0.024 and 0.022, respectively). In the other groups, no significant improvements in 10-m walking time were seen at post and post-4w compared with before. There was also no significant between-group difference in the 10-m walking time. Conclusions The newly developed electromyography-triggered transcutaneous spinal cord and hip stimulation, FAST walk, is safe and may improve the gait speed of persons with chronic stroke. We did not, however, find a significant between-group difference among the FAST walk, spinal stim, and treadmill gait groups. Trial registration: Japan Registry of Clinical Trial (JRCT registration ID: jRCTs032180289).
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spelling doaj-art-04280cdde86f44dfab2ff1d1f67f1dbd2025-08-20T03:42:23ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032025-07-012211910.1186/s12984-025-01690-0Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trialMami Tani0Tomofumi Yamaguchi1Kaoru Honaga2Yoko Takahashi3Hidemi Kono4Yuhei Murakami5Reina Isayama6Koshiro Haruyama7Yuji Fujino8Tadamitsu Matsuda9Issei Fukunaga10Masaaki Hori11Akira Tanuma12Futoshi Wada13Kozo Hatori14Toshiyuki Fujiwara15Department of Rehabilitation Medicine, Juntendo University Graduate School of MedicineDepartment of Physical Therapy, Faculty of Health Science, Juntendo UniversityDepartment of Rehabilitation Medicine, Juntendo University Graduate School of MedicineDepartment of Physical Therapy, Faculty of Health Science, Juntendo UniversityDepartment of Rehabilitation Medicine, Juntendo University Graduate School of MedicineDepartment of Rehabilitation Medicine, Juntendo University Graduate School of MedicineDepartment of Rehabilitation Medicine, Juntendo University Graduate School of MedicineDepartment of Physical Therapy, Faculty of Health Science, Juntendo UniversityDepartment of Physical Therapy, Faculty of Health Science, Juntendo UniversityDepartment of Physical Therapy, Faculty of Health Science, Juntendo UniversityDepartment of Radiological Technology, Faculty of Health Science, Juntendo UniversityDepartment of Radiology, Toho University Omori Medical CenterDepartment of Rehabilitation Medicine, Juntendo University Graduate School of MedicineDepartment of Rehabilitation Medicine, Juntendo University Graduate School of MedicineDepartment of Rehabilitation Medicine, Juntendo University Graduate School of MedicineDepartment of Rehabilitation Medicine, Juntendo University Graduate School of MedicineAbstract Background Transcutaneous spinal stimulation has been applied to gait rehabilitation for persons with neurological diseases. The authors developed electromyography-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation and called this system FAST walk. This study aimed to assess the effect of FAST walk in a randomized, controlled trial. Methods All participants were randomly allocated to three groups: FAST walk combined with treadmill gait training (FAST walk); spinal stimulation combined with treadmill gait training (spinal stim); and treadmill gait training (treadmill). Participants performed two sets of 15-min treadmill gait training with 5-min intervals in the FAST walk, spinal stim, and treadmill groups. Gait training was performed twice weekly for a total of 10 sessions. The primary outcome was 10-m walking time. The secondary outcomes were the time symmetry index (TSI) with gait analysis and spinal reciprocal inhibition on the conditioned-test H reflex study. Results Twenty persons with chronic stroke participated in this study, and 17 persons completed this study. For the primary outcome, there was no significant interaction between time and intervention in 10-m walking time on two-way analysis of covariance (ANCOVA) (P = 0.382, η2 = 0.064). For the FAST walk group, 10-m walking time improved significantly at post and post-4w (P = 0.024 and 0.022, respectively). In the other groups, no significant improvements in 10-m walking time were seen at post and post-4w compared with before. There was also no significant between-group difference in the 10-m walking time. Conclusions The newly developed electromyography-triggered transcutaneous spinal cord and hip stimulation, FAST walk, is safe and may improve the gait speed of persons with chronic stroke. We did not, however, find a significant between-group difference among the FAST walk, spinal stim, and treadmill gait groups. Trial registration: Japan Registry of Clinical Trial (JRCT registration ID: jRCTs032180289).https://doi.org/10.1186/s12984-025-01690-0Transcutaneous spinal cord stimulationCerebrovascular diseaseLocomotionHemiparesisNeuromodulationNeurorehabilitation
spellingShingle Mami Tani
Tomofumi Yamaguchi
Kaoru Honaga
Yoko Takahashi
Hidemi Kono
Yuhei Murakami
Reina Isayama
Koshiro Haruyama
Yuji Fujino
Tadamitsu Matsuda
Issei Fukunaga
Masaaki Hori
Akira Tanuma
Futoshi Wada
Kozo Hatori
Toshiyuki Fujiwara
Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial
Journal of NeuroEngineering and Rehabilitation
Transcutaneous spinal cord stimulation
Cerebrovascular disease
Locomotion
Hemiparesis
Neuromodulation
Neurorehabilitation
title Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial
title_full Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial
title_fullStr Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial
title_full_unstemmed Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial
title_short Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial
title_sort electromyography emg triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke a randomized controlled trial
topic Transcutaneous spinal cord stimulation
Cerebrovascular disease
Locomotion
Hemiparesis
Neuromodulation
Neurorehabilitation
url https://doi.org/10.1186/s12984-025-01690-0
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