Altered cortical activation patterns in post-stroke patients during walking with two-channel functional electrical stimulation: a functional near-infrared spectroscopy observational study
Restoration of independent walking ability is the primary objective of stroke rehabilitation; however, not all patients achieve this goal due to diverse impairments in the paretic lower limb and compensatory mechanisms that lead to an asymmetrical and mechanically inefficient gait. This investigatio...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2024.1449667/full |
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| author | Sheng Xu Shizhe Zhu Minyao Li Tianjiao Zhang Qinglei Wang Youxin Sui Ying Shen Kan Chaojie Ren Zhuang Chuan Guo Tong Wang Lan Zhu Lan Zhu |
| author_facet | Sheng Xu Shizhe Zhu Minyao Li Tianjiao Zhang Qinglei Wang Youxin Sui Ying Shen Kan Chaojie Ren Zhuang Chuan Guo Tong Wang Lan Zhu Lan Zhu |
| author_sort | Sheng Xu |
| collection | DOAJ |
| description | Restoration of independent walking ability is the primary objective of stroke rehabilitation; however, not all patients achieve this goal due to diverse impairments in the paretic lower limb and compensatory mechanisms that lead to an asymmetrical and mechanically inefficient gait. This investigation aimed to examine alterations in cortical activation in post-stroke patients while walking with a wearable two-channel functional electrical stimulation (FES) in comparison to walking without FES. This observational study was conducted to discern distinct activation patterns in 19 stroke patients during sessions with and without FES, while using functional near-infrared spectroscopy (fNIRS) to monitor changes in blood oxygen levels. Our findings revealed only a significant reduction in ΔOxy-Hb in the contralesional pre-motor cortex (z = −2.803, p = 0.005) during the FES-on walking sessions compared to the FES-off sessions. Furthermore, all regions in the FES-on session exhibited lower ΔOxy-Hb. Conversely, no significant differences were observed in ΔDeoxy-Hb. Moreover, a significant correlation was found between decrease in cPMC and the reduced cost time of walking under FES-on condition. The fNIRS analysis revealed diminished activation in the contralesional pre-motor cortex when walking with FES, implying that FES may facilitate a more automatic gait pattern while reducing a patient’s reliance on contralesional cortical resources. The findings of this study lay the groundwork for long-term neural rehabilitation. |
| format | Article |
| id | doaj-art-0f8743528dd74c2d80d474d015786789 |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj-art-0f8743528dd74c2d80d474d0157867892025-01-13T05:10:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011510.3389/fneur.2024.14496671449667Altered cortical activation patterns in post-stroke patients during walking with two-channel functional electrical stimulation: a functional near-infrared spectroscopy observational studySheng Xu0Shizhe Zhu1Minyao Li2Tianjiao Zhang3Qinglei Wang4Youxin Sui5Ying Shen6Kan Chaojie7Ren Zhuang8Chuan Guo9Tong Wang10Lan Zhu11Lan Zhu12Department of Rehabilitation Medicine, Changzhou Dean Hospital, Changzhou, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Rehabilitation Medicine, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Rehabilitation Medicine, Changzhou Dean Hospital, Changzhou, ChinaDepartment of Rehabilitation Medicine, Changzhou Dean Hospital, Changzhou, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, ChinaNanjing Qixia District Hospital, Nanjing, ChinaRestoration of independent walking ability is the primary objective of stroke rehabilitation; however, not all patients achieve this goal due to diverse impairments in the paretic lower limb and compensatory mechanisms that lead to an asymmetrical and mechanically inefficient gait. This investigation aimed to examine alterations in cortical activation in post-stroke patients while walking with a wearable two-channel functional electrical stimulation (FES) in comparison to walking without FES. This observational study was conducted to discern distinct activation patterns in 19 stroke patients during sessions with and without FES, while using functional near-infrared spectroscopy (fNIRS) to monitor changes in blood oxygen levels. Our findings revealed only a significant reduction in ΔOxy-Hb in the contralesional pre-motor cortex (z = −2.803, p = 0.005) during the FES-on walking sessions compared to the FES-off sessions. Furthermore, all regions in the FES-on session exhibited lower ΔOxy-Hb. Conversely, no significant differences were observed in ΔDeoxy-Hb. Moreover, a significant correlation was found between decrease in cPMC and the reduced cost time of walking under FES-on condition. The fNIRS analysis revealed diminished activation in the contralesional pre-motor cortex when walking with FES, implying that FES may facilitate a more automatic gait pattern while reducing a patient’s reliance on contralesional cortical resources. The findings of this study lay the groundwork for long-term neural rehabilitation.https://www.frontiersin.org/articles/10.3389/fneur.2024.1449667/fullfunctional electrical stimulationfNIRSstrokewalkcortical activation |
| spellingShingle | Sheng Xu Shizhe Zhu Minyao Li Tianjiao Zhang Qinglei Wang Youxin Sui Ying Shen Kan Chaojie Ren Zhuang Chuan Guo Tong Wang Lan Zhu Lan Zhu Altered cortical activation patterns in post-stroke patients during walking with two-channel functional electrical stimulation: a functional near-infrared spectroscopy observational study Frontiers in Neurology functional electrical stimulation fNIRS stroke walk cortical activation |
| title | Altered cortical activation patterns in post-stroke patients during walking with two-channel functional electrical stimulation: a functional near-infrared spectroscopy observational study |
| title_full | Altered cortical activation patterns in post-stroke patients during walking with two-channel functional electrical stimulation: a functional near-infrared spectroscopy observational study |
| title_fullStr | Altered cortical activation patterns in post-stroke patients during walking with two-channel functional electrical stimulation: a functional near-infrared spectroscopy observational study |
| title_full_unstemmed | Altered cortical activation patterns in post-stroke patients during walking with two-channel functional electrical stimulation: a functional near-infrared spectroscopy observational study |
| title_short | Altered cortical activation patterns in post-stroke patients during walking with two-channel functional electrical stimulation: a functional near-infrared spectroscopy observational study |
| title_sort | altered cortical activation patterns in post stroke patients during walking with two channel functional electrical stimulation a functional near infrared spectroscopy observational study |
| topic | functional electrical stimulation fNIRS stroke walk cortical activation |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2024.1449667/full |
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