The development of a closed-loop controlled functional electrical stimulation (FES) in gait training

A closed-loop functional electrical stimulation (FES) system is developed to provide hemiplegic patients with a real-time stimulation to their muscles to prevent the drop-foot and the quadriceps weakness from happening during gait training. The FES is controlled by position sensors (ps) and triggered by footswitches (f) with real-time feedback. As the FES receives the signals from these sensors, it adjusts and outputs an optimum set of stimulation parameters automatically. One hemiplegic patient was recruited to conduct clinical evaluation and treated by using the new closed-loop FES system. It was revealed that the mean velocity, cadence, stride length, active ankle motion range, and functional ambulation category (FAC) improved significantly from 0.12 +/- 0.07 ms-1, 40.3 +/- 18.3 steps min-1, 0.35 +/- 0.10 m, 15 degrees, level 2 to 0.42 +/- 0.23 ms-1, 68.2 +/- 19.0 steps min-1, 0.70 +/- 0.22 m, 40 degrees, level 4 respectively for the patient. A paired t-test indicated that differences in the electromyography (EMG) of the tibialis anterior and the quadriceps muscles between the patient's disabled (affected side) foot and normal (unaffected side) foot are not significant (p > 0.05) after 12 weeks of training. It is concluded that this new closed-loop FES system is capable of providing this hemiplegic patient with restoration to regular walking after appropriate gait training. Future studies, including randomized-controlled study, should be implemented to document the efficacy of this system.