Issue 24-1, 2025

Original article

https://doi.org/10.38025/2078-1962-2025-24-1-8-18

Effectiveness of Gait Training with Electromyogram in Stroke Patients: an Experimental Longitudinal Pilot Study

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1,2,3 ORCIDDmitry V. Skvortsov, 1,2,* ORCIDSergey N. Kaurkin, 1,2 ORCIDGalina E. Ivanova, 2 ORCIDNina K. Belonovskaya, 2 ORCIDAliya R. Khudaigulova

1 Federal Center of Brain Research and Neurotechnologies, Moscow, Russia
2 Pirogov Russian National Research Medical University, Moscow, Russia
3 Federal Research and Clinical Center for Specialized Types of Medical Care and Medical Technologies, Moscow, Russia


ABSTRACT

INTRODUCTION. Weakness in the tibialis anterior muscle caused by acute cerebral circulatory failure affects the speed, endurance, safety and quality of gait. Among various rehabilitation methods, electromyogram amplitude biofeedback (BFB) can be used. However, the available evidence on its effectiveness is conflicting.

AIM.  To study the possibility of restoring the function of the tibialis anterior muscle when walking by the biofeedback electromyogram amplitude training method in patients in the early recovery period of cerebral stroke

MATERIALS AND METHODS. In this study, we examined 22 patients (16 men and 6 women) who had suffered their first hemispheric ischaemic stroke and were in the early recovery period, with lesions in either the right or left cerebral hemisphere (15 right / 7 left). The patients received biofeedback walking training according to the electromyographic amplitude of the tibialis anterior muscle and an individual rehabilitation program. Prior to and following the rehabilitation program, gait biomechanics studies and examinations with clinical scales were conducted.

RESULTS AND DISCUSSION  There was a significant improvement in clinical scales of assessment of walking skills and safety as a result of rehabilitation. The Dynamic Gait Index (DGI) indicator is approaching the low risk of falls parameter ( 19 points), as a result of which walking becomes safer. The objective diagnosis revealed typical changes and asymmetries associated with hemiparesis. A notable finding was the asymmetry in ankle joint amplitudes during the swing period, which was significantly greater than that of the contralateral side and the control group, characterized by foot drop syndrome. As a result of the training, the rhythm coefficient and the maximum electrical activity of m. rectus femoris and m. hamstring of the contralateral side significantly improved. Clinically and instrumentally, the walking function of patients with hemiparesis has a number of significant and minor improvements during the treatment period. Nevertheless, there is no evidence to suggest that these changes can be attributed to the training program implemented for the target parameter, namely the activity amplitude of the m. tibialis anterior.

CONCLUSION.  The effectiveness of training according to the target parameter of electromyogram amplitude for automated locomotion (walking), in the presence of paresis of the central genesis, can be questioned and requires further research.

REGISTRATION:  ClinicalTrails.gov identifier No. NCT06299943; Registered 19.07.2021.


KEYWORDS: gait, cerebral stroke, electromyographic amplitude, biofeedback, biofeedback training, myography, tibialis anterior muscle, gait recovery, gait biomechanics

FOR CITATION:

Skvortsov D.V., Kaurkin S.N., Ivanova G.E., Belonovskaya N.K., Khudaigulova A.R. Effectiveness of Gait Training with Electromyogram in Stroke Patients: an Experimental Longitudinal Pilot Study. Bulletin of Rehabilitation Medicine. 2025; 24(1):8–18. https://doi.org/10.38025/2078-1962-2025-24-1-8-18 (In Russ.).

FOR CORRESPONDENCE: Sergey N. Kaurkin, Е-mail: kaurkins@bk.ru, kaurkin@fccps.ru


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