Table of Contents
ISRN Stroke
Volume 2014, Article ID 827453, 13 pages
Clinical Study

A Low-Cost Biofeedback System for Electromyogram-Triggered Functional Electrical Stimulation Therapy: An Indo-German Feasibility Study

1Max Super Speciality Hospital, Saket 110017, India
2Charité-Universitätsmedizin, 10117 Berlin, Germany
3The Institut National de Recherche en Informatique et en Automatique (INRIA), 34090 Montpellier, France

Received 13 January 2014; Accepted 4 March 2014; Published 1 June 2014

Academic Editors: R. Nistico and P. A. Nyquist

Copyright © 2014 Alakananda Banerjee et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Functional electrical stimulation (FES) facilitates ambulatory function after paralysis by activating the muscles of the lower extremities. The FES-assisted stepping can either be triggered by a heel-swich, or by an electromyogram-(EMG-) based gait event detector. A group of six chronic (>6 months poststroke) hemiplegic stroke survivors underwent transcutaneous FES-assisted training for 1 hour on stepping task with EMG biofeedback from paretic tibialis anterior (TA) and medial gastrocnemius (GM) muscles, where the stimulation of the paretic TA or GM was triggered with surface EMG from the same muscle. During the baseline, postintervention, and 2-day-postintervention assessments, a total of 5 minutes of surface EMG was recorded from paretic GM and TA muscles during volitional treadmill walking. Two-way ANOVA showed significant effects in terms of values for the 6 stroke subjects, 0.002, the 3 assessments, 0, and the interaction between subjects and assessments, . The study showed a significant improvement from baseline in paretic GM and TA muscles coordination during volitional treadmill walking. Moreover, it was found that the EMG-triggered FES-assisted therapy for stand-to-walk transition helped in convergence of the deviation in centroidal angular momentum from the normative value to a quasi-steady state during the double-support phase of the nonparetic. Also, the observational gait analysis showed improvement in ankle plantarflexion during late stance, knee flexion, and ground clearance of the foot during swing phase of the gait.