Multichannel Functional Electrical Stimulation Method in Post-Stroke Rehabilitation

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Abstract
Multichannel functional electrical stimulation (MFES) is a promising method for rehabilitation of post-stroke patients aimed at restoring walking function at different periods after acute cerebrovascular accident. This review systematizes modern concepts of the use of MFES in patients with cerebral stroke, analyzing the technical parameters of stimulation, methodological approaches to the procedures and the clinical effectiveness of the method. Analysis of literary data demonstrates significant variability of MFES protocols: the stimulation frequency varies from 20 to 100 Hz, the duration of procedures is from 15 to 60 minutes, the course of treatment can last from 3 to 30 weeks. The main targets of the impact are four muscle groups of the lower extremities: the anterior tibialis muscle, plantar flexors, quadriceps femoris and hamstrings. Synchronization of stimulation with the gait cycle is carried out mainly by means of contact sensors, accelerometers and EMG signals, although modern developments include inertial systems and machine learning algorithms. This review presents a comprehensive analysis of the technical aspects of MPES from the standpoint of the stages of motor learning and individualization of stimulation parameters. Particular attention is paid to the integration of MPES with robotic devices, including exoskeletons, which represents a new direction in rehabilitation. The work identifies critical gaps in existing research related to the lack of uniform criteria for selecting stimulation parameters and the need for a differentiated approach depending on the type of motor disorders, the period of the disease and the patient's cognitive capabilities. The presented analysis substantiates the need to develop personalized MPES protocols and conduct large-scale studies to optimize stimulation parameters in the rehabilitation of post-stroke patients.

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