Thomas Aout

Objective This study aimed to compare the effects of different conditions of functional electrical stimulation (FES) applied to the ankle plantarflexor muscles (gastrocnemius, soleus, or both combined) during push-off on lower limb joint biomechanics at controlled walking speeds in healthy young adults. Methods Fifteen healthy young adults walked along a 7-meter walkway at controlled speeds under six conditions: bilateral stimulation of the soleus, gastrocnemius, both muscles combined, and matched-speed trials without stimulation. Stimulation was applied below the discomfort threshold during push-off (heel-off to toe-off of the trailing leg). Two force plates and a motion capture system measured lower limb joint biomechanics. Results All FES conditions increased positive (+8%) and total mechanical work (+5%) at the ankle. FES reduced positive knee work (− 10%) and negative hip work (− 5%), although this was significant only for gastrocnemius stimulation alone or combined with soleus. The ankle’s contribution to both positive and total lower limb work increased with FES, while the contributions of the knee and hip decreased regardless of the stimulation condition. Additionally, FES increased ankle plantarflexion angle (13%) and velocity peaks (6%), without affecting spatiotemporal gait parameters at comparable speeds. Conclusion FES applied to the plantarflexor muscles during push-off leads to a proximal-to-distal redistribution of lower limb joint work during walking at controlled speeds in healthy young adults, with subtle differences depending on the stimulation condition. These findings underscore the potential of FES as a solution to redistribute lower limb joint work during walking.

Background: This systematic review aimed to provide a comprehensive overview of the effects of functional electrical stimulation (FES) on gait characteristics in healthy individuals. Methods: Six electronic databases (PubMed, Embase, Epistemonikos, PEDro, COCHRANE Library, and Scopus) were searched for studies evaluating the effects of FES on spatiotemporal, kinematic, and kinetic gait parameters in healthy individuals. Two examiners evaluated the eligibility and quality of the included studies using the PEDro scale. Results: A total of 15 studies met the inclusion criteria. The findings from the literature reveal that FES can be used to modify lower-limb joint kinematics, i.e., to increase or reduce the range of motion of the hip, knee, and ankle joints. In addition, FES can be used to alter kinetics parameters, including ground reaction forces, center of pressure trajectory, or knee joint reaction force. As a consequence of these kinetics and kinematics changes, FES can lead to changes in spatiotemporal gait parameters, such as gait speed, step cadence, and stance duration. Conclusions: The findings of this review improve our understanding of the effects of FES on gait biomechanics in healthy individuals and highlight the potential of this technology as a training or assistive solution for improving gait performance in this population.

Background: This systematic review aimed to provide a comprehensive overview of the effects of Functional Electrical Stimulation (FES) on gait characteristics in healthy individuals. Methods: Six electronic databases (PubMed, Embase, Epistemonikos, PEDro, COCHRANE Library, Scopus) were searched for studies evaluating the effects of FES on spatiotemporal, kinematic and kinetic gait parameters in healthy individuals. Two examiners evaluated the eligibility and quality of included studies using the PEDro scale. Results: A total of 15 studies met the inclusion criteria. Findings from the literature reveal that FES can be used to modify lower-limb joint kinematics, i.e., to increase or reduce the range of motion of hip, knee and ankle joints. In addition, FES can be used to alter kinetics parameters, including ground reaction forces, center of pressure trajectory, or knee joint reaction force. As a consequence of these kinetics and kinematics changes, FES can lead to changes in spatiotemporal gait parameters, such as gait speed, step cadence, and stance duration. Conclusion: The findings of this review improve our understanding of the effects of FES on gait biomechanics in healthy individuals, and highlight the potential of this technology as a training or assistive solution for improving gait performance in this population.