Keep Improving Kinematics in Walking (KIK-Walk) : Functional Electrical Stimulation Based Locomotor Training

The stroke is one of the leading causes of morbidity and mortality or disability among adult population world-wide. Today, the advances in acute medical management of stroke are changing the neurological population. The percentage of individuals that suffered stroke and survived the first month has increase to more than 85%. Therefore, it is critical to find clinically sustainable approaches to improve survivors’ quality of live, starting with the most important; walking. The current evidence shows that many stroke survivors have improved their walking after receiving therapeutic gait training utilizing various modalities in research in research programs internationally, regardless of the time elapsed since their disease onset. One of these recognizable modalities is a functional electrical stimulation (FES), however, despite its common availability compared with expensive robot-based therapies, its use is rather limited world-wide, mainly due to lack of training. This study is divided into three parts. First, a systematized review is presented to provide evidence concerning the use of FES-walking therapy in stroke rehabilitation. Results related to changes in gait speed and participants’ satisfactions compared with the use of standard ankle foot orthosis are provided. Second, a case study involving 5 weeks of FES-walking therapy is presented to assess the feasibility of this approach in a school setting so that the gained knowledge can be applied in standard clinical practice. The results of this work show that there is enough evidence to apply the FES-walking therapy in rehabilitation setting and that even and individual 14 years post stroke can improve gait pattern significantly. Nevertheless, the problem remains in the lack of training of pertinent physiotherapists and their believes towards this type of therapy modality. Therefore, the author hopes that this work can be used as the first step towards successful incorporation of this modality in standard stroke rehabilitation in Finland