Effectiveness Of Antagonist Functional Electrical Stimulation Combined With Close Kinetic Chain Exercises On Plantar Flexor Spasticity, Heel Strike, And Motor Recovery In Patients With Stroke

Abstract

Background: Stroke is a significant neurological event leading to functional deficits and long-term disability. Restoring walking ability is essential for independence and quality of life. Functional electrical stimulation (FES) has recently emerged as an effective method for post-stroke gait rehabilitation. The present study aimed to evaluate the combined effect of antagonist functional electrical stimulation and closed kinetic chain exercises on plantar flexor spasticity, heel strike, and motor recovery in individuals with stroke.

Methodology: A pre- and post-experimental study was carried out on 60 stroke patients selected through simple random sampling based on defined inclusion and exclusion criteria. Participants were randomly allocated into two groups (n=30 each). Group A performed closed kinetic chain exercises alone, while Group B received a combination of functional electrical stimulation (FES) and closed kinetic chain exercises. The intervention was administered for 1 hour daily, 5 days a week, over a period of 8 weeks.

Outcome Measures: Plantar flexor spasticity was evaluated using the Modified Modified Ashworth Scale, ankle dorsiflexion range of motion was measured with a universal goniometer, and motor recovery of the lower limb was assessed using the Fugl-Meyer Assessment Scale.

Results: Post-intervention analysis revealed that Group B demonstrated significantly greater improvement compared to Group A. The experimental group showed a highly significant increase in active ankle dorsiflexion range of motion (p<0.0001) and a marked reduction in plantar flexor spasticity. Additionally, Group B exhibited enhanced motor recovery and better gait performance compared to the control group (p<0.0001).

Conclusion: The findings suggest that combining antagonist functional electrical stimulation with closed kinetic chain exercises produces superior outcomes in reducing plantar flexor spasticity, improving heel strike, and enhancing motor recovery in patients with hemiplegic gait following stroke.