Effectiveness of backward walking with functional electrical stimulation on the rectus femoris and tibialis anterior for patients with chronic stroke

BACKGROUND: Backward walking is considered as a newly rising method used to enhance gait abilities, but evidence remains unclear. OBJECTIVE: To identify whether backward walking with functional electrical stimulation (FES) triggered by a foot switch on the rectus femoris and tibialis anterior could be effective in improving gait parameters of stroke survivors. METHODS: This was a cross-sectional study that included fourteen subjects with chronic stroke. Three walking conditions were performed at random: backward walking with FES attached onto the rectus femoris and tibialis anterior (RF+TA), backward walking with FES attached onto the tibialis anterior (TA only), and without electrical intervention (non-FES). The Zebris was used to assess the spatiotemporal gait parameters. Each condition was measured three times and the average value was used for analysis. RESULTS: Results showed significant increases in gait speed, cadence, step length, mid-stance percentage, maximal force in the affected midfoot (p <  0.05), and significant decreases in the double stance phase in the RF+TA condition compared to the TA only and the non-FES conditions (p <  0.05). CONCLUSION: Functional electrical stimulation to the rectus femoris and tibialis anterior during backward walking could be a clinically effective method to improve gait ability of stroke survivors.