Effects of flexor reflex stimulation on gait aspects in stroke patients. A pilot study

Abstract Background Gait deficits are very common after stroke and therefore an important aspect in poststroke rehabilitation. A currently little used method in gait rehabilitation after stroke is the activation of the flexor reflex (FR) by electrical stimulation of the sole of foot while walking. The aim of this study was to investigate the effect of FR stimulation on gait performance and gait parameters in stroke patients within a single session of flexor reflex stimulation using Incedo™. Methods Twenty-five patients with subacute (n = 14) and chronic (n = 11) stroke participated in the study. Motor functions were tested with a 10-meter walk test (10mWT), a 2-minute walk test (2minWT), and a gait analysis. These tests were performed with and without Incedo™ within a single session in randomized order. Results This study showed that stroke patients walked significant faster in 10mWT and a longer distance in 2minWT with Incedo™ compared to without electrostimulation (p < 0.03). The gait parameters remained unchanged except for the step length. A subgroup analysis indicated that subacute and chronic patients responded similarly to the stimulation. There was a correlation between the degree of response to electrostimulation while walking and degree of improvement in 2minWT ( r = 0.50, p = 0.01). Conclusions This study is the first to examine FR activation effects in chronic stroke patients und suggests that stimulation effects are independent of the time since stroke. A larger controlled clinical trial is warranted that addresses issues as the necessary number of therapeutical sessions and for how long stimulation-induced improvements outlast the treatment period. Trial registration: The trial was retrospectively registered in German Clinical Trials Register. Clinical trial registration number: DRKS00021457. Date of registration: 29 June 2020.