Multi-channel functional electrostimulation: the method of restoring the walking function in patients with a past history of acute cerebrovascular event

Multi-channel functional electrostimulation (MFES) represents a promising method for the rehabilitation of post-stroke patients, aimed at restoring the walking function in various periods after an acute cerebrovascular event. The review systematizes the modern concepts of using the MFES in patients with the consequences of cerebral stroke, analyzing the technical parameters of stimulation, the methodical approaches to conducting the procedures and the clinical efficiency of the method. The analysis of literature data demonstrates significant variability of MFES protocols: the stimulation frequency varies from 20 to 100 Hz, the duration of the procedure ranges from 15 to 60 minutes, the treatment course can last from 3 to 30 weeks. The main targets of stimulation are the four groups of muscles in the lower limbs — the anterior tibial muscle, the plantar flexors, the quadriceps muscle of thigh and the group of muscles on the posterior surface of thigh. The synchronization of stimulation with the walking cycle is conducted predominantly by means of contact sensors, accelerometers and electromyographic signals; modern developments include the inertial systems and the machine learning algorithms. The review presents a combined analysis of the technical aspects of MFES from the point of view of staging of motor learning and individualization of the stimulation parameters. Special attention was paid to the integration of MFES with the robotic devices, including the exoskeletons, which represents a new trend in rehabilitation. Along with the absence of the unified criteria for choosing the stimulation parameters, it is worth noting that there is a necessity of differentiated approach depending on the type of motor disorders, on the duration of the disease and on the cognitive capabilities of the patient. The analysis presented justifies the necessity of developing personalized MFES protocols and arranging a large-scale research for optimizing the stimulation parameters in the rehabilitation of post-stroke patients.