Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial.
Mami Tani, Tomofumi Yamaguchi, Kaoru Honaga and 13 others
PMID 40624543WHAT IT FOUND
No significant difference was found between groups in 10-m walking time after adding EMG-triggered spinal and hip stimulation to treadmill training.
The combined group improved within itself, but that alone does not show it beats treadmill training.
Key findings
01The primary 10-m walking time did not show a significant difference between groups over time (P = 0.382) or a significant overall between-group difference (P = 0.578).
02Only the FAST walk group showed significant within-group improvement in 10-m walking time after and at 4 weeks (P = 0.024 and 0.022).
03No adverse events related to the intervention were observed in all three groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 20 participants were randomly allocated, with 7 in FAST walk, 7 in spinal stim, and 6 in treadmill groups. Two participants dropped out after pre-assessment and one before post-assessment, and the paper does not clearly state the number analysed after dropouts. Participants were not blinded, and no sham stimulation was applied to the control group. The training dose was limited to 30-min gait training, 2 times/week, for 5 weeks because of Japan's health insurance system. The study did not compare FAST walk with hip extensor stimulation alone, so the added value of hip stimulation is unclear. FAST walk combined spinal stimulation, hip stimulation, and treadmill training, so the contribution of any single component cannot be separated. The FAST walk system is not commercially available.
Declared interests
Funding was from JSPS KAKENHI. No explicit conflict-of-interest statement is provided. The FAST walk system was made by Pacific Supply Co., was not commercially available, and was patented.
The easy way to misread this
Do not conclude that FAST walk is better than treadmill training because its group improved within itself; the primary between-group comparison was not significant, and the combined group received spinal stimulation, hip stimulation, and treadmill training together.