Following stroke, many patients do not regain a normal, safe gait pattern e
ven after receiving conventional physical therapy. One promising technique
is functional neuromuscular stimulation (FNS) with intramuscular (IM) elect
rodes (FNS-LM). Five subjects were admitted into the study at 3 weeks to 3
months following the stroke. For each subject, electrodes were placed intra
muscularly at the motor point of up to seven lower extremity paretic muscle
s. Subjects were treated for 6 months, twice weekly with FNS-IM for exercis
e and gait training. The stimulator and software provided individualized st
imulation patterns, with flexible stimulus parameters and activation timing
s of multiple muscles. Outcome measures were active joint movement, coordin
ation (Fugl-Meyer scale), balance (Tinetti scale), gait (Tinetti scale), ac
tivities of daily living (functional independence measure), and therapist a
nd subject satisfaction (survey instrument). Subjects tolerated well the pl
acement of IM electrodes with no adverse effects, and subjects lost no conv
entional rehabilitation time. Therapists and subjects were satisfied with t
he FNS-IM system as a rehabilitation tool. Post treatment, subjects demonst
rated improvements in impairment and disability in active joint movement, c
oordination, balance, gait and activities of daily living. Considered toget
her with prior research for chronic stroke subjects, this research suggests
that FNS-IM can be successfully and efficaciously utilized for gait traini
ng for those with acute stroke. (C) 2000 Published by Elsevier Science B.V.