Comparison of Gait Metrics in Patients With Stroke, Traumatic Brain Injury, and Multiple Sclerosis

Functional Electrical Stimulation (FES) is an established therapeutic approach that applies electrical currents to peripheral nerves to elicit muscle contractions, thereby facilitating movement in individuals with neurological impairments. FES has demonstrated benefits for improving motor function and gait in populations such as stroke survivors, individuals with spinal cord injury, and those with multiple sclerosis. By activating muscles during walking, FES can enhance gait parameters including speed, stride length, and symmetry, ultimately supporting greater independence and mobility.

Despite these documented benefits, comparative data across neurological conditions remain limited, and the degree to which FES influences specific gait metrics is not fully understood. Furthermore, most prior studies have relied on basic clinical assessments, which may not capture the nuanced changes in gait mechanics that occur with FES intervention.

The L300 system is a widely used FES device designed to address foot drop by stimulating the peroneal nerve to facilitate ankle dorsiflexion during the swing phase of gait. This targeted approach can improve walking efficiency and reduce compensatory movements. However, the integration of advanced gait analysis technologies-such as wearable sensors and instrumented walkways-offers an opportunity to obtain objective, high-resolution data on spatiotemporal and kinematic parameters. These tools enable a more comprehensive evaluation of gait before and after FES intervention, providing insights into both functional outcomes and underlying biomechanical changes.

• Functional Electrical Stimulation (Device): Functional Electrical Stimulation (FES) is an established therapeutic approach that applies electrical currents to peripheral nerves to elicit muscle contractions, thereby facilitating movement in individuals with neurological impairments. FES has demonstrated benefits for improving motor function and gait in populations such as stroke survivors, individuals with spinal cord injury, and those with multiple sclerosis. By activating muscles during walking, FES can enhance gait parameters including speed, stride length, and symmetry, ultimately supporting greater independence and mobility.
• Normal care (Device): No device, no FES

Primary outcomes

• Changes in gait speed [From enrollment to the end of treatment at 12 weeks]: Measuring changes in gait speed

Secondary outcomes

• Timed Up and Go [Baseline and 12-week Follow-Up]: The Timed Up and Go test measures basic mobility and balance. Participants start seated in a chair, stand up, walk a short distance (3 meters), turn around, walk back to the chair, and sit down. The time it takes to complete the task is recorded in seconds. Shorter times indicate better mobility and functional walking ability.
• 10-Meter Walk Test [Baseline and 12-Week Follow-Up]: The 10-Meter Walk Test measures walking speed over a short distance. Participants are asked to walk 10 meters at their normal walking pace. The time to walk the distance is recorded and used to calculate walking speed. Faster walking speeds indicate better walking ability.

Sex: All, ages: 18 Years to 80 Years

Inclusion Criteria:

* Adults aged 18-80 years.
* Diagnosis of stroke, traumatic brain injury, or multiple sclerosis confirmed by medical records.
* Presence of foot drop or impaired ankle dorsiflexion during gait.
* Ability to ambulate at least 10 meters with or without assistive devices.
* Cognitive ability to follow simple instructions and provide informed consent.

Exclusion Criteria:

* Severe lower limb contractures or orthopedic conditions that limit gait.
* Implanted electrical devices (e.g., pacemaker) contraindicating FES use.
* Uncontrolled medical conditions (e.g., severe cardiac disease).
* Pregnancy.
* Skin integrity issues preventing electrode placement.
* Participation in other interventional gait studies within the past 3 months.