{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:37:48Z","timestamp":1791333468937,"version":"4.3.1"},"reference-count":47,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T00:00:00Z","timestamp":1683244800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: Stroke is one of the leading causes of disability. To identify the best treatment strategies for people with stroke (PwS), the aim of the current study was to compare the effects of training on a treadmill with functional electrical stimulation (TT-FES) with training on a treadmill (TT), and to analyze the effects of sequence of training on mobility and the parameters of walking ability. (2) Methods: Prospective, longitudinal, randomized and crossover study, in which 28 PwS were distributed into groups, namely the A-B Group (TT-FES followed by TT) and B-A Group (TT followed by TT-FES), using the foot drop stimulator, and were measured with functional tests. (3) Results: We found improved mobility, balance, non-paretic limb coordination, and endurance only in the group that started with TT-FES. However, sensorimotor function improved regardless of the order of training, and paretic limb coordination only improved in the B-A Group, but after TT-FES. These data indicate that the order of the protocols changed the results. (4) Conclusions: Although biomechanical evaluation methods were not used, which can be considered a limitation, our results showed that TT-FES was superior to isolated training on a treadmill with regard to balance, endurance capacity, and coordination of the non-paretic limb.<\/jats:p>","DOI":"10.3390\/ijerph20095728","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T04:55:50Z","timestamp":1683262550000},"page":"5728","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Gait Training with Functional Electrical Stimulation Improves Mobility in People Post-Stroke"],"prefix":"10.3390","volume":"20","author":[{"given":"Maria Tereza Artero Prado","family":"Dantas","sequence":"first","affiliation":[{"name":"Laboratory Design and Scientific Writing, Department of Basic Sciences, ABC Faculty of Medicine, Santo Andr\u00e9 09060-650, Brazil"},{"name":"School of Arts, Sciences and Humanities, University of S\u00e3o Paulo (EACH\/USP), S\u00e3o Paulo 03828-000, Brazil"},{"name":"Course of Physiotherapy, University of West Paulista (UNOESTE), Presidente Prudente 19050-920, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah Cristina Gon\u00e7alves Luiz","family":"Fernani","sequence":"additional","affiliation":[{"name":"Laboratory Design and Scientific Writing, Department of Basic Sciences, ABC Faculty of Medicine, Santo Andr\u00e9 09060-650, Brazil"},{"name":"Course of Physiotherapy, University of West Paulista (UNOESTE), Presidente Prudente 19050-920, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4683-4671","authenticated-orcid":false,"given":"Talita Dias da","family":"Silva","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Medicine (Cardiology) at Paulista School of Medicine, Federal University of S\u00e3o Paulo (EPM\/UNIFESP), S\u00e3o Paulo 04024-002, Brazil"},{"name":"Faculty of Medicine, University City of Sao Paulo (UNICID), S\u00e3o Paulo 03071-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iramaia Salom\u00e3o Alexandre de","family":"Assis","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), S\u00e3o Paulo State University (UNESP), Bauru 17033-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto Cesinando de","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, S\u00e3o Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidney Benedito","family":"Silva","sequence":"additional","affiliation":[{"name":"Laboratory Design and Scientific Writing, Department of Basic Sciences, ABC Faculty of Medicine, Santo Andr\u00e9 09060-650, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz Carlos de","family":"Abreu","sequence":"additional","affiliation":[{"name":"Laboratory Design and Scientific Writing, Department of Basic Sciences, ABC Faculty of Medicine, Santo Andr\u00e9 09060-650, Brazil"},{"name":"Department of Integrated Health Education, Federal University of Esp\u00edrito Santo (UFES), Vit\u00f3ria 29040-090, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3678-8456","authenticated-orcid":false,"given":"Fabio Augusto","family":"Barbieri","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), S\u00e3o Paulo State University (UNESP), Bauru 17033-360, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2661-775X","authenticated-orcid":false,"given":"Carlos Bandeira de Mello","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Laboratory Design and Scientific Writing, Department of Basic Sciences, ABC Faculty of Medicine, Santo Andr\u00e9 09060-650, Brazil"},{"name":"School of Arts, Sciences and Humanities, University of S\u00e3o Paulo (EACH\/USP), S\u00e3o Paulo 03828-000, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S1474-4422(04)00800-2","article-title":"The global stroke initiative","volume":"3","author":"Bonita","year":"2004","journal-title":"Lancet Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.1161\/CIR.0000000000001123","article-title":"Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association","volume":"147","author":"Tsao","year":"2023","journal-title":"Circulation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1053\/apmr.2002.35473","article-title":"Motor recovery after stroke: A systematic review of the literature","volume":"83","author":"Hendricks","year":"2002","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1001\/jama.2015.6968","article-title":"Trajectory of Cognitive Decline After Incident Stroke","volume":"314","author":"Levine","year":"2015","journal-title":"JAMA"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1590\/S1413-35552010005000006","article-title":"Brazilian version of the Nottingham Sensory Assessment: Validity, agr\u00e9ment and rehability","volume":"14","author":"Lima","year":"2010","journal-title":"Rev. Bras. Fisioter."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.1161\/STR.0b013e318296aeca","article-title":"An Updated Definition of Stroke for the 21st Century","volume":"44","author":"Sacco","year":"2013","journal-title":"Stroke"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1590\/S1413-35552010005000018","article-title":"Psychometric properties of the portuguese version of the Jebsen-Taylor test for adults with mild hemiparesis","volume":"14","author":"Ferreiro","year":"2010","journal-title":"Rev. Bras. Fisioter."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1682\/JRRD.2009.08.0133","article-title":"Prevalence, predictors, and outcomes of poststroke falls in acute hospital setting","volume":"47","author":"Schmid","year":"2010","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1191\/026921501680425234","article-title":"Walking training of patients with hemiparesis at an early stage after stroke: A comparison of walking training on a treadmill with body weight support and walking training on the ground","volume":"15","author":"Nilsson","year":"2001","journal-title":"Clin. Rehabil."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"278","DOI":"10.3109\/09593985.2012.727526","article-title":"Walking during body-weight-supported treadmill training and acute responses to varying walking speed and body-weight support in ambulatory patients post-stroke","volume":"29","author":"Aaslund","year":"2013","journal-title":"Physiother. Theory Pract."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S1836-9553(13)70159-0","article-title":"Treadmill training is effective for ambulatory patients after stroke: A systematic review","volume":"59","author":"Polese","year":"2013","journal-title":"J. Physiother."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1080\/10749357.2017.1345445","article-title":"The efficacy of treadmill training on balance dysfunction in individuals with chronic stroke: A systematic review","volume":"24","author":"Tally","year":"2017","journal-title":"Top Stroke Rehabil."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1109\/TITB.2007.899493","article-title":"Gait analysis using a shoe-integrated wireless sensor system","volume":"12","author":"Bamberg","year":"2008","journal-title":"IEEE Trans. Inf. Technol. Biomed."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"9321","DOI":"10.3390\/s130709321","article-title":"Three dimensional gait analysis using wearable acceleration and gyro sensors based on quaternion calculations","volume":"13","author":"Tadano","year":"2013","journal-title":"Sensors"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.measurement.2013.08.020","article-title":"Triaxial joint moment estimation using a wearable three-dimensional gait analysis system","volume":"47","author":"Liu","year":"2014","journal-title":"Measurement"},{"key":"ref_16","first-page":"106","article-title":"Inertial Sensors and Wavelets Analysis as a Tool for Pathological Gait Identification","volume":"Volume 526","author":"Gzik","year":"2017","journal-title":"Innovations in Biomedical Engineering. Advances in Intelligent Systems and Computing"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1093\/ptj\/86.1.30","article-title":"Balance disability after stroke","volume":"86","author":"Tyson","year":"2006","journal-title":"Phys. Ther."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Glowinski, S., and Blazejewski, A. (2020). SPIDER as A Rehabilitation Tool for Patients with Neurological Disabilities: The Preliminary Research. J. Pers. Med., 10.","DOI":"10.3390\/jpm10020033"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1751","DOI":"10.1589\/jpts.27.1751","article-title":"Risk factors related to falling in stroke patients: A cross-sectional study","volume":"27","author":"Cho","year":"2015","journal-title":"J. Phys. Ther. Sci."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Brauer, S.G., Kuys, S.S., Paratz, J.D., and Ada, L. (2018). Improving physical activity after stroke via treadmill training and self-management (IMPACT): A protocol for a randomised controlled trial. BMC Neurol., 18.","DOI":"10.1186\/s12883-018-1015-6"},{"key":"ref_21","first-page":"CD006073","article-title":"Repetitive task training for improving functional ability after stroke","volume":"11","author":"French","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1177\/0309364615592696","article-title":"Neurological patients and their lower limb orthotics: An observational pilot study about acceptance and satisfaction","volume":"41","author":"Swinnen","year":"2017","journal-title":"Prosthet. Orthot. Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.jbmt.2015.06.008","article-title":"Compliance of patients wearing an orthotic device or orthopedic shoes: A systematic review","volume":"19","author":"Swinnen","year":"2015","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1272\/jnms.82.4","article-title":"Brain Plasticity and Rehabilitation in Stroke Patients","volume":"82","author":"Hara","year":"2015","journal-title":"J. Nippon. Med. Sch."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1007\/s00221-004-2153-1","article-title":"Motor cortex excitability following repetitive electrical stimulation of the common peroneal nerve depends on the voluntary drive","volume":"162","author":"Khaslavskaia","year":"2005","journal-title":"Exp. Brain Res."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.clinbiomech.2014.11.007","article-title":"Technical developments of functional electrical stimulation to correct drop foot: Sensing, actuation and control strategies","volume":"30","author":"Melo","year":"2015","journal-title":"Clin. Biomech."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2602","DOI":"10.1523\/JNEUROSCI.20-07-02602.2000","article-title":"Brief electrical stimulation promotes the speed and accuracy of motor axonal regeneration","volume":"20","author":"Neumann","year":"2000","journal-title":"J. Neurosci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1310\/tsr1505-412","article-title":"Neuromuscular Electrical Stimulation for Motor Restoration in Hemiplegia","volume":"15","author":"Chae","year":"2008","journal-title":"Top Stroke Rehabil."},{"key":"ref_29","first-page":"609","article-title":"Preliminary per formance of a surgical ly implanted neuroprosthesis for standing and transfers\u2014Where do we stand?","volume":"38","author":"Davis","year":"2001","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Veerbeek, J.M., van Wegen, E., van Peppen, R., van der Wees, P.J., Hendriks, E., Rietberg, M., and Kwakkel, G. (2014). What is the evidence for physical therapy poststroke? A systematic review and meta-analysis. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0087987"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"4192718","DOI":"10.1155\/2016\/4192718","article-title":"The Neural Correlates of Long-Term Carryover following Functional Electrical Stimulation for Stroke","volume":"2016","author":"Gandolla","year":"2016","journal-title":"Neural Plast."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1177\/1545968313481278","article-title":"Effect of a foot-drop stimulator and ankle-foot orthosis on walking performance after stroke: A multicenter randomized controlled trial","volume":"27","author":"Everaert","year":"2013","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1177\/1545968314521007","article-title":"The effects of peroneal nerve functional electrical stimulation versus ankle-foot orthosis in patients with chronic stroke: A randomized controlled trial","volume":"28","author":"Bethoux","year":"2014","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1177\/1545968315570325","article-title":"Long-Term Follow-up to a Randomized Controlled Trial Comparing Peroneal Nerve Functional Electrical Stimulation to an Ankle Foot Orthosis for Patients With Chronic Stroke","volume":"29","author":"Bethoux","year":"2015","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"175719","DOI":"10.1155\/2015\/175719","article-title":"The Effect of Body Weight Support Treadmill Training on Gait Recovery, Proximal Lower Limb Motor Pattern, and Balance in Patients with Subacute Stroke","volume":"2015","author":"Mao","year":"2015","journal-title":"Biomed. Res Int."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1515\/bmt.2010.055","article-title":"Amplifier design for EMG recording from stimulation electrodes during functional electrical stimulation leg cycling ergometry","volume":"56","author":"Shalaby","year":"2011","journal-title":"Biomed. Tech."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/1743-0003-6-18","article-title":"Pilot study of Lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke","volume":"6","author":"Westlake","year":"2009","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"114","DOI":"10.3138\/physio.62.2.114","article-title":"The effect of functional electrical stimulation on balance function and balance confidence in community-dwelling individuals with stroke","volume":"62","author":"Robertson","year":"2010","journal-title":"Physiother. Can. Spring"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1111\/j.1532-5415.2006.00701.x","article-title":"Meaningful change and responsiveness in common physical performance measures in older adults","volume":"54","author":"Perera","year":"2006","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1080\/16501970410017215","article-title":"Reliability of gait performance tests in men and women with hemiparesis after stroke","volume":"37","author":"Flansbjer","year":"2005","journal-title":"J. Rehabil. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1016\/j.apmr.2015.10.106","article-title":"Lower limb strength is significantly impaired in all muscle groups in ambulatory people with chronic stroke: A cross-sectional study","volume":"97","author":"Dorsch","year":"2016","journal-title":"Arch Phys. Med. Rehabil."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3233\/NRE-2009-0498","article-title":"Electrical stimulation as a means for achieving recovery of function in stroke patients","volume":"25","author":"Popovic","year":"2009","journal-title":"NeuroRehabilitation"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1177\/1545968305279279","article-title":"Coordination of hemiparetic locomotion after stroke rehabilitation","volume":"19","author":"Kautz","year":"2005","journal-title":"Neurorehabil. Neural Repair"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/S0022-510X(00)00391-9","article-title":"Feasibility of gait training for acute stroke patients using FNS with implanted electrodes","volume":"179","author":"Daly","year":"2000","journal-title":"J. Neurol. Sci."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/PHM.0000000000000269","article-title":"Surface Peroneal Nerve Stimulation in Lower Limb Hemiparesis: Effect on Quantitative Gait Parameters","volume":"94","author":"Sheffler","year":"2015","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1161\/01.STR.26.6.982","article-title":"Classification of walking handicap in the stroke population","volume":"26","author":"Perry","year":"1995","journal-title":"Stroke"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1177\/0269215515597048","article-title":"Full-movement neuromuscular electrical stimulation improves plantar flexor spasticity and ankle active dorsiflexion in stroke patients: A randomized controlled study","volume":"30","author":"Wang","year":"2016","journal-title":"Clin. Rehabil."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/9\/5728\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:29:38Z","timestamp":1760124578000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/9\/5728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,5]]},"references-count":47,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["ijerph20095728"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20095728","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,5]]}}}