Effects of functional electrical stimulation on cognition rate and gait in neurological patients during single- and dual-task walking

Abstract

Abstract People with neurological disorders and foot drop may suffer from cognitive-motor interference during walking. Functional Electrical Stimulation (FES) targets foot drop during gait but its effects on cognition remain underexplored. Fifteen individuals (4 males, 11 females; mean age 35.5 ± 12.5 years) with various neurological disorders, who had been using FES for at least three months, were recruited from our outpatient clinic. Subjects were assessed during walking with and without FES (FES CONDITION) and under single- and dual-task walking (TASK). The dual-task consisted of counting backwards from a number near 100 in steps of seven while walking. Cognition rate served as outcome parameter, with high values indicating subjects could efficiently maintain both cognitive task performance and walking speed. A linear mixed model analysis was conducted with FES CONDITION and TASK as fixed and SUBJECTS as random effects. The cognition rate during dual-task walking was significantly better with FES vs. without. FES showed minor effects on dorsiflexion in swing but larger effects on overall gait, as reflected in walking speed, step length and step width. While dual-task led to inferior results in gait, FES counteracted this effect and improved cognition rate. These findings suggest that FES not only addresses gait pattern and stability but also frees cognitive resources for walking. This shift in focus may enhance environmental awareness, social interaction or multitasking and thereby improving overall independence and quality of life, which is particularly relevant for patients with neurological disorders and an increased risk of falls.