Effect of functional electrical stimulation combined with kinesiotaping or anterior rafting strap binding on motor and gait outcomes in chronic middle cerebral artery stroke survivors: a randomized controlled trial

BACKGROUND: Chronic middle cerebral artery (MCA) stroke survivors frequently experience persistent lower-limb motor impairment, spasticity, and gait dysfunction, all of which substantially limit functional independence. Alongside routine rehabilitation, adjunctive non-invasive interventions such as taping and functional electrical stimulation (FES) may facilitate neuromuscular activation and biomechanical control during gait. OBJECTIVE: To compare the effects of FES combined with either kinesiotaping (KT) or anterior rafting strap binding, in addition to conventional physiotherapy, on motor and gait outcomes in individuals with chronic MCA stroke. METHODS: In this prospective, assessor-blinded randomized controlled trial, 57 chronic MCA stroke survivors were randomly allocated (1:1:1) to: (1) the FES group, (2) the FES + KT group, or (3) the FES + anterior rafting strap binding group. All participants received standardized conventional physiotherapy, including task-oriented gait training. Lower Extremity Fugl-Meyer Assessment (FMA-LE), gait speed measured with the 10-Meter Walk Test (10MWT), walking endurance measured with the 6-Minute Walk Test (6MWT), functional mobility measured with the Timed Up and Go (TUG), and ankle plantarflexor spasticity measured with the Modified Ashworth Scale (MAS) were assessed at baseline and after 12 weeks post-intervention. Descriptive statistics, ANOVA, and ANCOVA adjusting for baseline values, age, and stroke chronicity were performed, with statistical significance set at p < 0.05. RESULTS: The FES + KT group and the FES + anterior rafting strap binding group demonstrated significant improvements in motor and gait outcomes compared with the FES group (p < 0.05). Direct unadjusted post-hoc comparisons between the FES + anterior rafting strap binding and FES + KT groups were not statistically significant for FMA-LE, 10MWT, 6MWT, or TUG (p > 0.05). The adjusted ANCOVA estimates favoured the FES + anterior rafting strap binding group across the assessed outcomes; however, these adjusted findings should be distinguished from the unadjusted post-hoc comparisons. For plantarflexor spasticity, the direct post-hoc comparisons demonstrated a significantly greater reduction in the FES + anterior rafting strap binding group than in the FES + KT group (adjusted p = 0.039). CONCLUSION: The findings suggest that the FES + anterior rafting strap binding group may improve lower-limb motor recovery, gait performance, functional mobility, and plantarflexor spasticity in chronic MCA stroke survivors. However, direct unadjusted post-hoc comparisons between the FES + anterior rafting strap binding group and the FES + KT group were not statistically significant for FMA-LE, 10MWT, 6MWT, or TUG. These findings support the integration of biomechanical alignment strategies with neuromuscular stimulation to optimize gait rehabilitation in chronic stroke.