A primary aim of the proposed study is to assess the role of learning, i.e. classical conditioning, in accounting for the continuation of muscular control following termination of prosthetic or functional electric stimulation (FES). Application of FES to elicit foot dorsiflexion at appropriate phases of the gait cycle is viewed as a classical conditioning paradigm. It is hypothesize that learning, resulting from conditioning, accounts for at least a portion of the """"""""carry-over"""""""" effect, i.e., the observation that many hemiplegic patients can voluntarily dorsiflex following treatment with FES. The hypothesis will be tested by comparison of treatment outcomes across three levels of treatment: electrical stimulation noncontiguous with gait cycle in one group, and FES for dorsiflexion triggered by movement of the affected limb in a second or FES triggered by movement of the unaffected limb in a third group. Effectiveness of FES is expected to vary as a function of treatment and covariates of gait symmetry, proprioceptive sensitivity, and electromyographic (EMG) activity. Analysis of covariance (ANCOVA) will suggest conclusions respecting the relative contributions of the covariates to the observed treatment effects. Confirmation of the hypothesis will enable more valid selection of patients who are likely to benefit from FES and more effective development of the carry-over effect. The outcome of the investigation has ramnifications for theoretical aspects of muscle reeducation, particularly with respect to sensorimotor integration.
