Patients with stroke experience gait disorders due to various causes, including sensory impairment and muscle weakness, spasticity, etc., and the primary goal of rehabilitation is to regain independent walking. The ankle plantar flexors tightly contract to maintain a standing posture and contribute to postural control through anticipatory contractions before changes in the center of mass. The plantar flexors in the ankle create most of the energy required for forward propulsion of body mass during walking. The strength of the ankle plantar flexors on the paretic side is related to the gait speed of patients with stroke. The peripheral sensory inputs via Electrical muscle stimulation enhanced the activities of circuits in the somatosensory cortex thus it can cause neuroplasticity to brain. Electrical stimulation on ankle dorsiflexors could be an effective management to enhance gait performance and ankle control during walking in chronic stroke patients. Neuromuscular electrical stimulation on ankle plantar flexors may improve gait symmetry. When neuromuscular stimulation combined with activity can enhance efficacy. Many previous studies conducted trials on effectiveness of muscle stimulation but this study aims to perform a clinical trial to enhance evidence about effectiveness.~2 groups would be included in study, one group will receive stimulation through TENS and other through EMS. Both groups will receive exercise protocol and stimulation would be provided only during gait training. The outcome would be measured through different outcome measure tools.~Functional electrical stimulation device is used to improve dorsiflexion during walking, but it is somehow expensive treatment. To achieve same outcome during walking, it is aimed to see effect of EMS vs TENS. This would be an inexpensive alternate of FES device and could improve gait and quality of life if used during treatment protocol. So it is aimed to generate evidence about effectiveness of TENS vs EMS on lower limb during gait training to improve gait and quality of life.
The goal of this Randomized clinical trial is to compare effectiveness of EMS versus TENS during gait training in stroke patients to improve gait and quality of life. The main question it aims to answer is:~• To compare effectiveness of EMS versus TENS during gait training in post stroke survivors to improve gait and quality of life Participants will be a given consent form and after subjects read and sign the informed consent, they would be included in study according to eligibility criteria. 2 groups would be included in study, one group will receive stimulation through TENS and other through EMS. Both groups receive exercise protocol and stimulation would be provided only during gait training. We will measure outcome through different outcome measure tools.