Functional electrical stimulation during walking in children with unilateral spastic cerebral palsy: A randomized cross-over trial.

Autor: Moll I; School of Mental Health and Neurosciences, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.; Department of Nutrition and Movement Sciences, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.; Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands., Marcellis RGJ; Department of Physiotherapy, Maastricht University Medical Center, Maastricht, the Netherlands., Fleuren SM; Department of Physiotherapy, Maastricht University Medical Center, Maastricht, the Netherlands., Coenen MLP; Adelante, Center of Expertise in Rehabilitation and Audiology, the Netherlands., Senden RHJ; Department of Physiotherapy, Maastricht University Medical Center, Maastricht, the Netherlands., Willems PJB; Department of Nutrition and Movement Sciences, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands., Speth LAWM; Adelante, Center of Expertise in Rehabilitation and Audiology, the Netherlands., Witlox MA; Department of Orthopedics, Maastricht University Medical Center, Maastricht, the Netherlands., Meijer K; Department of Nutrition and Movement Sciences, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands., Vermeulen RJ; School of Mental Health and Neurosciences, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.; Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands.
Jazyk: angličtina
Zdroj: Developmental medicine and child neurology [Dev Med Child Neurol] 2024 May; Vol. 66 (5), pp. 598-609. Date of Electronic Publication: 2023 Oct 12.
DOI: 10.1111/dmcn.15779
Abstrakt: Aim: To study if functional electrical stimulation (FES) of the peroneal nerve, which activates dorsiflexion, can improve body functions, activities, and participation and could be an effective alternative treatment in individuals with unilateral spastic cerebral palsy (CP).
Method: A randomized cross-over trial was performed in 25 children with unilateral spastic CP (classified in Gross Motor Function Classification System levels I and II) aged 4 to 18 years (median age at inclusion 9 years 8 months, interquartile range = 7 years-13 years 8 months), 15 patients were male. The study consisted of two 12-week blocks of treatment, that is, conventional treatment (ankle foot orthosis [AFO] or adapted shoes) and FES, separated by a 6-week washout period. Outcome measures included the Goal Attainment Scale (GAS), the Cerebral Palsy Quality of Life questionnaire, and a three-dimensional gait analysis.
Results: Eighteen patients completed the trial. The proportion of GAS goals achieved was not significantly higher in the FES versus the conventional treatment phase (goal 1 p = 0.065; goal 2 p = 1.00). When walking while stimulated with FES, ankle dorsiflexion during mid-swing decreased over time (p = 0.006, average decrease of 4.8° with FES), with a preserved increased ankle range of motion compared to conventional treatment (p < 0.001, mean range of motion with FES +10.1° compared to AFO). No changes were found in the standard physical examination or regarding satisfaction with orthoses and feelings about the ability to dress yourself. In four patients, FES therapy failed; in 12 patients FES therapy continued after the trial.
Interpretation: FES is not significantly worse than AFO; however, patient selection is critical, and a testing period and thorough follow-up are needed.
(© 2023 The Authors. Developmental Medicine & Child Neurology published by John Wiley & Sons Ltd on behalf of Mac Keith Press.)
Databáze: MEDLINE
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