Article

Ankle-foot orthoses are the standard of care for foot drop in cerebral palsy
(CP), but may overly constrain ankle movement and limit function in those with
mild CP. Functional electrical stimulation (FES) may be a less restrictive and
more effective alternative, but has rarely been used in CP. The primary objective
of this study was to conduct the first trial in CP examining the acceptability
and clinical effectiveness of a novel, commercially available device that
delivers FES to stimulate ankle dorsiflexion. METHOD: Twenty-one individuals were
enrolled (Gross Motor Function Classification System [GMFCS] levels I and II,
mean age 13y 2mo). Gait analyses in FES and non-FES conditions were performed at
two walking speeds over a 4 month period of device use. Measures included ankle
kinematics and spatiotemporal variables. Differences between conditions were
revealed using repeated measures multivariate analyses of variance. RESULTS:
Nineteen individuals (nine females, 10 males; mean age 12y 11mo, range 7y 5mo to
19y 11mo; 11 at GMFCS level I, eight at level II) completed the FES intervention,
with all but one choosing to continue using FES beyond that phase. Average daily
use was 5.6 hours (SD 2.3). Improved dorsiflexion was observed during swing (mean
and peak) and at foot-floor contact, with partial preservation of ankle
plantarflexion at toe-off when using the FES at self-selected and fast walking
speeds. Gait speed was unchanged. INTERPRETATION: This FES device was well
accepted and effective for foot drop in those with mild gait impairments from CP.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith Press.
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Langue : ANGLAIS