Related Experiment Video
Updated: Aug 7, 2026
Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy
Published on: August 9, 2024
Functional electrical stimulation changes dynamic resources in children with spastic cerebral palsy
Chia-Ling Ho1, Kenneth G Holt, Elliot Saltzman
1Department of Physical Therapy and Athletic Training, Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA 02215, USA.
Insights
Functional electrical stimulation (FES) improved walking impulse in children with cerebral palsy (CP) but did not affect stiffness or gait parameters. This suggests FES can enhance force production, though not normalize gait patterns.
Area of Science:
- Biomedical Engineering
- Rehabilitation Science
- Pediatric Neurology
Background:
- Children with cerebral palsy (CP) frequently experience impaired walking ability.
- Gait abnormalities in CP can stem from difficulties in producing timely muscle force and altered joint mechanics.
Purpose of the Study:
- To investigate the impact of functional electrical stimulation (FES) on gastrocnemius-soleus muscle activation during walking in children with CP.
- To assess FES effects on force production (impulse), stiffness, stride length, and stride frequency.
Main Methods:
- A crossover study design involved 13 children with spastic CP and 6 typically developing children.
- Children with CP underwent walking trials with and without FES applied to the calf muscles.
- Kinematic data were analyzed using a biomechanical model to estimate impulse and stiffness.
Main Results:
- FES significantly increased speed-normalized dimensionless impulse in children with CP compared to their no-FES condition.
- No significant differences in impulse were observed between children with CP (no FES) and typically developing children.
- FES did not significantly alter stiffness, stride length, or stride frequency in children with CP.
Conclusions:
- Functional electrical stimulation is effective in enhancing walking impulse in children with CP.
- FES does not appear to reduce muscle-tendon stiffness or normalize spatiotemporal gait parameters.
- Further research may be needed to optimize FES parameters for more comprehensive gait improvement in CP.
Background And Purpose:
Children with cerebral palsy (CP) often are faced with difficulty in walking. The purpose of this experiment was to determine the effects of functional electrical stimulation (FES) applied to the gastrocnemius-soleus muscle complex on the ability to produce appropriately timed force and reduce stiffness (elastic property of the body) and on stride length and stride frequency during walking.
Subjects And Methods:
Thirteen children with spastic CP (including 4 children who were dropped from the study due to their inability to cooperate) and 6 children who were developing typically participated in the study. A crossover study design was implemented. The children with spastic CP were randomly assigned to either a group that received FES for 15 trials followed by no FES for 15 trials or a group that received no FES for 15 trials followed by FES for 15 trials. The children who were having typical development walked without FES. Kinematic data were collected for the children with CP in each walking condition and for the children who were developing typically. Impulse (force-producing ability) and stiffness were estimated from an escapement-driven pendulum and spring system model of human walking. Stride length and stride frequency also were measured. To compare between walking conditions and between the children with CP and the children who were developing typically, dimensional analysis and speed normalization procedures were used.
Results:
Nonparametric statistics showed that there was no significant difference between the children with CP in the no-FES condition and the children who were developing typically on speed-normalized dimensionless impulse. In contrast, the children with CP in the FES condition had a significantly higher median value than the children who were developing typically. The FES significantly increased speed-normalized dimensionless impulse from 10.02 to 16.32 when comparing walking conditions for the children with CP. No significant differences were found between walking conditions for stiffness, stride length, and stride frequency.
Discussion And Conclusion:
The results suggest that FES is effective in increasing impulse during walking but not in decreasing stiffness. The effect on increasing impulse does not result in more typical spatiotemporal gait parameters.
