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A functional electrical stimulation system improves knee control in crouch gait.

Sam Khamis1, Raz Martikaro, Shlomo Wientroub

  • 1The Gait and Motion Analysis Laboratory, Department of Pediatric Orthopaedics, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, 6 Weizman St., 64239, Tel Aviv, Israel, khamisam@gmail.com.

Journal of Children'S Orthopaedics
|March 20, 2015
PubMed
Summary
This summary is machine-generated.

Functional electrical stimulation (FES) may help reduce crouch gait in cerebral palsy (CP) by improving knee extension during walking. This approach shows potential for enhancing mobility and function in individuals with CP.

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Area of Science:

  • Biomedical Engineering
  • Neurorehabilitation
  • Gait Analysis

Background:

  • Crouch gait, characterized by excessive flexion in the ankle, knee, and hip during stance, is a common gait deviation in children with cerebral palsy (CP).
  • Current treatments aim to improve lower limb extension, but functional electrical stimulation (FES) has not been extensively studied for its efficacy in reducing crouch gait severity in CP.
  • This study explores the novel application of FES to the quadriceps muscles to address crouch gait in CP.

Purpose of the Study:

  • To assess the immediate and sustained effects of quadriceps FES on preventing crouch gait.
  • To evaluate FES's ability to promote ankle plantar flexion, knee extension, and hip extension during the stance phase of walking.
  • To investigate the potential of FES as an intervention for improving gait mechanics in individuals with CP.

Main Methods:

  • A case study involving an 18-year-old male with CP diplegia (GMFCS level II) was conducted.
  • The NESS L300 Plus neuroprosthesis system was used to deliver FES to the quadriceps.
  • Three-dimensional gait analysis, including kinematic and spatiotemporal parameters, was performed with and without FES and ground reaction ankle foot orthotics (GRAFOs).

Main Results:

  • FES application resulted in improved knee extension at midstance and maximal knee extension during the stance phase.
  • The patient demonstrated an enhanced ability to ascend and descend stairs using a "step-through" pattern post-FES adjustment.
  • Gait analysis indicated a positive short-term effect of FES on knee extension during walking.

Conclusions:

  • Quadriceps FES may be a viable strategy for decreasing crouch gait by improving knee extension during stance.
  • The effectiveness of FES appears contingent upon adequate passive range of motion in the hip, knee, and ankle.
  • Further research is warranted to validate these preliminary findings and explore long-term outcomes of FES in CP management.