The effects of functional electrical stimulation cycling on gait parameters in diplegic cerebral palsy: a...

Area of Science:

• Rehabilitation Medicine
• Pediatric Neurology
• Biomedical Engineering

Background:

• Spastic diplegic cerebral palsy (dCP) is a common neuromotor disorder affecting ambulatory children.
• Conventional physical therapy is a cornerstone of management, but its efficacy can be enhanced.
• Functional electrical stimulation cycling (FES-C) offers a potential adjunct therapy for improving functional outcomes.

Purpose of the Study:

• To evaluate the impact of FES-C, in addition to conventional physical therapy, on gait, muscle strength, gross motor function, and energy expenditure in ambulatory children with spastic dCP.
• To compare the effectiveness of FES-C combined therapy versus conventional physical therapy alone.

Main Methods:

• A randomized controlled trial involving 20 ambulatory children with spastic dCP, assigned to either a control group (conventional physical therapy) or an FES-C group (conventional physical therapy + FES-C).
• Training was conducted 3 days/week for 8 weeks.
• Assessments included functional muscle strength, gait analysis (Vicon-3D), Gross Motor Function Measure (GMFM-88), and energy expenditure (calorimetry) at baseline, 8 weeks, and 16 weeks.

Main Results:

• The FES-C group demonstrated significantly greater improvements in functional muscle strength, gross motor function, and energy expenditure compared to the control group post-training and during follow-up (p < 0.05).
• No significant differences were observed in most gait parameters between the two groups after treatment and follow-up (p > 0.05).
• A significant decrease in pelvic tilt during walking was noted in the FES-C group post-training (p < 0.05).

Conclusions:

• FES-C, when added to conventional physical therapy, is more effective in enhancing functional muscle strength, gross motor function, and reducing energy expenditure in ambulatory children with spastic dCP.
• The combined approach of FES-C and conventional physiotherapy shows promise for improving functional outcomes in pediatric cerebral palsy outpatients.
• While gait parameters did not show significant group differences, specific kinematic improvements like reduced pelvic tilt suggest targeted benefits of FES-C.