A randomized crossover study of functional electrical stimulation during walking in spastic cerebral palsy: the FES on participation (FESPa) trial

Moll, Irene; Marcellis, Rik; Coenen, Marcel; Fleuren, Sabine; Willems, Paul; Speth, Lucianne; Witlox, M.A.; Meijer, Kenneth; Vermeulen, R. Jeroen

doi:10.1186/s12887-021-03037-9

“…Moll et al [ 90 ] conducted a study to evaluate the levels of activity and participation in daily life of 25 children diagnosed with cerebral palsy (CP), after the utilization of functional electrical stimulation (FES) and an ankle–foot orthosis (AFO). Each participant underwent twelve weeks of conventional treatment (AFO/adapted shoes), followed by 12 weeks of FES treatment, separated by a six-week washout phase.…”

Section: Resultsmentioning

confidence: 99%

Passive Articulated and Non-Articulated Ankle–Foot Orthoses for Gait Rehabilitation: A Narrative Review

Nazha

¹

,

Szávai

²

,

Darwich

³

et al. 2023

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The aim of this work was to study the different types of passive articulated and non-articulated ankle–foot orthoses for gait rehabilitation in terms of working principles, control mechanisms, features, and limitations, along with the recent clinical trials on AFOs. An additional aim was to categorize them to help engineers and orthotists to develop novel designs based on this research. Based on selected keywords and their composition, a search was performed on the ISI Web of Knowledge, Google Scholar, Scopus, and PubMed databases from 1990 to 2022. Forty-two studies met the eligibility criteria, which highlighted the commonly used types and recent development of passive articulated and non-articulated ankle–foot orthoses for foot drop. Orthotists and engineers may benefit from the information obtained from this review article by enhancing their understanding of the challenges in developing an AFO that meets all the requirements in terms of ease of use, freedom of movement, and high performance at a relatively low cost.

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“…In this study, a total of 897 articles about the effect of functional electrical stimulation on gait parameters of children with cerebral palsy were retrieved from the database. After screening according to the above literature inclusion and exclusion criteria, 9 literatures [12][13][14][15][16][17][18][19][20] were finally included in the analysis, with a total of 282 children with cerebral palsy. Among them, 142 patients were divided into the functional electrical stimulation treatment test group, and 140 patients were included in the control group, treating with comfort treatment, general nursing, or other physical therapy.…”

Section: Computational and Mathematical Methods In Medicinementioning

confidence: 99%

Effect of Functional Electrical Stimulation on Gait Parameters in Children with Cerebral Palsy: A Meta-Analysis

Zhu¹,

Gao²,

Wang

³

et al. 2022

Computational and Mathematical Methods in Medicine

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Objective. At present, there are controversies on the effectiveness of functional electrical stimulation devices in gait improvement in the clinic, and the results reported in limited literature are contradictory. This paper summarizes and analyzes the relationship between functional electrical stimulation treatment and gait parameter changes in children with cerebral palsy, thus exploring the above controversies’ results. Methods. Two researchers conducted a detailed search of the literature from the establishment of the database to June 2022. Literature retrieved from databases, including PubMed, Embase, Ovid, Cochrane Library, and Web of Science and the search process followed the principles of Cochrane. The search keywords were “cerebral palsy”, “functional electrical stimulation”, “gait”, or “walk”. Gait and balance parameters were extracted from the literature. Gait parameters, such as walking speed and step length, were included in the meta-analysis. The study used standard mean difference (STD) and 95% confidence interval (CI) to calculate the mean difference between the two groups. The statistic I 2 was used to evaluate the heterogeneity between the evaluation studies. Begg’s test detected publication bias and the funnel chart was used for visual analysis. Furthermore, Review Manager software was used to make a risk bias map for literature publication bias analysis. Results. 9 literatures were included in the analysis, with a total of 282 children with cerebral palsy, including 142 patients in the functional electrical stimulation treatment group and 140 patients in the comfort treatment, general nursing, or other physical therapy. The randomization scheme and result report used in most studies were low risk, which was important for the credibility of this study. Most studies have limitations in the blinding method of participants and subjects, and most of them were single-blind studies, which might have a high risk. The results showed that functional electrical stimulation could increase the walking speed of children with cerebral palsy ( SMD = 0.82 , P < 0.0001 ) and increase the walking step length of children with cerebral palsy ( SMD = 1.34 , 95 % CI = 1.07 , 1.60 , Z = 9.91 , P < 0.0001 ). Funnel plot analysis showed that the literature distribution was uniform and symmetrical, and Begg’s test showed no publication bias in included literature. Conclusion. This study compared the effects of the functional nerve stimulation treatment group and control group on improving gait parameters of children with cerebral palsy. The results indicated that functional nerve stimulation treatment could increase the gait speed and step length of children with cerebral palsy, which could improve the walking of children with cerebral palsy. Furthermore, this study needs more research data to support our findings. The results of this study might better guide the clinical practice and better use of health as well as financial resources.

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“…The Medical Ethical Committee of the MUMC approved the study (METC 172033/NL63250.068.17) and the trial was registered at ClinicalTrials.gov (NCT03440632). The full protocol was recently published [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

Lower limb muscle fatigue after uphill walking in children with unilateral spastic cerebral palsy

Moll

¹

,

Essers

²

,

Marcellis

³

et al. 2022

Self Cite

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Fatigue during walking is a common complaint in cerebral palsy (CP). The primary purpose of this study is to investigate muscle fatigue from surface electromyography (sEMG) measurements after a treadmill-based fatigue protocol with increasing incline and speed in children with CP with drop foot. The secondary purpose is to investigate whether changes in sagittal kinematics of hip, knee and ankle occur after fatigue. Eighteen subjects with unilateral spastic CP performed the protocol while wearing their ankle-foot orthosis and scored their fatigue on the OMNI scale of perceived exertion. The median frequency (MF) and root mean square (RMS) were used as sEMG measures for fatigue and linear mixed effects model were applied. The MF was significantly decreased in fatigued condition, especially in the affected leg and in the tibialis anterior and peroneus longus muscle. The RMS did not change significantly in fatigued condition, while the OMNI fatigue score indicated patients felt really fatigued. No changes in sagittal kinematics of hip, knee and ankle were found using statistical non-parametric mapping. In conclusion, the current fatigue protocol seems promising in inducing fatigue in a population with CP with drop foot and it could be used to expand knowledge on muscle fatigue during walking in CP.

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A randomized crossover study of functional electrical stimulation during walking in spastic cerebral palsy: the FES on participation (FESPa) trial

Cited by 12 publications

References 58 publications

Passive Articulated and Non-Articulated Ankle–Foot Orthoses for Gait Rehabilitation: A Narrative Review

Passive Articulated and Non-Articulated Ankle–Foot Orthoses for Gait Rehabilitation: A Narrative Review

Effect of Functional Electrical Stimulation on Gait Parameters in Children with Cerebral Palsy: A Meta-Analysis

Lower limb muscle fatigue after uphill walking in children with unilateral spastic cerebral palsy

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