Electrostimulation to Increase Peroneal Muscle Strength in Pediatric Patients With Postsurgical Clubfoot

Abstract

Background: Idiopathic congenital clubfoot is a deformity with various components. Its treatment can be conservative and or surgical in order to eliminate the deformity and to obtain a pain-free foot allowing for adequate mobility. Objectives: Our objective was to evaluate whether neuromuscular electrostimulation is useful for improving peroneal muscle strength in post-operative congenital clubfoot in children. Patients and Methods: An experimental, prospective, longitudinal, and comparative study was carried out on 10 patients with congenital clubfoot in the experimental group, and on 10 for historical controls. Initial and post-treatment clinical evaluations were conducted on patients in both groups. Surface electromyography (SEMG) was used for the experimental group; each patient received 30 sessions of treatment with neuromuscular electrostimulation in order to obtain muscular contraction. Results: In both groups, there were more males with the average age or 5.5 years (ranging from 3 to 8 years of age). Peroneal muscular strength evaluated through the Daniels and Worthingham's test increased post-treatment only in the experimental group, and comparing these results to those of the historical group, a significance level of P = 0.001 was obtained. The motor unit potential amplitude in the SEMG increased in the experimental group with a significance level of P < 0.05. Conclusions: Neuromuscular electrostimulation can be used to increase muscle strength, and it is a safe and painless treatment.

Neuromuscular electrical stimulation for motor recovery in pediatric neurological conditions: a scoping review

“…In the 35 articles 24–58 on NMES in pediatric patients without CP, there were a total of 353 participants (293 unique participants) with a mean age of 7 years 4 months (range 1wk–38y). All but one study had participants who were 22 years old or younger; participants in the Oshima et al.…”

“…and Gelfer et al 44 . used NMES in addition to the standard Ponseti method in infants, and Morales‐Osorio et al 45 . used NMES in older children with a history of clubfoot to strengthen the peroneal muscle.…”

“…In clubfoot (n=64, across three studies), NMES may also have potential to augment traditional methods such as foot bracing to improve musculoskeletal alignment and function. One RCT and two cohort studies were included in this review; Youssef et al 46 and Gelfer et al 44 used NMES in addition to the standard Ponseti method in infants, and Morales-Osorio et al 45 used NMES in older children with a history of clubfoot to strengthen the peroneal muscle. The RCT was unable to show significant improvement with NMES compared to traditional methods, but it was likely underpowered; the two cohort studies suggested potential benefit from NMES.…”