Surface EMG analysis and changes in gait following electrical stimulation of quadriceps femoris and tibialis anterior in children with spastic cerebral palsy

Abstract

The findings of this study suggests that NMES therapy together with conventional physiotherapy more efficiently improves walking ability and functional outcomes as compared to conventional physiotherapy alone in children with spastic CP.

Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis

“…However, this was a lower quality study rated as fair with a small sample size and may not be reproducible due to the lack of methodological detail provided in the article. 47 Of the remaining 4 studies in the miscellaneous category, 2 (50%) reported significant increases in gait speed that exceeded the MCID with large effect sizes. Dursun et al 45 In summary, preliminary work on EMG biofeedback training of the ankle 45 and vibration training in standing 48 were shown to be effective in increasing gait speed in individual, good quality studies, and may warrant further investigation.…”

“…[43][44][45][46][47][48][49] Three of the studies (43%) used electrical stimulation as the intervention. 43,44,47 The remaining 4 studies (57%) included different interventions, such as EMG biofeedback, 45 stationary cycling, 46 whole body vibration, 48 and enhanced sensory input during a resisted functional activity. 49 Three studies of 3 different electric stimulation protocols had PEDro scores ranging from 5 to 7, with an average and median of 6.…”

“…49 Three studies of 3 different electric stimulation protocols had PEDro scores ranging from 5 to 7, with an average and median of 6. 43,44,47 One study was rated fair 47 and 2 were rated good. 43,44 The mean change in gait speed for these studies ranged from 0.05 to 0.17 m/sec with effect sizes of 0.00, 0.12 and 1.96.…”

“…One of the studies exceeded the MCID and reported within and between group statistical significance ( Table 2). 47 Children in the electrical stimulation studies (n = 46) ranged from 5-14 years of age. Interventions included neuromuscular electrical stimulation (NMES) of the quadriceps and tibialis anterior, 47 electrical stimulation to the gluteus maximus, 43 and cyclical NMES (duty cycle = 6 seconds on, 10-14 seconds off), followed by functional electrical stimulation (FES) to the quadriceps and dorsiflexors during gait.…”

Immediate Effect of Patterned Electrical Neuromuscular Stimulation on Pain and Muscle Activation in Individuals With Patellofemoral Pain

“…Studies of NMES and EMG activity in other conditions have produced conflicting results. 44,45 Arya et al 44 assessed surface EMG during gait in individuals with cerebral palsy and found no changes in the EMG activity of the quadriceps femoris or tibialis anterior. However, Chisari et al 45 identified an abnormal EMG pattern in individuals with myotonic dystrophy and noted an improved firing pattern during functional tasks after electrical stimulation.…”