Direct effect of percutaneous electric stimulation during gait in children with hemiplegic cerebral palsy: A report of 2 cases
Direct effect of percutaneous electric stimulation during gait in children with hemiplegic cerebral palsy: A report of 2 cases
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DOI：
10.1016/s0003-9993(03)00473-8
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发表时间：
2004-02-01
影响因子：
4.3
通讯作者：
McCarthy, JJ
中科院分区：
文献类型：
--
作者：
Pierce, SR;Laughton, CA;McCarthy, JJ
目的探讨经皮肌内功能性电刺激（FES）治疗脑瘫（CP）患儿的可行性。两名患有右侧偏瘫CP的儿童经皮将肌内电极植入受累肢体的腓肠肌和胫骨前肌。在步态周期期间使用力传感脚踏开关提供FES，以检测步态相变。在3种情况下（腓肠肌上、胫骨前肌上、腓肠肌和胫骨前肌上），儿童使用FES行走。对于每种情况，每天进行两次45分钟的步行，持续1周。每周练习后，立即在受试者针对该刺激条件和无刺激的自选步行速度下进行步态分析。两名儿童在初始接触时的踝关节背屈角度、挥杆时的背屈峰值均有所改善。摆动时的平均背屈，以及单独胫骨前肌刺激和胫腓肌和胫骨前肌联合刺激的早期站立时的踝关节工作。在所有刺激条件下，两个孩子在后期站立时踝关节工作都有所改善。结果表明，经皮肌肉FES可有效改善2例偏瘫CP患儿踝关节的运动学和动力学。
The feasibility of using percutaneous intramuscular functional electric stimulation (FES) in children with cerebral palsy (CP) as a method to improve ankle kinematics and kinetics during gait was investigated. Two children with right hemiplegic CP had percutaneous intramuscular electrodes implanted into the gastrocnemius and tibialis anterior muscles of the involved limb. FES was provided during the gait cycle using force-sensing foot switches to detect gait phase transitions. The children ambulated using, FES under 3 conditions (gastrocnemius on. tibialis anterior on, gastrocnemius and tibialis anterior on). For each condition, two 45-minute walking sessions were conducted per day for 1 week. Immediately after each week of practice, a gait analysis was performed at the subject's self-selected walking speed for that stimulation condition and without stimulation. Both children demonstrated improvements in ankle dorsiflexion angle at initial contact, peak dorsiflexion during swing. mean dorsiflexion during swing, and ankle work during early stance with tibialis anterior stimulation alone and combined szastrocnemius and tibialis anterior stimulation. Improvements in ankle work were found during late stance for both children with all stimulation conditions. These results suggest that percutaneous intramuscular FES was effective in improving aspects of ankle kinematics and kinetics of 2 children with hemiplegic CP.