Effect of functional electrical stimulation, applied during walking, on gait in spastic cerebral palsy
Effect of functional electrical stimulation, applied during walking, on gait in spastic cerebral palsy
复制标题
DOI：
10.1111/j.1469-8749.2005.tb01039.x
复制
发表时间：
2005-01
影响因子：
3.8
通讯作者：
N. Postans;M. Granat
中科院分区：
文献类型：
--
作者：
N. Postans;M. Granat
本研究旨在探讨功能性电刺激（FES）对痉挛型脑性瘫痪（CP）患儿步行的影响。8名诊断为双瘫（n=6）或偏瘫（n=2）痉挛性CP的儿童（5名男性，3名女性;平均年龄13岁2个月，SD 2岁2个月;范围8岁11个月至17岁6个月）完成了研究。所有参与者都可以走动。核心FES战略的基础上，共同CP步态偏差的发展和定制为每个孩子。每个孩子的FES策略在两个单独的测试会议进行了评估。通过三维运动分析监测FES对步态的影响。在每次测试中，评估每个儿童在无FES行走（阶段A）和有FES行走（阶段B）时的步态。采用A-B-A-B测试序列，以评估FES退出和恢复的影响。所有儿童在每个阶段进行10次连续行走。在另一天重复该序列，可评价干预的可重复性。为每个儿童预先定义了结局指标，包括运动学数据的汇总变量、时空变量和初始接触模式，并为这些结局指标设定了临床意义的目标。这些目标和实际结果之间进行了比较。三名儿童记录到一致的临床显著改善：一名儿童显示出统计学显著但无临床显著性的改善。一个孩子的结果好坏参半。剩下的三个孩子没有变化。步态分析被证明是一个有用的工具，在开发和确定FES策略的有效性。
This study investigated the effect of functional electrical stimulation (FES), applied during walking, on the gait of children with spastic cerebral palsy (CP). Eight children (five males, three females; mean age 13y 2mo, SD 2y 2m; range 8y 11mo to 17y 6mo) diagnosed with diplegic (n=6) or hemiplegic (n=2) spastic CP completed the study. All participants were ambulant. Core FES strategies based on common CP gait deviations were developed and tailored for each child. FES strategies for each child were evaluated in two separate test sessions. Effects of FES on gait were monitored with three‐dimensional motion analysis. Within each test session each child's gait was assessed when walking without FES (phase A) and with FES (phase B). An A‐B‐A‐B test sequence was employed allowing the effects of the withdrawal and reinstatement of FES to be assessed. All children performed 10 consecutive walks in each phase. Replication of this sequence on a separate day allowed the repeatability of the intervention to be evaluated. Outcome measures, including summary variables of kinematic data, temporal‐spatial variables, and mode of initial contact, were predefined for each child and targets for clinical significance were set for these outcome measures. Comparisons were performed between these targets and the actual outcomes. Consistent clinically significant improvements were recorded for three children: one child showed some improvement that was statistically significant but not clinically significant. Results for one child were mixed. There was no change in the remaining three children. Gait analysis proved to be a useful tool in both developing and determining the effectiveness of FES strategies.