Article

The primary goal was to determine whether repetitive
functional electrical stimulation (FES) for unilateral foot drop increases
tibialis anterior (TA) muscle size compared with an untreated baseline and the
contralateral side in cerebral palsy (CP). Secondary goals were to determine
whether positive changes in muscle size and gait, if found, accumulated during
the 3 intervals during which participants used the device.
FES devices differ
from traditional orthoses that often restrict muscle activation and may
exacerbate weakness, promote continued dependence on orthoses, or precipitate
functional decline. METHODS: Participants were 14 independent ambulators with
inadequate dorsiflexion in swing, with a mean age of 13.1 years, evaluated before
and after the 3-month baseline, 1-month device accommodation, 3-month primary
intervention, and 3-month follow-up phases. The FES device (WalkAide) stimulated
the common fibular nerve to dorsiflex the ankle and evert the foot while
monitoring use. TA muscle ultrasound, gait velocity, and ankle kinematic data for
barefoot and device conditions are reported. RESULTS: Ultrasound measures of TA
anatomic cross-sectional area and muscle thickness increased in the intervention
compared with baseline and with the contralateral side and were maintained at
follow-up. Maximum ankle dorsiflexion decreased at baseline but improved or was
maintained during the intervention phase with and without the device,
respectively. Muscle size gains were preserved at follow-up, but barefoot ankle
motion returned to baseline values. CONCLUSIONS:
This FES device produced
evidence of use-dependent muscle plasticity in CP. Permanent improvements in
voluntary ankle control after repetitive stimulation were not demonstrated.

Langue : ANGLAIS