Abstract
BackgroundCrouch gait is a major sagittal plane deviation in children diagnosed with cerebral palsy (CP). It is defined as a combination of excessive ankle dorsiflexion and knee and hip flexion throughout the stance phase. To the best of our knowledge, functional electrical stimulation (FES) has not been used to decrease the severity of crouch gait in CP subjects and assist in achieving lower limb extension.PurposeTo evaluate the short- and long-term effects of FES to the quadriceps muscles in preventing crouch gait and achieving ankle plantar flexion, knee and hip extension at the stance phase.MethodsAn 18-year-old boy diagnosed with CP diplegia [Gross Motor Function Classification System (GMFCS) level II] was evaluated. The NESS L300® Plus neuroprosthesis system provided electrical stimulation of the quadriceps muscle. A three-dimensional gait analysis was performed using an eight-camera system measuring gait kinematics and spatiotemporal parameters while the subject walked shod only, with ground reaction ankle foot orthotics (GRAFOs) and using an FES device.ResultsWalking with the FES device showed an increase in the patient’s knee extension at midstance and increased knee maximal extension at the stance phase. In addition, the patient was able to ascend and descend stairs with a “step-through” pattern immediately after adjusting the FES device.ConclusionsThis report suggests that FES to the quadriceps muscles may affect knee extension at stance and decrease crouch gait, depending on the adequate passive range of motion of the hip, knee extension, and plantar flexion. Further studies are needed in order to validate these results.
Highlights
Cerebral palsy (CP) is the most common cause of upper motor neuron lesions in children, causing spasticity and muscle tendon contractures, leading to bony deformation, weakness, and loss of selective motor control
Further studies are needed in order to validate these results
We present an 18-year-old boy diagnosed with cerebral palsy (CP) diplegia (Gross Motor Function Classification System (GMFCS) level II] [20], without cognitive impairment
Summary
Cerebral palsy (CP) is the most common cause of upper motor neuron lesions in children, causing spasticity and muscle tendon contractures, leading to bony deformation, weakness, and loss of selective motor control. Crouch gait is a major sagittal plane deviation defined as a combination of excessive ankle dorsiflexion and knee and hip flexion throughout the stance phase. This gait pattern is commonly found in children afflicted with severe CP diplegia or quadriplegia. Crouch gait is a major sagittal plane deviation in children diagnosed with cerebral palsy (CP) It is defined as a combination of excessive ankle dorsiflexion and knee and hip flexion throughout the stance phase. Purpose To evaluate the short- and long-term effects of FES to the quadriceps muscles in preventing crouch gait and achieving ankle plantar flexion, knee and hip extension at the stance phase. A three-dimensional gait analysis was performed using an eight-camera system measuring gait kinematics and spatiotemporal parameters while the subject walked shod only, with ground reaction ankle foot orthotics (GRAFOs) and using an FES device
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