Coupling effect of neuromuscular electrical stimulation on glutei and transcutaneous electrical nerve stimulation on hip adductors in scissoring gait

Abstract

Introduction: Spasticity and weakness are the two most important factors effecting gait in children with spastic diplegia. Spasticity in hip adductors and associated weakness in hip extensors and abductors leads to scissoring gait pattern. Proximal muscle stability is essential for distal mobility; this study focuses more on proximal muscle group facilitation for correction of deviations in scissoring gait. Objective: The objective of this study was to study the coupled effect of neuromuscular electrical stimulation (NMES) on glutei and transcutaneous electrical nerve stimulation (TENS) on hip adductors in improving gait parameters. Materials and Methods: The experimental group received NMES to hip extensors and hip abductors followed by TENS to hip adductors as an adjunct to conventional therapy for a period of 3 weeks whereas the control group received only conventional therapy. In experimental group, NMES was applied to gluteus maximus and medius for 10 min each and were asked them to perform the muscle action voluntarily. Later, TENS was applied to hip adductors for 10 min with passive hip abduction (HAB). Both the group received home program for the next 2 months. Results: A significant improvement was noted in spasticity, active range of motion (AROM) to HAB, extension, and gait parameters with P Conclusion: The coupled effect of NMES on glutei and TENS on hip adductors in children with scissoring gait gives rise changes in muscle tone, AROM, and gait parameter. All these contribute in improving the gait. These gains persist atleast for 3 months compared to the individuals who receive only conventional therapy. The improvement is seen within a short period of 3 weeks time compared to conventional therapy alone group which takes longer period of 12 weeks time.