Utilizing Functional Electrical Stimulation and Exoskeletons in Pediatrics: a Closer Look at Their Roles in Gait and Functional Changes in Cerebral Palsy

Abstract

A primary focus for many children with cerebral palsy (CP) is functional independence. However, due to neurologic insults that occur early in life, typical gait pattern development is impaired. Research has shown the importance of task-oriented movements in reorganizing the central nervous system in a functionally meaningful way. Advancements in technology, when used in conjunction with conventional strategies, have made it possible for therapists to utilize devices that provide repetitive patterning and feedback for gait retraining. This enables patients the opportunity to develop normal gait patterns and improve functional independence. Interventions such as functional electrical stimulation and exoskeletons can be utilized to assist patients with sequencing motor contractions of different muscles in more physiologic patterning. Children who suffer from neurologic insults may not only benefit from the restorative properties of these interventions, but also from the active engagement that is provided through the use of this technology. Therapists, utilizing these interventions, are able to encourage their patient’s interest and motivation while providing them with a repetitive goal-oriented task to assist with cortical reorganization. This review focuses on current literature addressing the use of functional electrical stimulation and exoskeletons in pediatric rehabilitation. The results of these studies demonstrate the effectiveness of these devices when compared to conventional therapeutic interventions. This review shows that continued research is needed on specific dosage in order to determine optimal outcomes.