Effect of Neuromuscular Electrical Stimulation during Gait in Children with Cerebral Palsy

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Our purpose was to determine whether NMES to the gastrocnemius or to the gastrocnemius/tibialis anterior of children with cerebral palsy during gait/functional activity will improve dorsiflexion at heel strike. Fourteen subjects aged four through 14 years with hemiplegia or diplegia were selected. There were four four-week phases: pretreatment; gastrocnemius stimulation; gastrocnemius/tibialis anterior stimulation; and posttreatment with the same gait/pregait activities throughout. During three observations in each phase, gait videos were made and mean ankle range of motion (ROM) at foot contact was measured from the screen later. A two-way analysis of variance (ANOVA) with two repeated measures was run at the 0.05 level. There was a significant main effect for treatment (F = 7.43, df= 3, p = 0.001) but not for time (F = 2.23, df = 2, p > 0.10) or for the interaction between treatment and time (F = 0.74, df = 6, p > 0.50). A Newman Keuls test found significant differences for both stimulation treatments. Heel strike dorsiflexion improved after gastrocnemius stimulation and gastrocnemius/tibialis anterior stimulation during gait/functional activity.

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