Efficiency of using the technology of functional electrical stimulation in gait disorder in patients with cerebral palsy

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Abstract

Cerebral palsy is a group of developmental disorders affecting motor skills and postural maintenance, leading to motion defects due to non-progressive damage and/or a developing brain anomaly in the fetus or the newborn child. Leg muscle weakness and spasticity associated with cerebral palsy limit the range of motion in the ankle joint and negatively affect the child’s motor ability. This article reviews scientific studies on an innovative method of functional electrical stimulation of walking in children with cerebral palsy. We searched for information in the Scopus, Web of Science, Medline, The Cochrane Library, PubMed, Pedro, Scholar, eLibrary, and CyberLeninka databases. The efficiency of remedial treatment of motion using functional electrical stimulators was assessed using biomechanical and neurophysiological methods of evidence-based medicine. When children are rehabilitated using electrical stimulation techniques such as functional electrical stimulation, the gait is restored significantly, dorsiflexion is improved, the gait pattern is normalized, stability when walking is increased, the number of falls is decreased, and the need for additional support is reduced. The effect of functional electrical stimulation on the normalization of walking speed, gait kinematics and symmetry, the ability to overcome obstacles, and the range of motion of the ankle joint and foot clearance during walking are discussed. In addition, the work analyzes the effect of functional electrical stimulation on reducing the patient’s energy consumption when walking, normalizing muscle tone, decreasing the risk of falls, and increasing confidence and comfort when walking. As part of this analysis, the speed of adaptation and patient tolerance of the devices for functional electrical stimulation are also discussed. A comparative characteristic of functional electrical stimulation using ankle joint orthoses is provided.

CONCLUSIONS: For many years, movement dynamics have used functional electrical stimulation technologies to rehabilitate neurological patients after stroke and multiple sclerosis. It is only a matter of time before these technologies also become the standard treatment for children with cerebral palsy in rehabilitation programs.

About the authors

Evgeniya A. Guryanova

Institute for Advanced Medical Studies

Author for correspondence.
Email: z-guryanova@bk.ru
ORCID iD: 0000-0003-1519-2319

MD, Dr. Sci. (Med.), Professor

Russian Federation, Cheboksary

Natalya V. Chebanenko

Russian Medical Academy of Continuous Professional Education

Email: nataqwe@yandex.ru
ORCID iD: 0000-0002-7231-0249

MD, Cand. Sci. (Med.), assistant professor

Russian Federation, Moscow

Felix G. Litvak

Ben-Gurion University of the Negev

Email: litvak.felix@gmail.com
SPIN-code: 8435-6912
Israel, Be’er Sheva

Valery P. Zykov

Russian Medical Academy of Continuous Professional Education

Email: childneur@mtu-net.ru
ORCID iD: 0000-0002-1401-5479

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

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