Use of functional electrical stimulation to augment traditional orthopaedic surgery in children with cerebral palsy.
The purpose of this study was to compare the functional outcomes of traditional lower extremity orthopaedic surgery to more limited surgery augmented with functional electrical stimulation (FES) applied while walking. Seventeen ambulatory children with cerebral palsy participated in this prospective pretest-posttest control group study. The surgical group (nine subjects) underwent traditional orthopaedic procedures. The FES group (eight subjects) underwent placement of percutaneous intramuscular FES electrodes and limited orthopaedic surgical procedures. Postoperatively, they were provided with an FES home walking program. One year after intervention, all children (combined data) showed improvements in passive range of motion, gait spatiotemporal parameters, and gross motor function (P < 0.05). No differences were seen between groups before or after intervention. The FES group underwent 4.5 fewer ablative procedures per child than the surgical group. These results suggest that FES in combination with more limited surgery may provide similar functional gains with fewer ablative procedures than traditional orthopaedic surgery.
Johnston
Therese E
TE
Research Department, Shriners Hospitals for Children, Philadelphia, Pennsylvania 19140, USA.tjohnston@shrinenet.org
Finson
Richard L
RL
McCarthy
James J
JJ
Smith
Brian T
BT
Betz
Randal R
RR
Mulcahey
M J
MJ
D002547:Cerebral Palsy / Q000150:complications*; D002648:Child; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005684:Gait; D006801:Humans; D009048:Motor Skills; D009140:Musculoskeletal Diseases / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D019637:Orthopedic Procedures / Q000379:methods*; D011446:Prospective Studies; D016059:Range of Motion, Articular; D016896:Treatment Outcome; D016138:Walking