Neuromuscular electrical stimulation of the gluteus medius improves the gait of children with cerebral palsy.
Neuromuscular electrical stimulation (NMES) of the gluteus medius muscles using a surface electrode during functional walking training has never been reported as a management option to improve gait in spastic diplegic children.


OBJECTIVE
This study was investigates the short and longer term effects of simultaneous continuous NMES of both hip abductors during walking on the temporal-spatial gait characteristics and hip adductor muscle tone in children with spastic diplegia caused by cerebral palsy (CP).


METHODS
Three groups of subjects participated: an experimental group of twenty-one ambulant spastic diplegic children; a CP control group containing ten ambulant spastic diplegic children; and a healthy control group with twenty normal children.


METHODS
The experimental group received three different NMES management programs. The first NMES program was designed to evaluate the immediate short-term effects of simultaneous continuous NMES of both gluteus medius muscles during walking. The second NMES program aimed to evaluate the effect of 15 minutes of simultaneous and continuous NMES of both gluteus medius muscles during walking, three sessions a day for a week. The third program was similar to the first and was designed to detect any additional changes in gait after full adaptation to NMES and completion of the second program. A dual channel stimulator with self-adhesive electrodes at the tolerable motor threshold level was used with a frequency of 20 Hz and pulse width of 50 micros. The effect of NMES programs was assessed using a three-dimensional gait analysis system and the Modified Ashworth Scale.


RESULTS
Significant improvement in the temporal-spatial parameters and hip adductor muscle tone of the experimental group (p < 0.001-0.05) was observed.


CONCLUSIONS
The NMES management programs used in this study improved the gait of spastic diplegic CP children.
Al-Abdulwahab
Sami S
SS
King Saud University, Rehabilitation Sciences Department, Riyadh, Saudi Arabia.
Al-Khatrawi
Wafa M
WM
D002081:Buttocks; D002547:Cerebral Palsy / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006615:Hip; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D009129:Muscle Tonus / Q000502:physiology; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology