Functional electrical stimulation to lower limb muscles after botox in children with cerebral palsy.
OBJECTIVE
This study examined the effect of lower limb functional electrical stimulation (FES) after botulinum toxin injection in children with cerebral palsy on self-selected walking speed, plantar flexor and dorsiflexor muscle strength, and an optimal time frame for initiating FES after the injection.


METHODS
Five subjects participated in a single-subject design. All subjects received a single botulinum toxin injection into the calf muscle, followed by a 4-week FES home program. Three subjects followed the protocol as prescribed; 2 subjects received no FES.


RESULTS
FES after botulinum toxin increased isometric plantar flexor muscle strength, but did not produce changes in self-selected walking speeds or isometric dorsiflexor strength. A 32-day interval between botulinum toxin and the start of FES was most effective.
FES after botulinum toxin seems to be effective in improving some gait variables, although further research is needed for substantiation.
Seifart
Anja
A
Department of Physiotherapy, Faculty of Health Sciences, University of Stellenbosch, Cape Town, South Africa. anjaseifart@webmail.co.za
Unger
Marianne
M
Burger
Marlett
M
D000054:Acceleration; D000465:Algorithms; D000704:Analysis of Variance; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002547:Cerebral Palsy / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy; D005080:Exercise Test; D005260:Female; D005684:Gait; D006429:Hemiplegia / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D007537:Isometric Contraction / Q000187:drug effects; D035002:Lower Extremity; D008297:Male; D053580:Muscle Strength / Q000187:drug effects; D053581:Muscle Strength Dynamometer; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000294:innervation; D009465:Neuromuscular Agents / Q000627:therapeutic use*; D016059:Range of Motion, Articular; D016138:Walking
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A