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Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy

Functional electrical stimulation of the ankle dorsiflexor (DF-FES) may have advantages over ankle foot orthoses (AFOs) in managing pediatric cerebral palsy (CP). This study assessed the functional benefit and orthotic effect of DF-FES in children with hemiplegic CP. We conducted an open-label prosp...

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Autores principales: Segal, Idan, Khamis, Sam, Sagie, Liora, Genizi, Jacob, Azriel, David, Katzenelenbogen, Sharona, Fattal-Valevski, Aviva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047387/
https://www.ncbi.nlm.nih.gov/pubmed/36980089
http://dx.doi.org/10.3390/children10030531
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author Segal, Idan
Khamis, Sam
Sagie, Liora
Genizi, Jacob
Azriel, David
Katzenelenbogen, Sharona
Fattal-Valevski, Aviva
author_facet Segal, Idan
Khamis, Sam
Sagie, Liora
Genizi, Jacob
Azriel, David
Katzenelenbogen, Sharona
Fattal-Valevski, Aviva
author_sort Segal, Idan
collection PubMed
description Functional electrical stimulation of the ankle dorsiflexor (DF-FES) may have advantages over ankle foot orthoses (AFOs) in managing pediatric cerebral palsy (CP). This study assessed the functional benefit and orthotic effect of DF-FES in children with hemiplegic CP. We conducted an open-label prospective study on children with hemiplegic CP ≥ 6 years who used DF-FES for five months. The functional benefit was assessed by repeated motor function tests and the measurement of ankle biomechanical parameters. Kinematic and spatiotemporal parameters were assessed by gait analysis after one and five months. The orthotic effect was defined by dorsiflexion ≥ 0° with DF-FES at either the mid or terminal swing. Among 26 eligible patients, 15 (median age 8.2 years, range 6–15.6) completed the study. After five months of DF-FES use, the results on the Community Balance and Mobility Scale improved, and the distance in the Six-Minute Walk Test decreased (six-point median difference, 95% CI (1.89, 8.1), –30 m, 95% CI (−83.67, −2.6), respectively, p < 0.05) compared to baseline. No significant changes were seen in biomechanical and kinematic parameters. Twelve patients (80%) who showed an orthotic effect at the final gait analysis experienced more supported walking over time, with a trend toward slower walking. We conclude that the continuous use of DF–FES increases postural control and may cause slower but more controlled gait.
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spelling pubmed-100473872023-03-29 Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy Segal, Idan Khamis, Sam Sagie, Liora Genizi, Jacob Azriel, David Katzenelenbogen, Sharona Fattal-Valevski, Aviva Children (Basel) Article Functional electrical stimulation of the ankle dorsiflexor (DF-FES) may have advantages over ankle foot orthoses (AFOs) in managing pediatric cerebral palsy (CP). This study assessed the functional benefit and orthotic effect of DF-FES in children with hemiplegic CP. We conducted an open-label prospective study on children with hemiplegic CP ≥ 6 years who used DF-FES for five months. The functional benefit was assessed by repeated motor function tests and the measurement of ankle biomechanical parameters. Kinematic and spatiotemporal parameters were assessed by gait analysis after one and five months. The orthotic effect was defined by dorsiflexion ≥ 0° with DF-FES at either the mid or terminal swing. Among 26 eligible patients, 15 (median age 8.2 years, range 6–15.6) completed the study. After five months of DF-FES use, the results on the Community Balance and Mobility Scale improved, and the distance in the Six-Minute Walk Test decreased (six-point median difference, 95% CI (1.89, 8.1), –30 m, 95% CI (−83.67, −2.6), respectively, p < 0.05) compared to baseline. No significant changes were seen in biomechanical and kinematic parameters. Twelve patients (80%) who showed an orthotic effect at the final gait analysis experienced more supported walking over time, with a trend toward slower walking. We conclude that the continuous use of DF–FES increases postural control and may cause slower but more controlled gait. MDPI 2023-03-09 /pmc/articles/PMC10047387/ /pubmed/36980089 http://dx.doi.org/10.3390/children10030531 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Segal, Idan
Khamis, Sam
Sagie, Liora
Genizi, Jacob
Azriel, David
Katzenelenbogen, Sharona
Fattal-Valevski, Aviva
Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy
title Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy
title_full Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy
title_fullStr Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy
title_full_unstemmed Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy
title_short Functional Benefit and Orthotic Effect of Dorsiflexion-FES in Children with Hemiplegic Cerebral Palsy
title_sort functional benefit and orthotic effect of dorsiflexion-fes in children with hemiplegic cerebral palsy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047387/
https://www.ncbi.nlm.nih.gov/pubmed/36980089
http://dx.doi.org/10.3390/children10030531
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