Examination of the use of a dual-channel functional electrical stimulation system on gait, balance and balance confidence of an adult with spastic diplegic cerebral palsy

Robinson, Barbara Susan; Williamson, E. M.; Cook, J.; Harrison, Kayla S.; Lord, Evan M.

doi:10.3109/09593985.2014.982774

Cited by 9 publications

(4 citation statements)

References 48 publications

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“…Eleven studies reported NMES-assisted gait for strengthening and improving gait pattern, including one case report ( Robinson et al, 2015 ), three single-subject research design studies (SSRD) ( Chan et al, 2004 ; Pool et al, 2014 ; Gonçalves et al, 2019 ), three prospective trials ( Johnston et al, 2004 ; Prosser et al, 2012 ; Damiano et al, 2013 ), and four RCTs ( Pool et al, 2016 ; 2015 , van der Linden et al, 2003 , 2008 ). Various NMES devices were used, including surface electrodes for non-wearable units targeting the gluteals, quadriceps, gastrocnemius, and tibialis anterior.…”

Section: Resultsmentioning

confidence: 99%

“…The eleven studies that investigated NMES-assisted gait found improved muscle structure, strength, SMC, gross motor skills, and gait ( van der Linden et al, 2003 , 2008 ; Chan et al, 2004 ; Johnston et al, 2004 ; Prosser et al, 2012 ; Damiano et al, 2013 ; Pool et al, 2016 , 2015 , 2014 ; Robinson et al, 2015 ; Gonçalves et al, 2019 ). NMES-assisted gait resulted in increased muscle volume of tibialis anterior as assessed on MRIs ( Pool et al, 2016 ), increased tibialis anterior CSA as assessed on ultrasound ( Damiano et al, 2013 ), increased strength as assessed by dynamometers ( Pool et al, 2016 , 2014 ), improved SMC as assessed by SCALE ( Pool et al, 2016 ), improved gross motor skills as assessed by GMFM ( van der Linden et al, 2003 ; Chan et al, 2004 ; Johnston et al, 2004 ; Gonçalves et al, 2019 ), and improved gait as assessed by kinematics, kinetics, and temporal-spatial parameters ( Chan et al, 2004 ; Johnston et al, 2004 ; van der Linden et al, 2008 ; Prosser et al, 2012 ; Pool et al, 2015 ; Robinson et al, 2015 ). Compliance was reported to be high for NMES intervention ( Chan et al, 2004 ; Prosser et al, 2012 ; Pool et al, 2016 , 2015 ).…”

Section: Resultsmentioning

confidence: 99%

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Neuromuscular electrical stimulation to augment lower limb exercise and mobility in individuals with spastic cerebral palsy: A scoping review

et al. 2022

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Background: Neuromuscular Electrical Stimulation (NMES) is an emerging assistive technology applied through surface or implanted electrodes to augment skeletal muscle contraction. NMES has the potential to improve function while reducing the neuromuscular impairments of spastic cerebral palsy (CP). This scoping review examines the application of NMES to augment lower extremity exercises for individuals with spastic CP and reports the effects of NMES on neuromuscular impairments and function in spastic CP, to provide a foundation of knowledge to guide research and development of more effective treatment.Methods: A literature review of Scopus, Medline, Embase, and CINAHL databases were searched from 2001 to 2 November 2021 with identified inclusion and exclusion criteria.Results: Out of 168 publications identified, 33 articles were included. Articles on three NMES applications were identified, including NMES-assisted strengthening, NMES-assisted gait, and NMES for spasticity reduction. NMES-assisted strengthening included the use of therapeutic exercises and cycling. NMES-assisted gait included the use of NMES to improve gait patterns. NMES-spasticity reduction included the use of transcutaneous electrical stimulation or NMES to decrease tone. Thirteen studies investigated NMES-assisted strengthening, eleven investigated therapeutic exercise and demonstrated significant improvements in muscle structure, strength, gross motor skills, walking speed, and functional mobility; three studies investigated NMES-assisted cycling and demonstrated improved gross motor skills and walking distance or speed. Eleven studies investigated NMES-assisted gait and demonstrated improved muscle structure, strength, selective motor control, gross motor skills, and gait mechanics. Seven studies investigated NMES for spasticity reduction, and five of the seven studies demonstrated reduced spasticity.Conclusion: A growing body of evidence supports the use of NMES-assisted strengthening, NMES-assisted gait, and NMES for spasticity reduction to improve functional mobility for individuals with spastic CP. Evidence for NMES to augment exercise in individuals with spastic CP remains limited. NMES protocols and parameters require further clarity to translate knowledge to clinicians. Future research should be completed to provide richer evidence to transition to more robust clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Neuromuscular electrical stimulation to augment lower limb exercise and mobility in individuals with spastic cerebral palsy: A scoping review

et al. 2022

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“…This early hypothesis is supported by the case studies published in Rose et al (21) and Behboodi et al (20). Additionally, a single subject case study published in 2015, assessing the effects of gait-specific multi-channel stimulation to the tibialis anterior and hamstrings in an adult with CP, demonstrated improvements in the Dynamic Gait Index, Performance Oriented Mobility Assessment, Observational Gait Scale, and Activities-specific Balance Confidence Scale scores (42). However, these are all case study examples, and the benefits of a multi-channel NMES system must be born out in a larger study.…”

Section: Discussionmentioning

confidence: 99%

A Scoping Review of Neuromuscular Electrical Stimulation to Improve Gait in Cerebral Palsy: The Arc of Progress and Future Strategies

Mooney

Rose

2019

Front. Neurol.

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Background: Neuromuscular deficits of children with spastic cerebral palsy (CP) limits mobility, due to muscle weakness, short muscle-tendon unit, spasticity, and impaired selective motor control. Surgical and pharmaceutical strategies have been partially effective but often cause further weakness. Neuromuscular electrical stimulation (NMES) is an evolving technology that can improve neuromuscular physiology, strength, and mobility. This review aims to identify gaps in knowledge to motivate future NMES research. Methods: Research publications from 1990- July 20th 2019 that investigated gait-specific NMES in CP were reviewed using the PubMed and Google Scholar databases. Results were filtered by the National Institute of Neurological Disorder and Stroke common data elements guidelines for CP. The Oxford Centre for Evidence Based Medicine guidelines were used to determine levels of evidence for each outcome. Gait-specific NMES research protocols and trends are described, with implications for future research. Results: Eighteen studies met inclusion criteria, reporting on 212 participants, 162 of whom received NMES while walking, average age of 9.8 years, GMFCS levels I–III. Studies included 4 randomized control trials, 9 cohort studies and 5 case studies. A historical trend emerged that began with experimental multi-channel NMES device development, followed by the commercial development of single-channel devices with inertial sensor-based gait event detection to facilitate ankle dorsiflexion in swing phase. This research reported strong evidence demonstrating improved ankle dorsiflexion kinematics in swing and at initial contact. Improved walking speed, step length, and muscle volume were also reported. However, improvements in global walking scores were not consistently found, motivating a recent return to investigating multi-channel gait-specific NMES applications. Conclusions: Research on single-channel gait-specific NMES found that it improved ankle motion in swing but was insufficient to address more complex gait abnormalities common in CP, such as flexed-knee and stiff-knee gait. Early evidence indicates that multi-channel gait-specific NMES may improve gait patterns in CP, however significantly more research is needed. The conclusions of this review are highly limited by the low level of evidence of the studies available. This review provides a historical record of past work and a technical context, with implications for future research on gait-specific NMES to improve walking patterns and mobility in CP.

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“…29,30 Six Minute Walk Test (6MWT) used in Phase I: examines physical functioning capacity by assessing walking distance over a total of six minutes on a hard, flat surface. 31 Test-retest reliability as ICC = 0.88 -0.91 overtime in heart failure patients.…”

Section: Physical Functioningmentioning

confidence: 99%

Develop and test a palliative care screening tool for rural patients with serious chronic illnesses: a study protocol

Young

Kupzyk

Parker³

et al. 2016

Int J Clin Trials

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Background: Delayed admission to palliative and hospice services is prevalent and, especially in rural areas, contributing to poor quality of care, caregiver stress and burden, reducing patients’ and their caregivers' quality of life and increasing healthcare costs. A reliable and sensitive screening tool would help clinicians identify patients in need of palliative care services. The purpose of the study is to develop and test a screening tool to be used by healthcare professionals in rural clinics and hospitals to identify patients with progressive, multiple chronic illnesses in need of primary palliative care services.Methods: A longitudinal, sequential mixed-method methods design will be used to achieve the purpose of the study. A rural community hospital and its affiliated community clinics in the Midwestern United Sates are selected for the study. In Phase I, we will conduct a cohort study using existing electronic health records. The cross-sectional and correlational quantitative data analysis will be used to test the psychometric properties of the current and modified palliative care screening tools. In Phase II, we will prospectively collect functioning and physical activity level data from the patients admitted to the palliative care program over time (monthly for 6 months). Again, the primary focus is to conduct correlational quantitative analysis to evaluate the psychometric properties of the modified palliative screening toolConclusions: The implication of this project is to 1) reduce healthcare disparities, 2) improve quality of care for rural patients with chronic serious illness; 3) inform the development of a hybrid (both inpatient and outpatient) screening tool for identifying palliative care needs that can be integrated into primary palliative care programs; and 4) enhance our understanding of mechanisms and relevant variables related to palliative care in rural patients living with chronic serious illness, leading to future program research in this field.

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Examination of the use of a dual-channel functional electrical stimulation system on gait, balance and balance confidence of an adult with spastic diplegic cerebral palsy

Cited by 9 publications

References 48 publications

Neuromuscular electrical stimulation to augment lower limb exercise and mobility in individuals with spastic cerebral palsy: A scoping review

Neuromuscular electrical stimulation to augment lower limb exercise and mobility in individuals with spastic cerebral palsy: A scoping review

A Scoping Review of Neuromuscular Electrical Stimulation to Improve Gait in Cerebral Palsy: The Arc of Progress and Future Strategies

Develop and test a palliative care screening tool for rural patients with serious chronic illnesses: a study protocol

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