Kinematic and Functional Gait Changes After the Utilization of a Foot Drop Stimulator in Pediatrics

Abstract

Foot drop is one of the most common secondary conditions associated with hemiplegia post stroke and cerebral palsy (CP) in children, and is characterized by the inability to lift the foot (dorsiflexion) about the ankle. This investigation focuses on children and adolescents diagnosed with brain injury and aims to evaluate the orthotic and therapeutic effects due to continuous use of a foot drop stimulator (FDS). Seven children (10 ± 3.89 years) with foot drop and hemiplegia secondary to brain injury (stroke or CP) were evaluated at baseline and after 3 months of FDS usage during community ambulation. Primary outcome measures included using mechanistic (joint kinematics, toe displacement, temporal-spatial asymmetry), and functional gait parameters (speed, step length, time) to evaluate the orthotic and therapeutic effects. There was a significant correlation between spatial asymmetry and speed without FDS at 3 months ( r = 0.76, p < 0.05, df = 5) and no correlation between temporal asymmetry and speed for all conditions. The results show orthotic effects including significant increase in toe displacement ( p < 0.025 N = 7) during the swing phase of gait while using the FDS. A positive correlation exists between toe displacement and speed (with FDS at 3 months: r = 0.62, p > 0.05, without FDS at 3 months: r = 0.44, p > 0.05). The results indicate an orthotic effect of increased dorsiflexion and toe displacement during swing with the use of the FDS in children with hemiplegia. Further, the study suggests that there could be a potential long-term effect of increased dorsiflexion during swing with continuous use of FDS.

The Impact of a Rotating Balance Platform on Leg Neuromuscular Activity in Healthy Young Adults

“…Targeted activation while avoiding muscle fatigue is conceivable when decreasing the number of repetitions or the extent of muscle contraction is brief [10] . It has been established that TA is a fundamental muscle for postural control [5] ; therefore, individuals with a weak or injured TA, such as those with HIV [11] and subjects with hemiparesis suffering from drop foot [12] , will improve from a directed, yet short, activation of the TA muscle while using this mpad balance platform.…”

Effect of functional electrical stimulation versus TheraTogs on gait and balance in children with hemiplegic cerebral palsy: a randomized controlled trial

“…The positive effect on walking recovery in these children is due to stimulating the peroneal nerve, which actively dorsiflexes the ankle and strengthens the muscles. At high levels, common peroneal nerve stimulation can produce hip and knee flexion, and it has also been claimed to reduce or counteract spasticity [18,32]. This may lead to a global improvement of walking function and, maybe, a lower cost of oxygen consumption.…”

“…Previous studies of FES to improve ankle function in children with CP [15][16][17] have reported beneficial effects in gait including improved dorsiflexion, improved gait speed, and reduced asymmetry. However, a large concern has been children's tolerance to wearing devices during normal daily activities [18].…”

“…Although the literature suggests that FES and Thera-Togs are effective in the treatment of CP [16][17][18][19][20], there is limited research comparing the two therapies. The purpose of this study was to compare the effects of FES and TheraTogs on the treatment of children with hemiplegic CP.…”

Вплив Ортезування На Силу М’язів Та Швидкість Ходьби Осіб З Гострим Порушенням Мозкового Кровообігу

“…Відновлення здатності ходити є основною метою реабілітації хворих на інсульт . Хоча 70 % пацієнтів відновлюють цю здатність, проте відчувають функціональні обмеження через спастичність, м'язову слабкість і погану рівновагу [13][14][15][16][17] . Падаюча стопа є однією з основних причин неправильної ходьби у постраждалих людей .…”