Gait Analysis

Date:
Sep 01, 1994

The use of electrical stimulation in the treatment of muscle spasticity and tendon contracture associated with cerebral palsy has been used by a number of clinicians over many years. The desired effects of electrical stimulation were increased muscle strength and greater mobility of restricted joint motion; both, important to increased function. The results of clinical use have been varied and often difficult to evaluate. This is particularly true about the long term effects of electrical stimulation.

In a recent article in the journal Developmental Medicine and Child Neurology1, a group of clinician-investigators did a carefully designed study of the use of electrical stimulation in the treatment of one sided muscle spasticity (hemiplegia) associated with cerebral palsy. The muscles tested were those responsible for dorso-flexion of the ankle (the upward movement of the foot on the leg).

The authors report that “electrical stimulation can be effective as a home-based therapy for the reduction of contracture (tendon shortening) in children with cerebral palsy”. They suggest that electrical stimulation may be most helpful in preventing additional contracture. They also report an increase in the range of passive (involuntary) movement of the ankle. However, functional analysis of gait showed no evidence of significant improvement.

Comment

The effects of electrical stimulation appear to be limited and temporary. It is usually used intermittently as one part of a broader treatment program. It appears to be most useful at times of rapid body growth or of increasing contracture of tendons. Although electrical stimulation can contribute to an increase in range of motion, there is little indication that when used alone it provides for improvement in function.

1Hazelwood, ME et al; DMCN; August 1994, 36/8; Pgs 661-673

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Most treatments for cerebral palsy (CP) are initially directed toward children. What is not clearly established is the long- term effects of such treatments. Many appear helpful in the short term but prove to be disadvantageous in the long run. Selective dorsal rhizotomy (SDR) is a permanent, irreversible neurosurgical procedure for reducing spasticity in cerebral palsy. Parents contemplating SDR for their child would like assurance that that there will not be harmful complications from it as the child ages into adolescence and adulthood. We now have new evidence... Continue reading this article.

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