Abstract
[Truncated]
Aims
This thesis investigated the effects of daily, community-applied functional electrical stimulation (FES) to the ankle dorsiflexors during the swing phase of gait in children and adolescents with unilateral spastic cerebral palsy (USCP).
Methods/Results
Two studies were conducted that investigated the effect of FES in children between 5 and 18 years of age with USCP and a Gross Motor Function Classification System (GMFCS) and Winters Gage and Hicks classification of I or II. The first was a single subject ABA pilot study (n=12) designed to determine the acceptability and effect of FES on impairments of body structure and function, gait, pilot outcome measures and to establish sample size for an adequately powered randomised controlled trial (RCT). Results indicated that intermittent, short-term use of FES applied in the community was potentially effective for addressing ankle related impairments in body structure and function affecting gait in children with USCP. The pilot study highlighted the need for comprehensive measurements, particularly for the effects of FES on activity and participation. Hence the RCT was adequately powered and designed to address the limitations that were highlighted in the pilot study. Thirty-two children were matched by age and GMFCS level and then randomly assigned to the FES group (n=16, eight weeks of daily FES) and control group (n=16 usual treatments). Outcome measurements represented the domains across the International Classification of Functioning, Child and Youth Version (ICF-CY), assessed at baseline (week 0), post treatment (week 8) and follow-up (week 14). The primary outcome measures at the level of body structure and function: tibialis anterior strength and muscle volume. At the activity level: lower limb mechanics during gait, community mobility and high-level balance skills. Finally, at the participation level: performance and satisfaction in participant/parent identified performance problems. The secondary outcome measures included selective motor control, antagonist gastrocnemius strength and muscle volume, ankle and knee passive and dynamic range of motion and foot sensation.
Aims
This thesis investigated the effects of daily, community-applied functional electrical stimulation (FES) to the ankle dorsiflexors during the swing phase of gait in children and adolescents with unilateral spastic cerebral palsy (USCP).
Methods/Results
Two studies were conducted that investigated the effect of FES in children between 5 and 18 years of age with USCP and a Gross Motor Function Classification System (GMFCS) and Winters Gage and Hicks classification of I or II. The first was a single subject ABA pilot study (n=12) designed to determine the acceptability and effect of FES on impairments of body structure and function, gait, pilot outcome measures and to establish sample size for an adequately powered randomised controlled trial (RCT). Results indicated that intermittent, short-term use of FES applied in the community was potentially effective for addressing ankle related impairments in body structure and function affecting gait in children with USCP. The pilot study highlighted the need for comprehensive measurements, particularly for the effects of FES on activity and participation. Hence the RCT was adequately powered and designed to address the limitations that were highlighted in the pilot study. Thirty-two children were matched by age and GMFCS level and then randomly assigned to the FES group (n=16, eight weeks of daily FES) and control group (n=16 usual treatments). Outcome measurements represented the domains across the International Classification of Functioning, Child and Youth Version (ICF-CY), assessed at baseline (week 0), post treatment (week 8) and follow-up (week 14). The primary outcome measures at the level of body structure and function: tibialis anterior strength and muscle volume. At the activity level: lower limb mechanics during gait, community mobility and high-level balance skills. Finally, at the participation level: performance and satisfaction in participant/parent identified performance problems. The secondary outcome measures included selective motor control, antagonist gastrocnemius strength and muscle volume, ankle and knee passive and dynamic range of motion and foot sensation.
| Original language | English |
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| Qualification | Doctor of Philosophy |
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| Publication status | Unpublished - 2016 |