The effects of functional electrical stimulation cycling on gait parameters in diplegic cerebral palsy: a single-blind randomized controlled trial

Abstract

Purpose

To investigate the effects of functional electrical stimulation cycling (FES-C) training in addition to conventional physical therapy on gait, muscle strength, gross motor function, and energy expenditure in ambulatory children with spastic diplegic cerebral palsy.

Materials and methods

Twenty children with diplegic cerebral palsy were randomly assigned to FES-C group (n = 10) or control group (n = 10). Subjects trained 3 days/week for 8 weeks. Control group received conventional physical therapy. The FES-C group additionally received FES-C training. The functional muscle test was used for muscle strength assessment. Vicon-3D system was used for gait analysis. Gross Motor Function Measure (GMFM-88) was used for motor function assessment and calorimeter was used for energy expenditure. Measurements were performed at the baseline, at the eight week and at the sixteenth week.

Results

Functional muscle strength, gross motor function, and energy expenditure improved more in the FES-C group after training and follow up (p < 0.05). There was no significant difference found between the changes in gait parameters of the two groups after treatment and follow up (p > 0.05). Pelvic tilt while walking decreased after training in the FES-C group (p < 0.05).

Conclusions

FES-C applied in addition to conventional physical therapy in children with diplegic cerebral palsy is more effective than conventional physical therapy for increasing functional muscle strength, improving gross motor function functions, and reducing energy expenditure.

Highlights

1. FES-C improves lower extremity functional muscle strength, gross motor function, and energy expenditure in ambulatory children with spastic dCP.

2. The use of FES-C in combination with conventional physiotherapy methods may be beneficial in outpatients with spastic dCP.

Keywords:

• Cerebral palsy
• gait analysis
• electric stimulation therapy
• resistance training
• oxygen expenditure

Acknowledgements

The authors thank all children with cerebral palsy who participated in the study and their parents.

Author contributions

D.T. contributed to every step of study planning, rehabilitation applications, data collection, and data analysis. Y.Y. was the supervisor of the doctoral dissertation and contributed to the study planning, evaluations of all parameters, statistical analysis of data, and manuscript writing, conduct of the study; E.Y. contributed to every step of study planning, the applications and evaluations of gait and energy consumption, and manuscript writing on the subject. M.K.G. contributed to the study planning, evaluations of all parameters conduct of the study, and manuscript writing. B.Y. and A.K.T. contributed to the study planning and conduct of the study and manuscript writing. All authors had complete access to the study data that support the publication.

Disclosure statement

No potential conflict of interest was reported by the author(s).