Clinical Application of Functional Electrical Stimulation to The Hemiplegic Cerebral Palsy Children

We intend to apply functional electrical stimulation (FES) instead of orthoses to conditions such as hemiplegic cerebral palsy children. The purpose of this paper is to report on application of FES to the hemiplegic cerebral palsy children. The subjects were two boys (both are 6years-old) and a 7 year-old girl. They were diagnosed as spastic hemiplegic cerebral palsy. Heel contacts were not seen, and crouching and circumduction gait due to equinus foot were observed. Calf muscle lengthening (Vulpius method) was performed initially, and percutaneous intramuscular electrodes were simultaneously implanted to the motor points of tibialis anterior muscle and soleus muscle. Custom made electrical stimulator was applied for gait restoration. Gait parameters were evaluated with 3-D motion analysis system and force plate. The velocities and the strides were increased. Foot contact was changed to a heel-strike pattern instead of toestrike pattern. Circumduction gait and knee recurvatum were improved. Combined method of muscle tendon lengthening and gait restoration by FES with percutaneous intramuscular electrodes is clinically useful for cerebral palsy children.