Comparison of the Immediate Effect between Functional Electrical Stimulation and Ankle Foot Orthoses on Gait Parameters in Cerebral Palsy

Abstract

Aim: To compare the immediate effect of functional electrical stimulation (FES) to solid ankle foot orthosis (SAFO) concerning spatiotemporal parameters and ankle kinematics during gait in hemiplegic cerebral palsy (CP). Methodology: Thirty spastic hemiplegic cerebral palsied children were randomly distributed into two equal groups; group A, who used the functional electrical stimulation (FES) and group B, who worn the solid ankle foot orthosis (SAFO).  Vicon 3D motion analysis system was used to measure the spatiotemporal parameters of gait and ankle dorsiflexion angle at initial contact and mid-swing before intervention and with application of either FES or SAFO. Spasticity was ranged between 2 and 1+ and determined by Modified Ashworth Scale score. Results: Following the application of  solid AFO, stride length and walking speed significantly increased than next to FES (p=0.0001, p=0.001) respectively. Whereas, number of steps/minute significantly decreased (p=0.001). Further, Solid AFO increased ankle dorsiflexion at initial contact (6.2±4.7º) and mid-swing (3.4±0.6º) more than FES at initial contact (1.86±3.9º) and mid-swing (-4.6± 5º). Conclusion: FES, unlikely found to evoke an immediate effect of spatiotemporal parameters while solid AFO improved the gait efficiency by enhancing spatiotemporal parameters. Both treatment interventions increased ankle dorsiflexion at initial contact and mid-swing but solid AFO was more effective immediately than FES.