The efficacy of neuromuscular electrical stimulation (NMES) to gastro-soleus muscle for children with cerebral palsy

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The efficacy of neuromuscular electrical stimulation (NMES) to gastro-soleus muscle for children with cerebral palsy


Author: Chan, Nar-chi Nerita
Title: The efficacy of neuromuscular electrical stimulation (NMES) to gastro-soleus muscle for children with cerebral palsy
Degree: M.Sc.
Year: 2002
Subject: Hong Kong Polytechnic University -- Dissertations
Cerebral palsied children -- Rehabilitation
Neuromuscular diseases -- Treatment
Electric stimulation
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: vi, 139 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record:
Abstract: This study was a two groups ABA experimental design. The main aim of the study was to find out the effect of functional neuromuscular electrical stimulation (NMES) on gastro-soleus complex in improving the deviated gait pattern in children with cerebral palsy(CP). Specific objectives of the study were: 1) to find the effectiveness of both the combined effect of NMES plus treadmill walking and treadmill walking only; 2) to find out the effect of NMES only in affecting the gait in children with CP; and 3) to investigate the carryover effect on each group. A total of twelve children with spastic diplegia or hemiplegia were recruited and randomly assigned to the two experimental groups. The total period of the study was eight weeks. Eight repeated measures on the gait analysis were performed with clinical measurement also carried out. The effect on the control period, immediate effect, cumulative effect and the carryover effect were illustrated by different repeated measure ANOVA performed. Results showed that some kinematics changes on the maximum ankle dorsiflexion during stance was detected with a significant difference of p = 0.035 on 'time' comparison. No difference between 'treatment' and 'treatment and time' interaction could be detected. Both groups had improvement in the range of dorsiiflexion after intervention and no difference could be proved between the two groups. The kinematic changes mainly occurred for the cumulative effect but not in immediate effect. Maintenance of the effect to the carryover period was achieved. Kinetics changes in ankle moment quotient (AMQ) and ankle power quotient (APQ) were not significant for bath the immediate and cumulative effect on both groups. Improvement in trend was observed on both groups in the immediate effect but not for cumulative effect. Functional changes were detected with GMFM in standing (GMST) and in walking (GMWK), with a significant level of p < 0.001 and p = 0.003 respectively on 'time' comparison for the cumulative effect. Significant interaction was also detected on GMWK with 'treatment by time' (p = 0.035). Difference between the two groups was not significant on 'treatment' comparison on both GMST and GMWK. The results illustrated that both groups showed improvement in GMST and GMWK for the cumulative effects but no difference could be shown between the two groups. The effects on both groups could be carried over to two weeks after interventions stopped. Both NMES plus treadmill walking and the treadmill walldng group showing positive improvements in the kinematics and fimctional outcomes that we measured. No statistical significance could be proved between the two groups. However, the trend in the kinematics changes and the score of Gross Motor Function Measures suggested that group A improved more than group B. No significant improvement and no significant differences between the two groups were shown in the kinetic variables. Also, it is only the trend showing some improvement of immediate effect on AMQ and APQ. Further study is recommended in specific mechanism of the effect and therefore, more idea on the treatment protocol could be suggested for our daily practice.

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