Thesis (MScPhysio (Physiotherapy))--Stellenbosch University, 2008. / Cerebral palsy (CP) is a common neurological condition seen in children which results in
childhood disability. Damage to the developing brain results in abnormal muscle tone and
decreased force generation, which leads to loss of independent function. Previous studies
investigating interventions targeting the typical equinus gait pattern seen in spastic CP
have reported inconclusive and widespread outcomes.
Objectives
The objectives of the study were to determine (1) the effect of functional electrical
stimulation (FES) after a single botulinum toxin injection into the triceps surae muscle as
a functional orthosis on various gait parameters and economy of movement; (2)
caregivers’ perceptions of the impact of the intervention on their child’s function and
participation, and (3) optimal timing intervals for introducing FES after a botulinum toxin
injection.
Method
Single-subject research with a multiple baseline approach was conducted on five
ambulant subjects (average age 5.1 years, SD=1.4) in the Cape Metropole with a dynamic
equinus gait due to hemiplegic CP. Two-dimensional gait analysis, isometric
dynamometry, Energy Expenditure Index (EEI), and a caregiver questionnaire were used
to gather data on walking speed, ankle angles at initial contact of gait, isometric plantarand
dorsiflexior muscle strength, energy expenditure during gait, as well as caregiver
perception on participation changes. Statistical analysis was conducted by means of
ANOVA tests and graphic data illustrations. Results
A statistically significant pre- to post intervention (FES after botulinum toxin) change
was found for plantarflexor muscle strength. This effect was partially maintained over the
withdrawal phase. Caregivers felt the intervention to have a positive influence on their
children’s walking speeds, as well as on age-appropriate function and participation. Selfselected
walking speed, dorsiflexor muscle strength, and ankle angles at initial contact
did not change significantly. A 32-day interval between between botulinum toxin and the
FES programme resulted in the most pronounced improvements in terms of walking
speed, EEI scores, and plantarflexor muscle strength.
Conclusion
FES to the lower limb, 32 days after botulinum toxin into the triceps surae, applied for 30
minutes per day, five times a week over a total of four weeks, seemed to improve selected
gait parameters as well as caregiver perception of impact on function and activities of
daily living. However, further research is needed.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/2860 |
| Date | 03 1900 |
| Creators | Seifart, Anja |
| Contributors | Unger, M., Burger, M., Stellenbosch University. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Physiotherapy. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Rights | Stellenbosch University |
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