ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

A fundamental knowledge of muscle and nerve physiology is crucial to the understanding and appropriate application of neuromuscular electrical stimulation (NMES) for children. This report presents a brief discussion of the physiology and theory supporting the use of NMES, including explanation of various waveforms, factors influencing fatigue, and stimulus parameters. Precautions and contraindications for the use of NMES, specifically as they relate to the pediatric population, are highlighted. Also, various therapeutic applications and their rationale are introduced.

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Our purpose was to determine whether NMES to the gastrocnemius or to the gastrocnemius/tibialis anterior of children with cerebral palsy during gait/functional activity will improve dorsiflexion at heel strike. Fourteen subjects aged four through 14 years with hemiplegia or diplegia were selected. There were four four-week phases: pretreatment; gastrocnemius stimulation; gastrocnemius/tibialis anterior stimulation; and posttreatment with the same gait/pregait activities throughout. During three observations in each phase, gait videos were made and mean ankle range of motion (ROM) at foot contact was measured from the screen later. A two-way analysis of variance (ANOVA) with two repeated measures was run at the 0.05 level. There was a significant main effect for treatment (F= 7.43,df= 3,p= 0.001) but not for time (F= 2.23,df= 2,p> 0.10) or for the interaction between treatment and time (F= 0.74,df= 6,p> 0.50). A Newman Keuls test found significant differences for both stimulation treatments. Heel strike dorsiflexion improved after gastrocnemius stimulation and gastrocnemius/tibialis anterior stimulation during gait/functional activity.

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Disuse muscle atrophy is a significant component of the long-term disability in cerebral palsy and other childhood neurologic disorders. Traditional methods of electrical stimulation, which include neuromuscular electrical stimulation (NMES) and functional electrical stimulation (FES), produce active muscle contraction to strengthen and produce functional gain. Therapeutic electrical stimulation (TES) is a new form of stimulation that uses subcontraction stimulus to promote muscle growth. The presumed mechanism is increased blood flow during a time of trophic hormone secretion during sleep. The TES technique is considered a technologic adjunct to ongoing therapy. TES-stimulated muscle growth requires that ongoing therapy be conducted to strengthen the muscle and to channel the added strength into useful function.

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The purpose of this manuscript is to provide an overview of research on functional electrical stimulation (FES) for persons with spinal cord injuries (SCI) with particular emphasis on advancements made with children and adolescents. Results of research on FES in pediatrics show that for children and adolescents with C5 and C6 level SCI, FES improves hand function, increases independence and ease of task completion in activities of daily living (ADL), is preferred over alternative methods and facilitates social interchange. For young persons with high tetraplegia, FES systems must activate multiple joints (shoulder, elbow, hand) creating challenges related to control sources, portability, and ease of use. Laboratory-based evaluation showed that FES and an orthosis enabled performance of hand-to-mouth activities. Further development and laboratory-based testing is needed before providing children with high level cervical injuries FES systems for home and school use. With FES, children and adolescents with complete thoracic level injuries have achieved stance, level ambulation, and upright mobility such as side-stepping and stair ascent and descent. Comparison data between FES and knee-ankle-foot orthoses (KAFO) suggest that FES is equally effective, and in some instances superior to, mobility function provided by KAFO. Current FES technology is best suited to provide ambulatory ability for children with incomplete SCI and stance and upright mobility for children with complete thoracic injuries. Totally implanted FES systems are currently being used with adults and skeletally mature adolescents, and through our studies on the effect of growth on implant technology, FES implant systems for upper and lower extremity applications with children will be realized in the very near future.

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The purpose of this paper is to discuss the emergent application of percutaneous intramuscular functional electrical stimulation (FES) for children with cerebral palsy (CP). Viewing CP as a multidimensional clinical syndrome that is primarily characterized by deficits in motor control with simultaneous secondary musculoskeletal impairments challenges the therapist to be broad-based in management approaches and intervention choices. Effective interventions for children with CP must impact on peripheral, central, and compensatory mechanisms to affect change in the child's functional abilities. Intramuscular FES may be uniquely able to activate weak or inaccurate muscle responses to achieve strengthening and functional improvements through coordinated, sequenced muscle activation. Two children with spastic diplegia underwent bilateral implantation of percutaneous intramuscular electrodes into the gluteus maximus, gluteus medius, vastus lateralis, vastus medialis, gastrocnemius, and tibialis anterior. Intervention with FES consisted of the creation of stimulation programs for strengthening key antigravity muscles during stance as well as exercise programs to activate weak muscles during appropriate gait subtasks, such as stable stance, unilateral limb loading, weight transfer, and limb advancement. The children were asked to work with the stimulation, using the stimulated input as a motor learning assist. Both children showed clinical improvements in lower extremity range of motion and spatial gait characteristics, but, more importantly, there were improvements in gross motor function. The improvements seen continued to be evident whether the stimulation was on or off, perhaps an effect of carryover and motor learning. These results are promising and suggest that the simultaneous activation, strengthening, and training of multiple muscle groups afforded by FES may offer an intervention approach that uniquely addresses both the peripheral and central problems contributing to impairment in children with CP.

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0898-5669    

出版商:OVID    

年代:1997

数据来源: OVID