Study on the effect of intelligent assistance model functional electrical stimulation on children with spastic diplegic cerebral palsy / 中华实用儿科临床杂志

ABSTRACT

Objective To study the effect of functional electrical stimulation(FES) with innovative static state combined assistance pattern on lower extremity muscle status,motor function and walking function in children with spastic diplegic cerebral palsy.Methods A total of 40 children with spastic diplegic cerebral palsy were randomly divided into a observation group (20 cases) and a control group (20 cases),which were selected from the Third Affiliated Hospital of Jiamusi University from March 2016 to July 2016.The observation group included 11 males and 9 females,aged 3 to 6 years old,on the average of (4.80 ± 1.06) years;the control group including 7 males and 13 females,aged 3 to 6 years old,with mean age (4.75 ± 0.96) years.The control group was only treated with conventional rehabilitation therapy such as kinesitherapy and occupational therapy.On the basis of routine rehabilitation therapy,the observation group was treated with functional electrical stimulation with innovative static state combined with intelligent assistance patterns.All the therapies including conventional and FES treatment were conducted once per day,5 times per week,total for 8 weeks totally.The outcomes before treatment,4 weeks after treatment and 8 weeks after treatment for all the subserved objects were evaluated by modified Ashworth scale(MAS),including joint range of motion(ROM),manual muscle assessment (MMT),gross motor function scale (GMFM-88 D and E regions),gait analysis and musculoskeletal ultrasound (measured muscle thickness).All the data were collected and analyzed by SPSS 17.0 statistical software.Results After 4 weeks to 8 weeks of treatment,2 groups of children with joint range of motion of lower limbs,muscle strength,muscle tension,GMFM-88 score of D and E regions,muscle thickness and gait in 2 groups of children were improved than those before treatment (P ＜ 0.05),after 4 to 8 weeks of treatment,2 groups of children with lower limb joint activity,muscle strength,muscle tension,GMFM-88 score,D and E regions of the muscle thickness and gait in 2 groups of children were improved than those before treatment,and the differences were significant (P ＜ 0.05).The evaluation index of the observation group,Ashworth [left (1.80 ± 0.52) scores,right (3.40 ± 0.88) scores],ROM [left (19.5 ± 2.8) °,right (19.4 ± 1.5) °],muscle strength [left (1.80 ± 0.52) grade,right (2.O0 ± 0.56) grade] and muscle thickness[left gastrocnemius (32.35 ± 1.79) mm,right gastrocnemius (32.95 ± 2.63) mm,left anterior tibial muscle (30.60 ± 1.00) mm,right anterior tibial muscle (30.05 ± 1.8) mm],were all significantly better than those of the control group (all P ＜ 0.05).Step length (23.75-3.19) cm and step speed (0.45 ± 0.01) m/s compared with the control group improved significantly compared with the control group (P ＜ 0.05),the GMFM scores [D regions (31.30 ± 1.46) scores,E regions (48.95 ± 1.40) scores] was significantly higher than those of the control group (P ＜ 0.05).Conclusions The FES with innovative static state combined with intelligent assistance pattern can effectively improve the lower limb muscle state and motor function in children with spastic diplegic cerebral palsy.