Functional electrical stimulation to lower limb muscles after botox in children with cerebral palsy.

PURPOSE: This study examined the effect of lower limb functional electrical stimulation (FES) after botulinum toxin injection in children with cerebral palsy on self-selected walking speed, plantar flexor and dorsiflexor muscle strength, and an optimal time frame for initiating FES after the injection.

METHODS

Five subjects participated in a single-subject design. All subjects received a single botulinum toxin injection into the calf muscle, followed by a 4-week FES home program. Three subjects followed the protocol as prescribed; 2 subjects received no FES.

RESULTS

FES after botulinum toxin increased isometric plantar flexor muscle strength, but did not produce changes in self-selected walking speeds or isometric dorsiflexor strength. A 32-day interval between botulinum toxin and the start of FES was most effective.

CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE: FES after botulinum toxin seems to be effective in improving some gait variables, although further research is needed for substantiation.