THE IMPACT OF FUNCTIONAL ELECTRICAL STIMULATION TO THE LOWER LEG AFTER A SINGLE BOTULINUM TOXIN INJECTION IN CHILDREN WITH A SPASTIC EQUINUS GAIT DUE TO CEREBRAL PALSY
Bibliographic record
Abstract
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. ResultsA 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. ConclusionFES 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.v ABSTRAK Serebrale verlamming (SV) is 'n algemene neurologiese toestand in kinders wat tot ongeskiktheid lei.Skade van die ontwikkelende brein veroorsaak abnormale spiertonus en 'n vermindering in kragvoortbrenging, wat 'n verlies aan onafhanklike funksionering tot gevolg het.Vorige studies wat intervensies nagevors het om die tipiese toonloopgang in spastiese SV aan te spreek, het onbesliste en wydverspreide uitkomste getoon. DoelDie doel van die studie was om die effek van funksionele elektriese stimulasie (FES) na afloop van 'n enkele botulinum toksien inspuiting in die triseps surae spier (1) as 'n funsionele loophulpmiddel op verskeie loopparameters en energieverbruik met beweging te bepaal, sowel as om (2) die versorgers se indruk rakende die impak van die intervensie op hulle kinders se funksionering en deelname asook (3) om die beste tydsinterval vir die begin van FES na 'n botulinum toksien inspuiting te bepaal. MetodologieEnkel-deelnemer navorsing met 'n veelvoudige basislyn benadering is op vyf ambulante deelnemers met 'n dinamiese toonlooppatroon as gevolg van SV (gemiddelde ouderdom: 5.1 jaar, SD=1.4) in die Kaapse Metropool onderneem.Twee-dimensionele loopanalises, isometriese kragmetings, "Energy Expenditure Index" (EEI), en 'n versorger vraelys is gebruik om data oor loopspoed, enkelhoeke tydens eerste kontak van loop, isometriese plantar-en dorsifleksor spierkrag, energieverbruik tydens loop, sowel as die versorger se indruk rakende veranderinge in alledagse deelname te versamel.Statistiese analise is uitgevoer deur middel van "ANOVA" toetse en grafiese data-illustrasies.vi Resultate 'n Statisties beduidende verskil in terme van plantarfleksor spierkrag is getoon.Hierdie uitkoms is gedeeltelik volgehou oor die twee-maande onttrekkingsfase.Versorgers het gevoel dat die intervensie (FES na botulinum toksien) 'n positiewe uitwerking op hulle kinders se loopspoed sowel as op ouderdomstoepaslike funksie en deelname gehad het.Loopspoed, dorsifleksor spierkrag, en enkelhoeke by eerste kontak van loop het nie beduidende veranderinge getoon nie.'n Interval van 32 dae tussen die botulinum toksien inspuiting en die begin van die FES program het die mees uitgesproke effekte in terme van loopspoed, EEI, en plantarfleksor spierkrag getoon. GevolgtrekkingFES tot die onderbeen, 32 dae na 'n botulinum toksien inspuiting in die triseps surae spier, vir 30 minute per dag, vyf keer 'n week oor 'n total van vier opeenvolgende weke, blyk om geselekteerde loopparameters sowel as die versorger se indruk van die intervensie se impak op funksionering en deelname te verbeter.Verdere navorsing word benodig.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".