Applications of FES Artificial Walking for Cerebral Palsy

Stanford University, Stanford CA

Investigators

Linked publications & trials

Abstract

DESCRIPTION (provided by applicant): The goal of the proposed conference is to create a research network on functional electrical stimulation (FES) assisted walking in cerebral palsy (CP). The conference will bring together experts in FES artificial walking, neuromuscular physiology, computer science, biomechanical modeling and gait analysis to advance FES assisted walking for children with CP and to plan a multi-centered clinical trial using state of the art technologies. The clinical trial will assess the effects of FES on walking patterns and on neuromuscular physiology in children with CP. An initial research network meeting will be held for attendees of the 63rd Annual American Academy for Cerebral Palsy and Developmental Medicine conference in Scottsdale Arizona, September 2009. This initial meeting will be followed by a two day conference on FES Assisted Walking for CP at Stanford University in November 2009. Walking deficits in children with spastic CP result from weak, short muscles and joint contracture due to loss of descending motor drive, poor selective motor control, spasticity and slow muscle growth. Current treatments for gait deficits offer only partial improvement, thus most children with CP walk with a fatiguing, awkward gait and limited mobility. More effective treatment for gait deficits in CP is needed at an early age when there is optimal neuronal plasticity, rapid musculoskeletal growth and a greater likelihood of preventing gait abnormalities. Functional electrical stimulation (FES) is a developing assistive technology that can generate purposeful, useful movements through electrical activation of paralyzed or weak muscles. While current surgical and medical treatments for gait deficits result in further muscle weakness, FES technology has the potential to improve walking patterns as well as improve neuromuscular physiology and muscle strength. Treatment with FES may also stimulate more normal musculoskeletal growth in children with CP, preventing contracture. More effective early treatment is most likely to improve motor control, prevent growth related deformities, and reduce the need for surgery. The FES artificial walking technology offers a promising new treatment for gait deficits, thus it is important to assess the utility of FES assisted walking in children with CP for improving gait and neuromuscular physiology. Public Health Relevance: Cerebral palsy (CP) has one of the highest lifetime costs among common birth defects;more effective treatment will improve functional mobility, reduce the need for surgery and reduce economic lifetime costs. Current treatments offer only partial improvement and most ambulatory children with CP walk with a fatiguing, awkward gait;thus better treatment is needed at an early age when there is optimal neuronal plasticity, rapid growth and greater likelihood of preventing gait abnormalities. The goal of the proposed conference is to create a research network on functional electrical stimulation (FES) assisted walking in CP, a developing assistive technology with potential to improve both walking patterns and neuromuscular physiology and thus reduce the personal and economic lifetime costs of CP.