Electro-suit treatment of children with unilateral cerebral palsy alters nonlinear dynamics of walking

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Background: Cerebral palsy (CP) is characterized by spasticity and muscle contracture development and associated with mild to severe motor impairments including reduced gait function. Treatment with the Exopulse® suit has been shown to reduce spasticity of the affected muscles and constitutes a non-invasive alternative to pharmaceutical agents and surgical denervation. The present study investigated the effect of systematic treatment with the Exopulse® suit on the nonlinear dynamics and variability of trunk accelerations during walking in children with unilateral CP. Methods: Twelve patients (mean age: 12 years, range 7–17 years) with unilateral CP (GMFCS level 1 and 2) received 24 weeks Exopulse® suit treatment with patient-specific muscle stimulation. Before and after the treatment, the patients completed 4 min treadmill walking while trunk accelerometry was obtained. The nonlinear dynamics was quantified by the largest Lyapunov exponent and the complexity index from the multiscale entropy and movement variability was quantified by the root mean square ratio. Pre- vs post-treatment differences were evaluated by a paired Student's t-test. Findings: The largest Lyapunov exponent (p-value = 0.041) and the complexity index (p-value = 0.030) of the acceleration in the anterior-posterior direction was significantly lower post-treatment. No other between-trial differences were observed. Interpretation: The present study suggests that 24 weeks of Exopulse® suit treatment alters the nonlinear dynamics but not the variability of the trunk accelerations during walking in children with unilateral CP. The temporal structure of the trunk acceleration in the anterior-posterior direction was altered towards that of healthy individuals.

OriginalsprogEngelsk
Artikelnummer105714
TidsskriftClinical Biomechanics
Vol/bind98
ISSN0268-0033
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
This work was supported by the European Union, Eurostars under Grant number E!10627 Mollii. The company Exopulse setup the electric stimulation the Exopulse Mollii suits for this study.

Publisher Copyright:
© 2022

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