Effect of Neuromuscular Electrical Stimulation on Gluteus Maximus and Quadriceps in Cerebral Palsy Children with Crouch Gait

Background: Cerebral palsy (CP) is a persistent disorder of movement and posture caused by non-progressive pathological processes of the immature brain. This is the natural history of the gait disorder in children with more severe diplegia and in the majority of children with spastic quadriplegia. One of the most common movement abnormalities among children with cerebral palsy is a crouched gait. Neuromuscular electrical stimulation (NMES) is the application of electrical current transcutaneously to innervated, superficial muscle to stimulate muscle fibers, augment muscle contraction, increase range of motion (ROM), and increase sensory awareness. The purpose of the study was to investigate the effects of NMES on Gluteus maximus and Quadriceps strength in cerebral palsy children with crouch gait, and the subsequent effect on their gross motor function. Methods: Total 40 children (13 females, 27 males, age group 5 years to 11 years) were recruited for study from the paediatric section of physiotherapy department of Swami Vivekanand National Institute of Rehabilitation Training and Research according to the inclusion and exclusion criteria and were randomly allotted in 2 groups. All were randomly assigned to either the stimulation (group 1) or control group (group 2). The stimulation group received neuromuscular electrical stimulation to gluteus maximus and quadriceps muscles for 15 minutes each, 5 days/week for a period of 6 weeks. Results: Both the groups showed significant improvement in strength of gluteus maximus and quadriceps of CP children with crouch gait, but experimental group showed significantly more improvement as compared to control group. There was also statistically significant difference in dimension D and E (standing and walking) of the gross motor function measure between the experimental group and control group. Conclusion: This study has shown that neuromuscular electrical stimulation in addition to conventional exercise is found to be effective in improving strength and function than conventional exercise alone.