THERAPEUTIC ELECTRICAL-STIMULATION FOR SPASTICITY - QUANTITATIVE GAITANALYSIS

Improvement in motor function following electrical stimulation is rela ted to strengthening of the stimulated spastic muscle and inhibition o f the antagonist. A 26-year-old man with familial spastic paraparesis presented with gait dysfunction and bilateral lower limb spastic muscl e tone. Clinically, muscle strength and sensation were normal. He was considered appropriate for a trial of therapeutic electrical stimulati on following failed trials of physical therapy and baclofen. No other treatment was used concurrent with the electrical stimulation. Before treatment, quantitative gait analysis revealed 63% of normal velocity and a crouched gait pattern, associated with excessive electromyograph ic activity in the hamstrings and gastrocnemius muscles. Based on thes e findings, bilateral stimulation of the quadriceps and anterior compa rtment musculature was performed two to three times per week for three months. Repeat gait analysis was conducted three weeks after the cess ation of stimulation treatment. A 27% increase in velocity was noted a ssociated with an increase in both cadence and right step length. Righ t hip and bilateral knee stance motion returned to normal (rather than ''crouched''). No change in the timing of dynamic electromyographic a ctivity was seen. These findings suggest a role for the use of electri cal stimulation for rehabilitation of spasticity. The specific mechani sm of this improvement remains uncertain.