Traitement du pied varus de l’enfant atteint de paralysie cérébrale unilatérale par neurostimulation fibulaire superficielle : étude rétrospective

Objective

To assess the effect of superficial fibular transcutaneous neurostimulation as a treatment for hypertonic varus foot in children with unilateral cerebral palsy.

Method

We made a retrospective assessment of a transcutaneous electric stimulation protocol, applied on the superficial fibular nerve territory 3 hours per day during 3 months. We measured and compared maximum foot varus angle during swing phase and during stance, and fore-foot supination angle at initial contact and at mid-stance, on gait video captures before and after stimulation.

Results

Five children with unilateral cerebral palsy were included in this retrospective study. Their mean age was 8.5 years, and the average follow up after the end of the electric stimulation was 12 months. Statistical analysis was made with non-parametric Wilcoxon test. We found a significant decrease of fore-foot supination angle at initial contact (P = 0.042) and a significant decrease of rear-foot varus angle at mid-stance (P = 0.039), one month after the end of the electric stimulation, compared with the measures before electric stimulation. We found non-significant decrease of supination angle at mid-stance and maximal varus angle during swing phase.

Conclusion

Superficial fibular transcutaneous neurostimulation seams to be an effective treatment for hypertonic varus foot in children with unilateral cerebral palsy. Our findings are limited by the retrospective design of our study, and the small sample size. These encouraging results need to be confirmed by a bigger comparative prospective survey.