PhD conferral Irene Moll

Keywords: cerebral palsy, cognition, functional electro-simulation, fatigue
 

"Cerebral Palsy: Cognition, fatigue and assessing functional electrical stimulation during walking"

Cerebral palsy occurs in about 2 in 1,000 children and is the most common cause of movement limitations in children. Cerebral palsy is caused by damage in the immature brain. This leads to a disorder in the development of movement and posture that results in a limitation in activities, such as walking but sometimes sitting. Our research shows that children who have more white matter damage and worse movement at a young age are more likely to have intellectual disability later on. About 1 in 2 patients with cerebral palsy has an intellectual disability. This has implications for school and rehabilitation opportunities. In terms of movement, the majority of patients with cerebral palsy can walk on their own, however, often with difficulty: this may be slower and different from normal, for example with a club foot. Current treatments for this are physical therapy and a splint. A new treatment for footdrops is functional electrostimulation (FES). This involves using electrodes to stimulate a nerve and muscle that causes the foot to lift, in the swing phase of walking. The main question of this dissertation is whether functional electrostimulation (FES) during walking in children with cerebral palsy is a good treatment: does it lead to better functioning? To find an answer, we took measurements at all levels of the International Classification of Functioning, Disability, and Health (ICF). Among other things, we looked at personal goals using the Goal Attainment Scale. We also wanted to consider factors other than exercise. We conclude that FES can be used for some patients as an alternative to a splint. We also concluded that cerebral palsy affects more than movement, as it often causes intellectual disability and (muscle) fatigue.

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