Evaluating the Effects of an Electrical Stimulator on Improving the Walking Ability of Children With Cerebral Palsy

\*Inclusion Criteria\*

CP Group:

* Age 7-18
* Diagnosis of spastic diplegic cerebral palsy (CP)
* GMFCS level I-III (be able to walk with or without assistive devices)
* MIGR \< 40% femoral head covering in acetabulum
* Crouch, equinus, or jump gait
* At least 0° passive dorsiflexion range of motion (ROM)
* Sufficient visuoperceptual, cognitive, and communication skills
* Seizure-free or well-controlled seizures
* No other neurological or musculoskeletal disorders (e.g. dystonia, severe scoliosis, hip instability
* Ability to travel to the University of Nebraska at Omaha two times
* Ability to communicate pain or discomfort
* Ability to obtain child assent and obtain parent/guardian consent

Healthy adults (control) group:

* Adults aged 20 to 40
* Adults with good physical health
* Adults with the ability to follow verbal instructions
* Adults with the ability to walk on a treadmill for 15 minutes
* No orthopedic surgery on the lower limb within the past 3 months

\*Exclusion Criteria\*

CP Group:

* Diagnosis of athetoid or ataxic cerebral palsy (CP)
* Scoliosis with primary curve \> 49%
* Spinal fusions extending into the pelvis
* Lower Extremity (LE) joint instability or dislocation
* Severe tactile hypersensitivity
* LE botulinum injections in the past 6 mo
* Implanted medical device contraindicative of functional electrical stimulation (FES)
* Pregnancy
* Severe LE spasticity (Modified Ashworth Scale score of 4 or greater)
* History of pulmonary disease limiting exercise tolerance (Asthma Control Test screen)
* History of cardiac disease (American Heart Association, AH,) screen)
* Excessive LE joint pain during walking
* Severely limited range of joint motion/ irreversible muscle contractures, i.e.\> 10° knee flexion, \>15° hip flexion contractures, or \>5° plantarflexion contractures
* LE surgery or significant injury within 1 yr.

Healthy adults (control) group:

* Adults with any chronic illnesses or medical conditions that could impact their health.
* Adults with significant behavioral or emotional issues that could indicate developmental disorders or psychological conditions.
* Adults with diagnosed developmental disorders (e.g., autism, ADHD, learning disabilities)
* Adults with surgery on their lower limb within the past 3 months.