Electroestimulación en el tratamiento de pacientes pediátricos con pie equino varo aducto congénito postoperados. Estudio piloto

Abstract

Idiopathic congenital clubfoot (CC) is a deformity with a difficult correction, it has several components: equinus, varus, adductus, cavus foot and internal tibial torsion. Treatment can be conservative and / or surgical in order to eliminate these deformities and get a pain-free walking foot allowing the patient to perform a right step. As a treatments result the patient may remain immobilized for long periods, which favors a muscular imbalance between the evertors and inverters; therefore the dynamic electrostimulation intervention on muscles as peroneal evertors, can help improve the balance between these muscles. Objective: To assess whether neuromuscular electrical stimulation is useful to improve muscle strength of the peroneal muscles in children who underwent a CC correctional surgery. Material and methods: A prospective, longitudinal, descriptive and comparative study was done. An experimental group with 10 CC feet and 10 feet of historical records were selected. There were performed initial and final clinical assessments to both groups, and surface electromyography (SEMG) assessments to experimental group, which received 30 sessions of neuromuscular electrical stimulation treatment to obtain muscular contraction. Results: In both groups a predominance of males were found, mean age was 5.5 years (range 3 to 8). The peroneal muscle strength, assessed by Daniels scale, increased post-treatment only in the experimental group and compared with the historical records was obtained p = 0.001. The motor unit potentials amplitude in the SEMG was increased in the experimental group at p <0.05. Conclusions: The neuromuscular electrical stimulation after 30 sessions demonstrated an increase in peroneal muscle 14 strength compared with patients who received only conventional therapy without electrostimulation