Walking on toes is for ballerinas. Doing it every day would prove difficult.

Some people with cerebral palsy walk like clumsy ballerinas. When they walk, they step with the balls of their feet, unable to get their heels on the floor. It leaves them with stiff leg muscles and sore backs.

"I could barely go two to three hours without laying down and resting," at work, Marcus Bull Bear said. "I had a lot of spasms in my lower back because of the hip displacement."

Bull Bear has cerebral palsy, a pre-birth condition caused by damage to the motor area of the brain that affects muscle control. Surgery has helped improve the movement in his left leg, and now a new medical device helps with movement in his right leg.

The cerebral palsy affects his lower extremities. To improve movement in his legs, he does stretches, which he has had to do since he was 2; and he had extensive surgery on his left leg to rotate his leg outward and stretch the hamstrings and achilles tendons.

It took about a year and a half of rehabilitation and therapy to get the benefits of the surgery. For his right leg, which was less affected by the cerebral palsy, he used a brace to keep his foot properly aligned. Without it, his foot kicked inward.

But the brace interfered with his work as a furniture assembler. He needed more foot flexibility to get around at work. A new medical device replaced the brace. The device sends electrical impulses to a nerve below the knee. The muscle contracts, bringing up the toes up and the heel down.

"It's like a heavy tingling sensation, a slight zap," Bull Bear said.

When he first started the nerve stimulation treatment, his shin muscle would be fatigued, but now he's used to what the device does. He's able to go up and down stairs without his brace and can control his foot more, he said.

Most patients who use the device are stroke patients and there is a device for the arms and a device for the legs, such as the one Bull Bear uses. It helps retrain and strengthen muscles for better movement.

The device consists of electrodes in a brace that fits below the knee, a sensor that fits in the shoe and a remote control to program it and operate it. The device is programmed through a hand-held computer.

The sensor in the shoe helps determine the type of electrical pulse to send out to the nerve.

"It senses different terrains … Grass, sidewalks and even surfaces send different electrical impulses," physical therapist Bryan Guthmiller said.

So far, Bull Bear just uses the device during physical therapy sessions with Guthmiller at Medcenter One. The device can be purchased by patients to use at home, but insurance does not cover it, Guthmiller said. It costs about $6,000 for the leg stimulation unit.

(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@;bismarcktribune.com.)