The effect of electrical stimulation on the trunk control in young children with spastic diplegic cerebral palsy

Abstract

This study was designed to determine the effectiveness of electrical stimulation over the trunk in improving sitting balance in young children with spastic diplegic cerebral palsy who displayed poor trunk control. The subjects ranged in age from 8 to 16 months and were randomly assigned to two groups. Both group had physical therapy for 6 weeks. Electrical stimulation (ES) group had additional electrical stimulation over the abdomen and posterior back muscles. Radiographic studies were carried out on the whole spine while they were sitting before and after treatment. Kyphotic angle, Cobb's angle and lumbo-sacral angle were measured. Additionally, sitting score-Gross Motor Function Measure (GMFM) was also evaluated. There was no difference of these values at initial evaluation between the two groups. Following 6 weeks of intensive therapy, the changes of kyphotic angle and sitting score-GMFM were significantly higher in ES group statistically when compared with those of the control group. The Cobb's angle following treatment was improved in ES group, but not statistically compared with that of control group. This study suggests that electrical stimulation over the trunk become a beneficial therapeutic technique in improving the sitting posture and trunk control in young children with spastic diplegic cerebral palsy.

Comprehensive Hand Repetitive Intensive Strengthening Training (CHRIST)-induced morphological changes in muscle size and associated motor improvement in a child with cerebral palsy: An experimenter-blind study

“…For example, NMES was used to evoke muscle activation to produce adequate joint movement throughout the entire or maximum possible range of motion at the appropriate time so that normal arm swing flexion and stance extension pattern could occur and become internalized with repetitive practice. Specific parameters of the NMES used encompassed: waveform type, biphasic; frequency, 35Hz; amplitude, 20 mA; pulse width, 250 seconds; and on/off ratio, 1:1 [6,31]. NMES was discontinued after 2 weeks when the child was able to fully extension her elbow independently.…”

Effect of Functional Electrical Stimulation on Activity in Children With Cerebral Palsy

“…After screening titles and abstracts, 45 full papers were retrieved. After being assessed against the inclusion criteria, 5 randomized controlled trials 6,[16][17][18][19] were included in the review. See the Figure for flow of studies through the review.…”

“…[4][5][6] However, forms of electrical stimulation vary. For example, neuromuscular electrical stimulation activates muscles in isolation when aimed at reducing impairments such as weakness 1 or spasticity, 7,8 whereas threshold electrical stimulation affects muscles at subcontraction levels (often during sleep) when aimed at increasing circulation.…”

The effects of different physiotherapy interventions on the activities of daily living and the quality of life in children with cerebral palsy

“…Yapılan çalışmalarda gövde kaslarına uygulanan elektrik stimülasyonundan sonra bireylerin oturma dengelerinin geliştiği, kifoz açısının ve Cobb açıları-nın düştüğü, KMFÖ'nün oturma skorunun da önemli ölçüde arttığı gösterilmiştir (22,23). Yapılan başka bir çalışmada ise paravertebral kaslara kinezyoteyp uygulaması yapılmış, kinezyoteyp uygulamasının kaba motor fonksiyonlarda ve fonksiyonel bağım-sızlık üzerinde doğrudan bir etkisi olmamasına karşın oturma postürünü (baş, boyun, ayak pozisyonu, kol ve el hareketleri) olumlu yönde etkilediği göste-rilmiştir ve kinezyoteyp uygulamasının fizyoterapi programına ek olarak uygulandığında faydalı bir yöntem olacağı ifade edilmiştir (24).…”