Effects of functional electrical stimulation on trunk control in children with diplegic cerebral palsy

Abstract

Purpose: This study aimed to investigate the efficiency of FES application on the abdomen-posterior back muscles in children with CP that were enrolled into physical therapy and rehabilitation (PTR) program. Method: The study included 55 spastic diplegic children that were hospitalized for rehabilitation. Those with deformities that could disrupt the balance in sitting and cause problems in evaluations were excluded. The patients were randomly divided into two equal groups according to their time of presentation. Thirty-two children completed the study. The control group received PTR program only for 4 weeks. The children in the FES group received PTR in addition to electrical stimulation. Electrical stimulation was applied 5 days a week for 4 weeks to abdomen-posterior back muscles in 30-minute-long sessions. To evaluate the balance in sitting, sitting score of gross motor function measurement (GMFM) and to evaluate the trunk asymmetry in sitting, radiographic measurements were used. Thus, kyphosis, Cobb and sacral angles were measured. Results: The comparisons of the measurements of the two groups before and after the treatment showed that the GMFM sitting score and the sacral angle were statistically significantly increased, and the kyphotic and Cobb angles were statistically significantly decreased. After the treatment, both groups demonstrated an increase in the GMFM score, but the increase in the FES group was statistically significantly higher than that in the control group. With respect to radiological measurements, the changes observed in both the kyphotic and Cobb angles after the treatment were statistically significantly higher in the FES group than in the control group. The rates of the changes in the sacral angle did not differ among the groups. Conclusion: We believe to provide balance in sitting for children with CP, FES applied on abdomen-back muscles along with conventional therapy to maintain trunk control is more effective than conventional therapy alone.

Implications for Rehabilitation

• FES is used to increase the muscle strength and improve functions.

• When used in children with CP, FES application on the abdomen-posterior muscles reduces cobb and kyphosis angles and increases sitting balance.

• It is well-tolerated by children with CP and offers positive contributions to rehabilitation program.

Keywords::

• Cerebral palsy
• functional electrical stimulation
• trunk control

Declaration of Interest: The authors report no conflict of interest.