Electrotherapy: Muscle Stimulation support


Electrical stimulation may lead to increases in muscle strength and motor function. Electrical stimulation is provided by Transcutaneous Electrical Nerve Stimulation (TENS) Unit which is portable, non-invasive and can be used in the clinic or at home by a therapist or parent. 
Seek a qualified therapist for application for all other electrotherapies:

 Neuromuscular Electrical Stimulation (NMES) involves application of transcutaneous electrical current that results in muscle contraction. NMES has been postulated to increase muscle strength by increasing the cross-sectional area of the muscle and by increased recruitment of type 2 muscle fibers.

 Functional Electrical Stimulation (FES) refers to the application of electrical stimulation during a given task or activity when a specific muscle is expected to be contracting. 

Research has shown there is some evidence to support the use and effectiveness of NMES in children with cerebral palsy, however, many of the studies are limited by confounding variables including concomitant use of other therapies, wide variation in methods of application, heterogeneity of subjects, difficulty in measuring functional outcomes and lack of control subjects.
Current research proposes that neuromuscular and threshold electrical stimulation as an effective modality in cerebral palsy is used for strengthening the quadriceps muscles in ambulatory diplegic children with cerebral palsy, who have difficulty with specific resistive strength training.

 Therapeutic electrical stimulation (TES) therapy uses a low-level impulse, this impulse may increase blood flow and promote muscle growth. The treatment is performed by attaching electrodes from the TES unit over specific muscle groups. A sports therapist or qualified therapist specifically trained to use TES sets up the parameters required for the individual child. Results are usually reported between three to six months.

Some controlled trials have reported subjective improvements with TES.  One study found an improvement in gross motor function measure (GMFM) score at 1 year, and a recent review of 12 studies noted improvements in muscle function and, or strength.
Therapeutic electrical stimulation is a complementary therapy, and not a substitute for more conventional treatments. By promoting muscle growth and strength, the child may obtain faster and greater progress when combined with an appropriate strength development programme.

Mintaze Kerem G. (2009). Rehabilitation of children with cerebral palsy from a physiotherapist’s perspective. Acta Orthop Traumatol Turc. 34(2):173-80.
Patel DR. (2005) Therapeutic interventions in cerebral palsy. The Indian Journal of Pediatrics. 1;72(11):979-83.
Simone Battibugli, Francesco C Blumetti, José A Pinto, Marcel Jun Tamaoki, Alexandre Francisco de Lourenço, and João Carlos Belloti (2017) Electrical stimulation therapy for children with cerebral palsy. Online Journal National Institute of Health.