The effect of electrical stimulation on the trunk control in young children with spastic diplegic cerebral palsy
Open accessAbstract
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.
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An unspecified dose of NDT alone or NDT combined with conventional rehabilitation treatments improved postural alignment over 6 weeks in children with spastic diplegia, aged between 8 months and 10 years.
“An unspecified dose of NDT alone, 41 or NDT ('based on the Bobath technique') combined with 'conventional rehabilitation' treatments (i.e. joint mobility, muscle strengthening, and mobility activities), 42 improved postural alignment (BF&S, two of level II, conduct weak; see Table SIIIa) over 6 weeks in children with spastic diplegia, aged between 8 months and 10 years. 41,42”
From Exercise interventions improve postural control in children with cerebral palsy: a systematic review (2015) · cites this paper as [41]
Materials and Methods (p. 2) describes six weeks of NDT-based physical therapy in the control group, and Results (p. 3) reports a significant change in its kyphotic angle, a measure of sitting posture. However, the Discussion (p. 4) says this study’s children were all younger than two years; it does not support the sentence’s age range extending to ten years. (LLM, conf=0.87)
Experimental — accuracy not yet measuredFES, along with rehabilitation, improved postural alignment (BF&S) to a greater extent than rehabilitation alone (evidence level II, conduct weak).
“FES, along with rehabilitation, improved postural alignment (BF&S) to a greater extent than rehabilitation alone (evidence level II, conduct weak; see Table SIIIa). 41,42”
From Exercise interventions improve postural control in children with cerebral palsy: a systematic review (2015) · cites this paper as [41]
Two studies, both evidence level II, applied FES to abdominal and lumbar muscles simultaneously with the aim of improving muscle strength and function.
“Two studies, 41,42 both evidence level II (Table I), applied FES to abdominal and lumbar muscles simultaneously, with the aim of improving muscle strength and function.”
From Exercise interventions improve postural control in children with cerebral palsy: a systematic review (2015) · cites this paper as [41]
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“…relation between impaired balance and functional limitations has meant that a major focus of many intervention programs in children with CP is to improve postural control, thereby enabling the child to recover stability more effectively (Pape et al. 1993, Hur 1995, Butler 1998, Park et al. 2001).”
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“Adding adjuncts such as taping, electrical stimulation, and trunk belts may be effective when the physical therapy interventions are strictly restricted to the body structure and function domain of the ICF, as seen with neurodevelopmental therapy and conventional physical therapy interventions in this review.(37,39,40…”
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“LR and PSw durations were close GPD-MoCap while TSw, MSw and TSw showed greater differences.”
Influentialvan der Linden, M. L., Hazlewood, M. E., Aitchison, A., Hillman, S. J., & Robb, J. (2003) · Developmental Medicine & Child Neurology · doi:10.1017/s0012162203000732 · Cited by 57 · see citing works
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“Literature presents only one publication where the effects of FES application on the trunk muscles of children [16].”
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“This is contrary to the findings of studies that reported an improvement after applying a similar type of electrical stimulation to children with CP (Dubowitz et al. 1988, Hazlewood et al. 1994, Wright and Granat 2000, Park et al. 2001).”
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“On the other hand, reports from studies in other parts of the world showed that diplegic type constituted the majority.(14,16,28,29,30) There was no specific reason to account for this variation, but geographical differences may be considered.”
ResultEffect of Functional Electrical Stimulation on Activity in Children With Cerebral Palsy
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“Some studies have investigated the effect of passive interventions such as splinting with lycra suits(4) or trunk braces(5) or functional electrical stimulation (FES).(6,7) Other studies have investigated active interventions such as using vibration(8) or introducing instability during activity(9) or introducing novel…”
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“Previous studies were revealed that ES decreased kyphosis and the Cobb angle, improved spinal alignment in sitting position in neurologic patients, and was beneficial for spinal mobility in the patients with chronic low back pain [26,46].”
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“They often show the difficulty to achieve well-balanced sitting posture and display the poor sitting posture such as flexed trunk with kyphotic curvature of the spine and asymmetry of trunk [5].”
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“Because a relation between constraints in balance control and functional limitations has been established, increased efficacy of postural control should be a goal of intervention programs (Pape et al. 1993, Hur 1995, Burtner 1998, Park et al. 2001).”
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“There were several studies having a similar conclusion that younger children may show greater improvements than the older after receiving neuromuscular electrical stimulation.(17,18,32,33) Although we could not determine the reason for greater improvements in younger children, a previous case report(34) indicated that…”
ResultFunctional Electrical Stimulation (FES) and the Effect on Equine Multifidi Asymmetry
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“…techniques can enhance the effects and minimize the risk of muscle, tendon, or skin injury from stretching exercises, such as electrical stimulation 44 taping and casting, 45,46 acupuncture 47 , and orthopedic surgeries such as selective dorsal rhizotomy 48 which are too invasive to enhance…”
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“Consistent with the results of this study, Park et al.[20] found out that the KA and CA significantly decreased in study group who received electrical stimulation on back muscles to improve trunk control; however, there was no change in the lumbosacral angle after the treatment.”
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“A carefully planned coordinated recruitment of such activated muscles using engineering control methods could mitigate some of the issues listed above, and stabilize the trunk to improve seated posture and enable more functional interactions with objects in the environment [1,4,5].”
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“display rounded lower back in sitting and flexed trunk with kyphotic curvature of the spine with trunk asymmetry [8].”
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“Differences from the results of previous studies [19,23] are probably due to these factors and, according to our results, LESS with longer stimulation duration and higher intensity can be considered an effective treatment for scoliosis in relatively older children with severe CP.”
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“Of five randomized trials, three trials reported statistical significance between-group differences in favor of FES compared with those without FES.”
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- Authors
- Park, E. S., Park, C. I., Lee, H. J., & Cho, Y. S.
- Affiliations
- Yonsei University (KR)
- Venue
- Journal of Korean Medical Science
- Publisher
- Korean Academy of Medical Sciences
- Published
- 2001
- Volume
- 16
- Issue
- 3
- Pages
- 347
- ISSN
- 1011-8934 (ISSN-L)
- 1598-6357
- PMC
- PMC3054749
- OpenAlex
- W2079833245
- Cited by
- 72
- References
- 0
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 2 · 2021: 2 · 2020: 7 · 2019: 7 · 2018: 7 · 2017: 4 · 2016: 6 · 2015: 4 · 2014: 5 · 2013: 2 · 2012: 4
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Korean Medical Science (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Cerebral Palsy and Movement Disorders
- Health Sciences › Medicine › Neurology › Botulinum Toxin and Related Neurological Disorders
- Social Sciences › Psychology › Developmental and Educational Psychology › Children's Physical and Motor Development
- Keywords
- electrical stimulation, spastic diplegia, trunk control, sitting balance, trunk muscle strengthening, kyphotic angle, sitting posture, Gross Motor Function Measure, infants and toddlers, physiotherapy
- MeSH terms
- Cerebral Palsy, Electric Stimulation Therapy, Humans, Infant, Spine, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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