THE IMPACT OF NEUROMUSCULAR ELECTRICAL STIMULATION COMBINED WITH CONVENTIONAL THERAPY ON LOWER LIMB MOTOR FUNCTION IN CHILDREN WITH CEREBRAL PALSY: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Cerebral palsy (CP) is a non-progressive neurodevelopmental disability which predominantly affects motor function, including that of the lower extremities. Neuromuscular electrical stimulation (NMES) has recently been proposed as a complement to conventional physiotherapy for enhancing motor outcomes in children with CP.

Objective: This study evaluated the adjunctive effect of NMES as an adjunct to conventional physiotherapy in comparison with conventional physiotherapy alone on the improvement of the lower limb motor function in children with spastic CP.

Method: A single-blinded, randomized controlled trial was carried out on 60 children with spastic CP of 6–12 years of age. All participants were randomly assigned to a intervention group treated with NMES combined with conventional treatment (n=30) and a control group treated with conventional therapy alone (n=30). The intervention was of 12 weeks duration and was delivered five days a week. Outcome measures evaluated the GMFM-66 and MAS (evaluated at baseline and following the intervention).

Results The intervention group had a significantly greater increase in their GMFM-66 scores (mean difference 7.4, p < 0.001) than the control group (mean difference 3.1, p = 0.04). The NMES group also demonstrated marked decreases in spasticity using the MAS (p < 0.01) compared with controls.

Conclusion: NMES combined with conventional physiotherapy is more effective for improving motor function of the lower limbs and for reducing spasticity in children with spastic cerebral palsy compared with conventional therapy. On the basis of these results, NMES may be integrated in pediatric neuro-rehabilitation protocols.