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[Effects of transcutaneous electrical nerve stimulation on motor function in ambulant children with spastic cerebral
Kai-shou Xu1, Lu He, Jin-ling Li
1Department of Neurology and Rehabilitation, Guangzhou Children's Hospital, Guangzhou 510120, China.
Insights
Transcutaneous electrical nerve stimulation (TENS) effectively reduced spasticity and improved motor function in children with spastic cerebral palsy (CP). This 6-week treatment enhanced standing, walking, and walking velocity compared to a control group.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Context:
- Spastic cerebral palsy (CP) is a common childhood motor disorder.
- Impaired motor function and spasticity significantly impact quality of life.
- Effective interventions are crucial for managing CP symptoms.
Purpose:
- To evaluate the efficacy of transcutaneous electrical nerve stimulation (TENS) in improving motor function in children with spastic cerebral palsy.
- To assess TENS's impact on spasticity, standing, walking, and walking velocity.
Summary:
- A 6-week randomized controlled trial involving 78 children with spastic CP compared TENS plus functional exercise to exercise alone.
- The TENS group showed significant reductions in spasticity (CSS) and improvements in motor function (GMFM, walking velocity) at 6, 12, and 24 weeks.
- TENS demonstrated superior outcomes in reducing spasticity and enhancing functional performance.
Impact:
- This study highlights TENS as a valuable therapeutic option for ambulant children with spastic CP.
- Findings suggest TENS can lead to meaningful improvements in daily mobility and functional independence.
- Provides evidence for integrating TENS into standard CP rehabilitation protocols.
Objective:
To investigate the effects of transcutaneous electrical nerve stimulation (TENS) on motor function in children with spastic cerebral palsy (CP).
Methods:
After signing the informed consent, 78 children with CP, aged 45.6 +/- 8.5 months (36 to 58 months), were randomly divided into a TENS group (n = 40) and a control group (n = 38). All the subjects received standardized functional exercise program. In TENS group, 2 TENS devices were used and the surface electrodes were applied on the spastic musculotendinous and antagonist muscles in the affected lower extremity. TENS lasted for 20 min per session, 5 days weekly for 6 weeks. After 6 weeks, the functional exercise program was applied by the caregivers. Demographic data were recorded, including age, gender, number of the hemiplegic and diplegic CP, level of gross motor function classification system (GMFCS). Clinical assessments included the composite spasticity scale (CSS), D and E dimensions of the Gross Motor Function Measure (GMFM), and walking velocity was determined before treatment and at 6, 12 and 24 weeks after treatment.
Results:
No statistically significant differences were found in age, gender, number of the hemiplegic and diplegic CP, level of GMFCS, as well as clinical assessments (CSS, GMFM and walking velocity) before treatment between the 2 groups (P > 0.05). All the children showed a reduction of spasticity (CSS) after 6, 12 and 24 weeks of treatment (P < 0.05). When compared with the results obtained before treatment, the improvement of standing and walking (GMFM), walking velocity was statistically significant after 6, 12 and 24 weeks of treatment (P < 0.05). Furthermore, the differences of CSS, GMFM and walking velocity between the two groups at 6, 12 and 24 weeks examination were also statistically significant (after 24 weeks of treatment: t value was 8.96, 3.14 and 2.35, P < 0.05, respectively).
Conclusion:
When compared with the control group, 6 weeks of TENS treatment on the affected lower extremity was more effective in terms of reducing spasticity and improving functional performance in standing, walking, and walking velocity in ambulant children with the spastic CP.
