Related Experiment Video
Updated: May 26, 2026
Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy
Published on: August 9, 2024
Effects of functional electrical stimulation on trunk control in children with diplegic cerebral palsy
İlkay Karabay1, Asuman Dogan, Meryem Doğan Arslan
1The PMR Clinic, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey. ilkaykarabay@gmail.com
Insights
Functional electrical stimulation (FES) on back muscles improves sitting balance and trunk control in children with cerebral palsy (CP) more than conventional therapy alone.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Pediatrics
Background:
- Children with cerebral palsy (CP) often experience challenges with sitting balance and trunk control.
- Physical therapy and rehabilitation (PTR) programs are crucial for managing CP symptoms.
- The effectiveness of specific interventions like functional electrical stimulation (FES) requires further investigation.
Purpose of the Study:
- To evaluate the efficacy of FES applied to the abdomen-posterior back muscles in conjunction with PTR for children with CP.
- To compare the outcomes of PTR alone versus PTR combined with FES.
Main Methods:
- A study involving 55 children with spastic diplegic CP undergoing a 4-week PTR program.
- Participants were randomly assigned to a control group (PTR only) or an FES group (PTR + FES).
- Sitting balance was assessed using the Gross Motor Function Measure (GMFM) sitting score, and trunk asymmetry was evaluated through radiographic measurements (kyphosis, Cobb, and sacral angles).
Main Results:
- The FES group showed statistically significant improvements in GMFM sitting scores compared to the control group.
- Radiographic measurements indicated significantly greater reductions in kyphotic and Cobb angles in the FES group.
- While both groups improved, the FES intervention yielded superior results for sitting balance and trunk alignment.
Conclusions:
- FES applied to the abdomen-back muscles, combined with conventional PTR, is more effective for improving sitting balance in children with CP than PTR alone.
- This combined approach enhances trunk control, a critical factor in functional mobility for children with CP.
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.
