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Effects of lateral electrical surface stimulation on scoliosis in children with severe cerebral palsy: a pilot study
Eun Jae Ko1, In Young Sung1, Gi Jeong Yun2
1a Department of Rehabilitation Medicine , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea.
Insights
Lateral electrical surface stimulation (LESS) effectively treats scoliosis in children with severe cerebral palsy (CP). This non-surgical approach also shows potential for improving trunk balance in these patients.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Pediatric Orthopedics
Background:
- Severe cerebral palsy (CP) often presents complex challenges, including scoliosis and impaired trunk balance.
- Treatment options for scoliosis in children with severe CP are limited, especially for those unable to undergo surgery.
Purpose of the Study:
- To investigate the efficacy of lateral electrical surface stimulation (LESS) in managing scoliosis and enhancing trunk balance in children with severe CP (GMFCS levels IV-V).
Main Methods:
- A cohort of 11 children with severe CP and scoliosis underwent 3 months of home-based LESS (2 sessions/day, 1 hour/session).
- Stimulation parameters included 40-80 mA intensity, 200 μs pulse width, 25 Hz frequency, with a 6s on/6s off cycle applied to the convex side of the curve.
- Radiographic (Cobb's, kyphotic, sacral angles) and functional (GMFM-88 sitting, TCMS) outcomes were assessed at baseline and at 1 and 3 months post-intervention.
Main Results:
- Significant improvements in Cobb's angle were observed at 1 and 3 months after LESS initiation.
- A positive correlation was found between LESS intensity and improvements in the GMFM-88 sitting score.
- Caregivers reported perceived positive effects of LESS without major adverse events.
Conclusions:
- Lateral electrical surface stimulation (LESS) demonstrates effectiveness in reducing scoliosis in children with severe CP.
- LESS may offer a valuable non-surgical therapeutic option for improving trunk balance and managing scoliosis in this population.
Purpose:
To evaluate the effects of lateral electrical surface stimulation (LESS) on scoliosis and trunk balance in children with severe cerebral palsy (CP).
Methods:
Children with severe CP (GMFCS level IV or V) and stationary or progressive scoliosis were enrolled. Children were recommended of two sessions of LESS/day, 1 h/session, for 3 months at home: at 40-80 mA intensity, 200 μs pulse width, 25 Hz frequency, on for 6 s and then off for 6 s on the convex side of the trunk curve. Radiologic (Cobb's, kyphotic, and sacral angles) and functional [gross motor function measurement (GMFM)-88 sitting score, and trunk control measurement scale (TCMS)] measurements were evaluated at 4 periods: (a) 3 months before, (b) just before, (c) 1 month after, and (d) 3 months after LESS.
Results:
The median Cobb's angle of 11 children (median age, 9 years) was 25°, and it showed significant improvements after both 1 and 3 months of LESS. The LESS intensity correlated with the improvement of GMFM-88 siting score. The parents or main caregivers of the children believed LESS had several positive effects without major adverse effects.
Conclusions:
LESS is effective in scoliosis in children with severe CP and it may improve trunk balance. Implications for rehabilitation Scoliosis is a very complicated problem for the children with severe CP. They do not have many options for treatments and scoliosis is usually refractory. Lateral electrical surface stimulation (LESS) is effective in scoliosis in children with severe CP and it may improve trunk balance. LESS may be another option of managing stationary or progressive scoliosis in the children with severe CP who are unable to undergo surgery.
