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Effectiveness of Functional Electrical Stimulation - Cycling Treatment in Children with Cerebral Palsy
Natalya Özen1, Ece Unlu1, Ozgur Zeliha Karaahmet1
1Department of Physical Medicine and Rehabilitation, Diskapi Yildirim Beyazit Education and Research Hospital, Ankara Turkey.
Insights
Functional electrical stimulation (FES) cycling showed no added benefit over standard treatment for children with cerebral palsy (CP). However, FES cycling is safe and well-tolerated for CP patients.
Area of Science:
- Pediatric Rehabilitation
- Neuromuscular Electrical Stimulation
- Movement Science
Background:
- Cerebral palsy (CP) presents significant challenges in motor function, gait, and daily activities.
- Standard treatments aim to improve function, but novel approaches are continuously explored.
- Functional electrical stimulation (FES) cycling is a potential therapeutic modality.
Purpose of the Study:
- To evaluate the efficacy of FES bicycle therapy in children with CP.
- To compare FES cycling with sham stimulation and standard care.
- To assess effects on motor function, gait, spasticity, daily activities, and aerobic capacity.
Main Methods:
- A 4-week randomized controlled trial involving 25 children with CP (GMFCS levels I-III).
- Three groups: FES-cycling + standard treatment, sham FES-cycling + standard treatment, and standard treatment alone.
- Assessments included Modified Ashworth Scale, Modified Tardieu Scale, WeeFIM, GMFM-88, 6-minute walk test, and Visual Gait Analysis.
Main Results:
- All groups demonstrated significant improvements in motor function, gait, spasticity, daily living activities, and aerobic capacity.
- No significant differences were observed among the three groups for any assessed clinical parameter.
- No changes in Gross Motor Function Classification System (GMFCS) levels were noted.
Conclusions:
- Rehabilitation, including standard treatment, significantly improves outcomes in children with CP.
- FES-cycling did not provide superior benefits compared to sham stimulation or standard treatment.
- FES cycling is a safe and well-tolerated intervention for children with CP.
Aim:
The purpose of this study was to evaluate the effects of functional electrical stimulation (FES) bicycle therapy system on motor function, gait pattern, spasticity, daily living activities, and aerobic capacity in children with cerebral palsy (CP) and to compare the results with sham stimulation and standard treatment.
Methods:
Patients with cerebral palsy who received botulinum toxin type-A injections to lower extremities and those with Gross Motor Function Measure Classification System (GMFCS) levels I - III, were included in the study. Twenty-five patients were randomly assigned into three treatment groups for 4-weeks: Group 1, FES-cycling and standard treatment; Group 2, Sham stimulus FES-cycling and standard treatment; Group 3, Standard treatment. Clinical assessment tools included the Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), Pediatric Functional Independence Measure (WeeFIM), GMFCS, Gross Motor Function Measure-88 (GMFM-88), selective motor control tests, 6-minute walk test, and Visual Gait Analysis (VGA).
Results:
In all groups, there were significant improvements in MAS, MTS, WeeFIM, GMFM-88, 6-minute walk test, and VGA scores. No changes in GMFCS levels were observed in any group. At the end of the study, there was no significant difference among the groups in terms of any clinical assessment parameter.
Conclusions:
All groups showed statistically significant improvements in motor function, walking pattern, spasticity, daily living activities, and aerobic capacity in patients with CP following the rehabilitation period. Although FES-cycling demonstrated no superiority over the other approaches and provided no additional benefit to the results, FES appears to be safe and well-tolerated in children with CP, at least as much as standard exercise treatment.
