Effect of therapeutic electrical stimulation on spasticity, gait pattern and ankle range of motion in spastic cerebral palsied children

ABSTRACT

This study aimed to evaluate the effect of therapeutic electrical stimulation [TES] of the anterior tibial group of muscles on spasticity, range of motion [ROM] of the ankle joint and gait patterns in children with spastic CP. The study was carried out at neurology outpatient clink of Alexandria University Children's Hospital [El-Shatby]. Sixty spastic cerebral palsied children were randomly selected. They were divided into three groups I, II, and III. Group [I] comprised 34 children with spastic hemiplegia. Group [II] comprised 19 children with spastic diplegia. Group [III] comprised 7 children with spastic quadriplegia. Patients of the three groups were treated by electrical stimulation of the anterior tibial group of muscles at a frequency of 30 Hz with pulse width of 100ns for 7 seconds contraction and 15 seconds relaxation for one hour every other day for 3 months. Re-assessment was done using the following parameters self-concept assessment, spasticity assessment of the ankle joint, goniometry of the ankle joint and gait pattern assessment [step length and step width] was done at the end of the study period. The study showed that TES had a significant positive effect on spasticity reduction in all types of spastic CP. Also, TES had a significant positive effect on ankle joint angle where it increased the passive ROM in all types of spastic CP. Furthermore, TES had a significant positive effect on gait patterns in the form of an increase in step length and decrease in step width in all types of spastic CP. Also, it had a significant positive effect on self-concept score in all types of spastic CP. Therapeutic electrical stimulation [TES] of the anterior tibial group of muscles in children with spastic cerebral palsy is an effective modality in decreasing spasticity of the extensor group of muscles of lower limb and increasing ability of dorsiflexion of the foot which will increase joint range of motion, improve gait patterns. All these will raise the patients' self concept with better quality of life despite cerebral palsy