Combination of Functional Electrical Stimulation and Noninvasive Spinal Cord Electrical Stimulation for Movement Rehabilitation of the Children with Cerebral Palsy

Abstract

Movement and posture disability are appropriate to cerebral palsy (CP).The aim of the current study was to examine the hypothesis that the functional muscle electrical stimulation (FES) and transcutaneous spinal cord electrical stimulation (TSCS) combined with locomotor treadmill training improve posture and motor function in children with severe CP. Thirty-one children with CP (spastic diplegia) (7-13 years old; mainly levels III of GMFCS) participated in the study. The experimental group received muscle FES and TSCS at T11 and L1 spinal levels, combined with locomotor treadmill training, whereas the participants of the control group received locomotor treadmill training only. After treatment, the GMFM-88 score increased in 81% children of the experimental group and in 33% children of the control group. In the experimental group, there were a significant decrease of the stabilogram area in the eye opened condition and the significant decrease of forward shift of center of pressure projection in the sagittal plane in both eye opened and eye closed conditions, whereas in the control group any significant changes of stabilogram parameters did not observed. Knee torque and range of knee motion significantly increased in the experimental group. After electrical stimulation, the decrease of muscle co-activation in proximal and distal muscles occurred, whereas in the control group muscle co-activation decreased in proximal muscles only. Thus, improvement of motor functions and balance control system in children with severe CP in response to the combination of TSCS, FES and locomotor training revealed. Combination of these techniques can be used for the effective neurorehabilitation.