Transcutaneous electrical nerve stimulation in the management of calf muscle spasticity in cerebral palsy: A pilot study

Abstract

This study sets out to evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) in the management of calf muscle spasticity in children with cerebral palsy. The study follows a one group pre-test–post-test design involving fifteen children with spastic cerebral palsy, presenting with calf muscle spasticity. Spasticity was assessed before and after a 30 min application of TENS to the bilateral calf muscles. The H-reflex (electromyography) of the calf muscles and Modified Ashworth Scale (MAS) served as a measure of spasticity. A goniometer was used to measure the range of motion (ROM) angles for ankle dorsiflexion. We report here no significant difference (p > 0.05) between the left and right H-reflex responses, MAS scores, and ROM scores recorded at baseline (pre-test). Correlation analysis show no correlation (p > 0.05) between the pre-test HA Max (maximum H-reflex amplitude)/MA Max (maximum M-Wave Amplitude) ratio and MAS scores of both the left and right calf muscles. However, TENS significantly reduced (p < 0.05) the HA of the left calf muscle and MAS scores of the left and right calf muscles. Additionally, TENS significantly increased the ROM scores of the left and right calf muscles. Our findings lend support to existing evidence that TENS is effective in reducing spasticity. The potential mechanism underlying this effect is a reduction in neuron excitability.

Interferential current therapy improved constipation and pelvic floor muscle activity in cerebral palsy children

“…This is in line with the study by Logosu et al in 15 children with spastic CP aged between 1 and 10 years who were given 100 Hz electrical stimulation (TENS) therapy for 30 minutes on the ankle dorsiflexion muscle which resulted in a significant decrease in MAS and an increase in range of motion (p = 0.038). TENS can reduce spasticity in CP by reducing neuronal excitability 30 and decreasing stretch reflex sensitivity 31 . A significant increase in muscle activity at rest in individuals with spastic CP indicates the occurrence of hypertonia 29,32 .…”

Functional Recovery and Regenerative Effects of Direct Transcutaneous Electrical Nerve Stimulation in Treatment of Post-COVID-19 Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome: A Clinical Case

“…In addition to the treatment of peripheral nervous system diseases, direct TENS has found application in the management of patients with brain and spinal cord disorders. It is suggested that the pathogenetic basis of the central antispastic effect of TENS is a decrease in neuronal excitability, a decrease in the sensitivity of the stretch reflex [ 27 , 28 ] and an increase in presynaptic inhibition [ 29 ]. Clinically, in patients with central paralysis, direct TENS was reported to be effective in the regression of motor deficit of ankle dorsiflexion after direct stimulation of the common peroneal nerve [ 30 ] and in the recovery of motor function of the hand after direct stimulation of the median nerve [ 31 ].…”

Dry needling with electrical stimulation for the treatment of a pediatric patient with spastic cerebral palsy: a case report

“…Transcutaneous electrical nerve stimulation (TENS), the application of surface electrodes on affected muscles, decreases neuron excitability and is also used to decrease spasticity in CP [10,23,24]. TENS increases PROM [23] and improves localized oxygenation [25] and muscle blood research demonstrates that patients with spastic CP benefit from TENS to our knowledge, only one study combined DN with surface electrode electrical stimulation (ES) to treat a stroke patient [23].…”