Cerebral palsy is due to abnormalities or damage in the early brain development, mainly resulting in motor dysfunction. Spasticity is one of the most common symptoms of cerebral palsy, affecting about 80% of patients. Recent studies have pointed out that muscle size and structure are related to the activity level of patients.
Therefore, different treatment schemes (such as exercise, brace adaptation, botulinum toxin injection and surgical treatment) can be used to improve the range of motion and muscle strength of patients, and make them stand and walk stably. Previous studies have confirmed that active resistance exercise can improve muscle size, but this method is only suitable for patients with a certain level of muscle strength.
Neuromuscular electrical stimulation transmits current to muscles through electrodes, which can be used for functional training and play a compensatory role. In order to determine the short-term effect of neuromuscular electrical stimulation on the size and structure of tibialis anterior muscle and gastrocnemius muscle in children with cerebral palsy, karabay and others from Ankara physical and rehabilitation medical hospital in Turkey evaluated the above muscles with ultrasound. Their research results were published in the online journal of Am J phys Med rehabil in November 2014.
This study was a prospective controlled study, including 28 children with spastic diplegia. The researchers divided the subjects who met the enrollment requirements into two groups. Group a received neuromuscular electrical stimulation therapy + routine physical therapy, and group B only received physical therapy. The researchers evaluated the subjects before and after treatment. The clinical evaluation applied gross motor function, selective motor control, joint range of motion and degree of spasm. The ultrasonic imaging evaluation focused on the cross-sectional area, pinnate angle and muscle bundle length of tibialis anterior muscle and gastrocnemius muscle.
After treatment in group A, the cross-sectional areas of tibialis anterior muscle and gastrocnemius muscle increased significantly. After treatment, the cross-sectional areas of tibialis anterior muscle and gastrocnemius muscle in group B decreased, and there was no significant difference in other evaluation methods between the two groups.
The results of this study suggest that in patients with cerebral palsy, after 20 times of neuromuscular electrical stimulation, the cross-sectional areas of excitatory and antagonistic muscles have increased. Future studies need to include a larger sample size and longer follow-up to determine the role of neuromuscular electrical stimulation on muscle structure, possible related functions and clinical prognosis.