Includes TENS machines, muscle stimulation, cerebellar and spinal cord stimulation. Physical methods to relieve pain and improve function. Therapeutic electrical stimulation (TES) is used to improve function in spasticity, for example after surgery or to prevent wasting after immobilisation (disuse atrophy). Uses include flexing the ankle for walking and extending stiff fingers. A method sometimes called 'Threshold electrical stimulation' was initially used to treat non-healing wounds and broken bones. With cerebral palsy, used during physical therapy or when asleep (because muscles are more relaxed then). Aims to strengthen the weaker antagonistic muscles and counteract disuse atrophy with electrodes from a small battery, placed according to specific protocols, and to achieve results very gradually so that they appear after three to six months.
Caution: although TENS machines are freely available in high street shops, they can be dangerous when used incorrectly. This information is to describe treatment given with professional training.
A newer form of electrical stimulation is Operative Neuromodulation (a field which includes Functional Neuroprosthetics). An electrical device is implanted to regulate the activity within the nervous system, for example to enable movement. This is a type of neural networks surgery.
Sakas DE et al. An introduction to operative neuromodulation and functional neuroprosthetics, the new frontiers of clinical neuroscience and biotechnology.
Acta Neurochirurgica, Supplement 2007;97(Pt 1):3-10.
Kang BS et al. Effects of Botulinum Toxin A Therapy with Electrical Stimulation on Spastic Calf Muscles in Children with Cerebral Palsy. American Journal of Physical Medicine and Rehabilitation. 2007 Sep 12.
Barbosa AP et al. Therapeutic effects of electrical stimulation on manual function of children with cerebral palsy: Evaluation of two cases. Disability and Rehabilitation. 2007 Jun 21:1-6
Glinsky J et al. Efficacy of electrical stimulation to increase muscle strength in people with neurological conditions: a systematic review. Physiotherapy Research International. 2007 Sep;12(3):175-94.
Daichman J et al. The effects of a neuromuscular electrical stimulation home program on impairments and functional skills of a child with spastic diplegic cerebral palsy: a case report. Pediatric Physical Therapy. 2003 Fall;15(3):153-8.
