title: Neuromuscular electrical stimulation and dynamic bracing as a treatment for upper-extremity spasticity in children with cerebral palsy.
abstract: We have investigated a therapeutic regimen using neuromuscular electrical stimulation (NMES) and dynamic bracing to assess their effectiveness in reducing upper-extremity spasticity in children with cerebral palsy. Nineteen patients between 4 and 21 years of age with documented diagnoses of spastic cerebral palsy were treated. The patients included in the study followed a regimen of two 30-minute sessions of NMES of the antagonist extensors combined with dynamic orthotic traction during the day. A static brace was used at night. Spasticity of the wrist and fingers was assessed periodically using the Zancolli classification. Treatment ranged from 3 to 43 months. After treatment with electrical stimulation and dynamic bracing, all the patients moved up 1 to 3 levels in the Zancolli classification and showed a marked improvement in upper-extremity function. These results show that combining NMES and dynamic orthotic traction dramatically decreases spasticity of the upper extremity in young patients with cerebral palsy.
authors.affiliation: Christine M. Kleinert Institute for Hand and Micro Surgery and the University of Louisville School of Medicine, Division of Plastic and Reconstructive Surgery, KY, USA.
authors.forename: L R
authors.initials: LR
authors.lastname: Scheker
authors.forename: S P
authors.initials: SP
authors.lastname: Chesher
authors.forename: S
authors.initials: S
authors.lastname: Ramirez
mesh_terms: D000293:Adolescent; D000328:Adult; D001915:Braces; D002547:Cerebral Palsy / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome