Functional electrical stimulation combined with botulinum toxin type A to improve hand function in children with spastic hemiparesis - a pilot study.
BACKGROUND
Children with spastic hemiparesis frequently present with impaired hand function due to paresis, spasticity, and disturbed motor control. The aim of this study was to examine the effectiveness of functional electrical stimulation in combination with botulinum toxin type A in these children.


METHODS
Randomized, controlled, observer-blinded pilot study.


METHODS
Children with impaired hand function.


METHODS
Either a combined treatment group (functional electrical stimulation and botulinum toxin type A) or a botulinum toxin type A group alone. Botulinum toxin type A was injected into arm muscles according to the patient's clinical requirements. Functional electrical stimulation of the wrist and finger extensor muscles was started after five to six days. Patients were given a stimulation device and asked to use it at home twice daily for 15 min, for a total period of three months.


METHODS
Active and passive range of motion, muscle tone, muscle strength, and functional tests for children.


RESULTS
Six children aged between 7 and 17 years with spastic hemiparesis were enrolled. In both groups, active and passive range of motion, muscle tone, and muscle strength improved after three and six months compared to baseline data. The functional score was improved only in the group that received combined treatment.


CONCLUSIONS
Combined treatment with functional electrical stimulation and botulinum toxin type A is a promising treatment option to improve upper limb function in children with spastic hemiparesis.
Department of Physical Medicine and Rehabilitation, Medical University of Vienna, General Hospital of Vienna, Vienna, Austria. karin.pieber@meduniwien.ac.at
Karin
K
Pieber
Malvina
M
Herceg
Franziska
F
Wick
Martina
M
Grim-Stieger
Günther
G
Bernert
Tatjana
T
Paternostro-Sluga
D000293:Adolescent; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006225:Hand; D006429:Hemiplegia / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D009465:Neuromuscular Agents / Q000627:therapeutic use; D010865:Pilot Projects; D016896:Treatment Outcome
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A
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