title: Effects of lateral electrical surface stimulation on scoliosis in children with severe cerebral palsy: a pilot study.
abstract: OBJECTIVE
  To evaluate the effects of lateral electrical surface stimulation (LESS) on scoliosis and trunk balance in children with severe cerebral palsy (CP).
  
  
  METHODS
  Children with severe CP (GMFCS level IV or V) and stationary or progressive scoliosis were enrolled. Children were recommended of two sessions of LESS/day, 1 h/session, for 3 months at home: at 40-80 mA intensity, 200 μs pulse width, 25 Hz frequency, on for 6 s and then off for 6 s on the convex side of the trunk curve. Radiologic (Cobb's, kyphotic, and sacral angles) and functional [gross motor function measurement (GMFM)-88 sitting score, and trunk control measurement scale (TCMS)] measurements were evaluated at 4 periods: (a) 3 months before, (b) just before, (c) 1 month after, and (d) 3 months after LESS.
  
  
  RESULTS
  The median Cobb's angle of 11 children (median age, 9 years) was 25°, and it showed significant improvements after both 1 and 3 months of LESS. The LESS intensity correlated with the improvement of GMFM-88 siting score. The parents or main caregivers of the children believed LESS had several positive effects without major adverse effects.
  
  
  CONCLUSIONS
  LESS is effective in scoliosis in children with severe CP and it may improve trunk balance. Implications for rehabilitation Scoliosis is a very complicated problem for the children with severe CP. They do not have many options for treatments and scoliosis is usually refractory. Lateral electrical surface stimulation (LESS) is effective in scoliosis in children with severe CP and it may improve trunk balance. LESS may be another option of managing stationary or progressive scoliosis in the children with severe CP who are unable to undergo surgery.
authors.affiliation: a Department of Rehabilitation Medicine , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea.
authors.forename: Eun Jae
authors.identifier: http://orcid.org/0000-0001-7198-5407
authors.initials: EJ
authors.lastname: Ko
authors.affiliation: a Department of Rehabilitation Medicine , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea.
authors.forename: In Young
authors.identifier: http://orcid.org/0000-0001-6545-6744
authors.initials: IY
authors.lastname: Sung
authors.affiliation: b Department of Rehabilitation Medicine , Chunghae Geriatric Hospital , Kyungju , Republic of Korea.
authors.forename: Gi Jeong
authors.identifier: http://orcid.org/0000-0001-7461-7562
authors.initials: GJ
authors.lastname: Yun
authors.affiliation: a Department of Rehabilitation Medicine , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea.
authors.forename: Jung-A
authors.identifier: http://orcid.org/0000-0001-5275-278X
authors.initials: JA
authors.lastname: Kang
authors.affiliation: a Department of Rehabilitation Medicine , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea.
authors.forename: JaYoung
authors.identifier: http://orcid.org/0000-0002-5010-8090
authors.initials: J
authors.lastname: Kim
authors.affiliation: a Department of Rehabilitation Medicine , Asan Medical Center, University of Ulsan College of Medicine , Seoul , Republic of Korea.
authors.forename: Go Eun
authors.identifier: http://orcid.org/0000-0003-1481-1317
authors.initials: GE
authors.lastname: Kim
mesh_terms: D017028:Caregivers / Q000523:psychology; D002547:Cerebral Palsy / Q000150:complications / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D003258:Consumer Behavior; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010865:Pilot Projects; D004856:Postural Balance; D056910:Republic of Korea; D012600:Scoliosis / Q000209:etiology / Q000628:therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Cerebral palsy; electrical stimulation; postural balance; scoliosis