Functional Electrical Stimulation Interventions for Children and Youth with Cerebral Palsy

Abstract

Electrical stimulation (ES) dates to the eighteenth century and is used to treat many disorders. Functional electrical stimulation (FES), a form of ES, is currently used in the treatment of spinal cord injuries and stroke and has recently been used in the treatment of CP. The goal of FES is to elicit functional movement and it can be applied in conjunction with volitional movement to facilitate motor learning. Many commercial FES devices are available for clinical or at-home use. Most FES research in CP has focused on walking therapies, although cycling and upper extremity therapies have also been explored. Various neuroprosthetic (in the presence of FES) and neurotherapeutic (improved function without FES, following training with FES) effects have been observed. Research on FES in CP is still in its infancy, although positive results have been reported. Generalizability, however, is limited due to insufficient sample sizes and variations in training regimens. Research focused on FES in activities of daily living has the best outcomes. Research that includes active participation and focuses on behavioral outcomes such as community participation, in addition to kinematic and kinetic measures, is expected to show the most improvement on quality of life. There is little evidence of rejection of treatment due to pain or discomfort, which has been a concern in the past. Although FES is a low-risk, high-reward treatment modality, further research is required to determine optimal training regimens and stimulation parameters. Successful therapies will likely involve relatively complex feedbackcontrolled devices that modulate stimulation based on functional movement to help the user perform activities of daily living.