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Enhancement of Muscle Activity by Electrical Stimulation in Cerebral Palsy: A Case—Control Study

Department of Biomedical Engineering, Israel Institute of Technology

Emanuel Tirosh, MD

Department of Technion, and the Faculty of Medicine Technion, Israel Institute of Technology, Child Development Center, Bnai Zion Medical Center, Haifa, Israel

Rachel Marmur, MA

Department of Technion, and the Faculty of Medicine Technion, Israel Institute of Technology, Child Development Center, Bnai Zion Medical Center, Haifa, Israel

Joseph Mizrahi, DSc

Department of Biomedical Engineering, Israel Institute of Technology, jm{at}bm.technion.ac.il

The objectives of this study were to compare the effects of low-intensity electrical stimulation of the quadriceps muscle in children with cerebral palsy in the following 2 modes: reconditioning by long-term training of the muscle versus real-time assist to the muscle during motion. To evaluate the force enhancement in the assist mode, we developed a method to dissociate the volitional and the induced components from the total electromyographic signal. The study group, including 5 children with cerebral palsy (mean age, 3.3 years; 0.4 SD), underwent 2 testing sessions: 1 before and 1 after 3-month training by electrical stimulation. Each session included 2 series of trials: 1 with electrical stimulation, as an orthotic assist, and 1 without electrical stimulation. The tests included flexion—extension movements of the knee at a self-selected pace. The results showed that, compared to before training, there was a significant increase in the average motion velocity and a decrease in motion jerk and in knee torque after training in both the electrical stimulation— assisted and —unassisted modes. Of special interest was the significant decrease in quadriceps—hamstrings cocontraction following training by electrical stimulation but not during electrical stimulation—assisted motion. The results obtained for the group with cerebral palsy were statistically different from those of the control group, but this difference decreased after long-term training by electrical stimulation. It was concluded that, in children with cerebral palsy, electrical stimulation is more beneficial in long-term training than when used as a real-time motion assist. Although muscle strength is not affected, more centrally controlled attributes such as cocontraction are improved.

Key Words: cerebral palsy • cocontraction • electrical stimulation • muscle enhancement

This version was published on March 1, 2008

Journal of Child Neurology, Vol. 23, No. 3, 259-267 (2008)
DOI: 10.1177/0883073807308695


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