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Effects of Neuromuscular Electrical Stimulation on the Wrist and Finger Flexor Spasticity and Hand Functions in Cerebral Palsy

Abstract Purpose To evaluate the effects of neuromuscular electrical stimulation on wrist range of motion, wrist and finger flexor spasticity, and hand functions in patients with unilateral cerebral palsy. Method Twenty-four children with unilateral spastic cerebral palsy (14 boys and 10 girls) betw...

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Published in:Pediatric neurology 2014-09, Vol.51 (3), p.360-364
Main Authors: Yıldızgören, Mustafa Turgut, MD, Nakipoğlu Yüzer, Güldal Funda, MD, Ekiz, Timur, MD, Özgirgin, Neşe, MD
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container_start_page 360
container_title Pediatric neurology
container_volume 51
creator Yıldızgören, Mustafa Turgut, MD
Nakipoğlu Yüzer, Güldal Funda, MD
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Özgirgin, Neşe, MD
description Abstract Purpose To evaluate the effects of neuromuscular electrical stimulation on wrist range of motion, wrist and finger flexor spasticity, and hand functions in patients with unilateral cerebral palsy. Method Twenty-four children with unilateral spastic cerebral palsy (14 boys and 10 girls) between the ages of 5 and 14 years were randomized into neuromuscular electrical stimulation and control groups. Conventional exercises were applied, and static volar wrist-hand orthosis was administered to all patients 5 days a week for 6 weeks. Additionally, 30-minute neuromuscular electrical stimulation sessions were applied to the wrist extensor muscles in the neuromuscular electrical stimulation group. Patients were evaluated by Zancolli Classification System, Manual Ability Classification System, and Abilhand-Kids Test. Results Compared with baseline, a significant increase was evident in active wrist extension angle at the fourth and sixth weeks in both groups (all P  
doi_str_mv 10.1016/j.pediatrneurol.2014.05.009
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Method Twenty-four children with unilateral spastic cerebral palsy (14 boys and 10 girls) between the ages of 5 and 14 years were randomized into neuromuscular electrical stimulation and control groups. Conventional exercises were applied, and static volar wrist-hand orthosis was administered to all patients 5 days a week for 6 weeks. Additionally, 30-minute neuromuscular electrical stimulation sessions were applied to the wrist extensor muscles in the neuromuscular electrical stimulation group. Patients were evaluated by Zancolli Classification System, Manual Ability Classification System, and Abilhand-Kids Test. Results Compared with baseline, a significant increase was evident in active wrist extension angle at the fourth and sixth weeks in both groups (all P  &lt; 0.001), more prominent in the neuromuscular electrical stimulation group at the fourth and sixth weeks ( P  = 0.015 and P  = 0.006, respectively). A decrease was observed in the spasticity values in the neuromuscular electrical stimulation group at the fourth and sixth weeks ( P  = 0.002 and P  = 0.001, respectively) and in the control group only at the sixth week ( P  = 0.008). Abilhand-Kids values improved only in the neuromuscular electrical stimulation group ( P  &lt; 0.001). Conclusion Neuromuscular electrical stimulation application in addition to conventional treatments is effective in improving active wrist range of motion, spasticity, and hand functions in cerebral palsy.</description><identifier>ISSN: 0887-8994</identifier><identifier>EISSN: 1873-5150</identifier><identifier>DOI: 10.1016/j.pediatrneurol.2014.05.009</identifier><identifier>PMID: 25011433</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; cerebral palsy ; Cerebral Palsy - physiopathology ; Cerebral Palsy - therapy ; Child ; Child, Preschool ; Electric Stimulation Therapy - instrumentation ; Electric Stimulation Therapy - methods ; Female ; Fingers - physiopathology ; functional electrical stimulation ; hand functions ; Humans ; Inpatients ; Male ; Muscle Spasticity - physiopathology ; Muscle Spasticity - therapy ; Musculoskeletal Manipulations ; Neurology ; Occupational Therapy ; Orthotic Devices ; Pediatrics ; Range of Motion, Articular ; Severity of Illness Index ; spasticity ; Treatment Outcome ; Wrist - physiopathology</subject><ispartof>Pediatric neurology, 2014-09, Vol.51 (3), p.360-364</ispartof><rights>Elsevier Inc.</rights><rights>2014 Elsevier Inc.</rights><rights>Copyright © 2014 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-72d228d929e064221c89fa5a505a1965f793d95a410231351a14b3fe44895be93</citedby><cites>FETCH-LOGICAL-c438t-72d228d929e064221c89fa5a505a1965f793d95a410231351a14b3fe44895be93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25011433$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yıldızgören, Mustafa Turgut, MD</creatorcontrib><creatorcontrib>Nakipoğlu Yüzer, Güldal Funda, MD</creatorcontrib><creatorcontrib>Ekiz, Timur, MD</creatorcontrib><creatorcontrib>Özgirgin, Neşe, MD</creatorcontrib><title>Effects of Neuromuscular Electrical Stimulation on the Wrist and Finger Flexor Spasticity and Hand Functions in Cerebral Palsy</title><title>Pediatric neurology</title><addtitle>Pediatr Neurol</addtitle><description>Abstract Purpose To evaluate the effects of neuromuscular electrical stimulation on wrist range of motion, wrist and finger flexor spasticity, and hand functions in patients with unilateral cerebral palsy. Method Twenty-four children with unilateral spastic cerebral palsy (14 boys and 10 girls) between the ages of 5 and 14 years were randomized into neuromuscular electrical stimulation and control groups. Conventional exercises were applied, and static volar wrist-hand orthosis was administered to all patients 5 days a week for 6 weeks. Additionally, 30-minute neuromuscular electrical stimulation sessions were applied to the wrist extensor muscles in the neuromuscular electrical stimulation group. Patients were evaluated by Zancolli Classification System, Manual Ability Classification System, and Abilhand-Kids Test. Results Compared with baseline, a significant increase was evident in active wrist extension angle at the fourth and sixth weeks in both groups (all P  &lt; 0.001), more prominent in the neuromuscular electrical stimulation group at the fourth and sixth weeks ( P  = 0.015 and P  = 0.006, respectively). A decrease was observed in the spasticity values in the neuromuscular electrical stimulation group at the fourth and sixth weeks ( P  = 0.002 and P  = 0.001, respectively) and in the control group only at the sixth week ( P  = 0.008). Abilhand-Kids values improved only in the neuromuscular electrical stimulation group ( P  &lt; 0.001). Conclusion Neuromuscular electrical stimulation application in addition to conventional treatments is effective in improving active wrist range of motion, spasticity, and hand functions in cerebral palsy.</description><subject>Adolescent</subject><subject>cerebral palsy</subject><subject>Cerebral Palsy - physiopathology</subject><subject>Cerebral Palsy - therapy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Electric Stimulation Therapy - instrumentation</subject><subject>Electric Stimulation Therapy - methods</subject><subject>Female</subject><subject>Fingers - physiopathology</subject><subject>functional electrical stimulation</subject><subject>hand functions</subject><subject>Humans</subject><subject>Inpatients</subject><subject>Male</subject><subject>Muscle Spasticity - physiopathology</subject><subject>Muscle Spasticity - therapy</subject><subject>Musculoskeletal Manipulations</subject><subject>Neurology</subject><subject>Occupational Therapy</subject><subject>Orthotic Devices</subject><subject>Pediatrics</subject><subject>Range of Motion, Articular</subject><subject>Severity of Illness Index</subject><subject>spasticity</subject><subject>Treatment Outcome</subject><subject>Wrist - physiopathology</subject><issn>0887-8994</issn><issn>1873-5150</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNqNUl2LFDEQDKJ46-lfkIAvvszY-dpNEARZdj3hUGEVH0M206NZZzJrMiO3L_52M7enoE9CoKFTVU1XNSHPGNQM2PLFoT5iE9yYIk5p6GoOTNagagBzjyyYXolKMQX3yQK0XlXaGHlBHuV8AABluHxILrgCxqQQC_Jz07box0yHlr6b9fop-6lziW660k_Bu47uxtCX3hiGSMsbvyL9nEIeqYsN3Yb4BRPddngzJLo7ujwGH8bT7efVLWKKfuZmGiJdY8J9KqIfXJdPj8mDtlR8clcvyaft5uP6qrp-_-bt-vV15aXQY7XiDee6MdwgLCXnzGvTOuUUKMfMUrUrIxqjnGTABROKOSb3okUptVF7NOKSPD_rHtPwfcI82j5kj13nIg5TtkwprbhagijQl2eoT0POCVt7TKF36WQZ2DkAe7B_BWDnACwoWwIo7Kd3g6Z9j80f7m_HC2BzBmBZ90fAZLMPGH1RTMVw2wzhPwe9-kfHdyHOcX3DE-bDMKVYHLXMZm7B7uZbmE-BSQCulRG_ANcWtHQ</recordid><startdate>20140901</startdate><enddate>20140901</enddate><creator>Yıldızgören, Mustafa Turgut, MD</creator><creator>Nakipoğlu Yüzer, Güldal Funda, MD</creator><creator>Ekiz, Timur, MD</creator><creator>Özgirgin, Neşe, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140901</creationdate><title>Effects of Neuromuscular Electrical Stimulation on the Wrist and Finger Flexor Spasticity and Hand Functions in Cerebral Palsy</title><author>Yıldızgören, Mustafa Turgut, MD ; Nakipoğlu Yüzer, Güldal Funda, MD ; Ekiz, Timur, MD ; Özgirgin, Neşe, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-72d228d929e064221c89fa5a505a1965f793d95a410231351a14b3fe44895be93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>cerebral palsy</topic><topic>Cerebral Palsy - physiopathology</topic><topic>Cerebral Palsy - therapy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Electric Stimulation Therapy - instrumentation</topic><topic>Electric Stimulation Therapy - methods</topic><topic>Female</topic><topic>Fingers - physiopathology</topic><topic>functional electrical stimulation</topic><topic>hand functions</topic><topic>Humans</topic><topic>Inpatients</topic><topic>Male</topic><topic>Muscle Spasticity - physiopathology</topic><topic>Muscle Spasticity - therapy</topic><topic>Musculoskeletal Manipulations</topic><topic>Neurology</topic><topic>Occupational Therapy</topic><topic>Orthotic Devices</topic><topic>Pediatrics</topic><topic>Range of Motion, Articular</topic><topic>Severity of Illness Index</topic><topic>spasticity</topic><topic>Treatment Outcome</topic><topic>Wrist - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yıldızgören, Mustafa Turgut, MD</creatorcontrib><creatorcontrib>Nakipoğlu Yüzer, Güldal Funda, MD</creatorcontrib><creatorcontrib>Ekiz, Timur, MD</creatorcontrib><creatorcontrib>Özgirgin, Neşe, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yıldızgören, Mustafa Turgut, MD</au><au>Nakipoğlu Yüzer, Güldal Funda, MD</au><au>Ekiz, Timur, MD</au><au>Özgirgin, Neşe, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of Neuromuscular Electrical Stimulation on the Wrist and Finger Flexor Spasticity and Hand Functions in Cerebral Palsy</atitle><jtitle>Pediatric neurology</jtitle><addtitle>Pediatr Neurol</addtitle><date>2014-09-01</date><risdate>2014</risdate><volume>51</volume><issue>3</issue><spage>360</spage><epage>364</epage><pages>360-364</pages><issn>0887-8994</issn><eissn>1873-5150</eissn><abstract>Abstract Purpose To evaluate the effects of neuromuscular electrical stimulation on wrist range of motion, wrist and finger flexor spasticity, and hand functions in patients with unilateral cerebral palsy. Method Twenty-four children with unilateral spastic cerebral palsy (14 boys and 10 girls) between the ages of 5 and 14 years were randomized into neuromuscular electrical stimulation and control groups. Conventional exercises were applied, and static volar wrist-hand orthosis was administered to all patients 5 days a week for 6 weeks. Additionally, 30-minute neuromuscular electrical stimulation sessions were applied to the wrist extensor muscles in the neuromuscular electrical stimulation group. Patients were evaluated by Zancolli Classification System, Manual Ability Classification System, and Abilhand-Kids Test. Results Compared with baseline, a significant increase was evident in active wrist extension angle at the fourth and sixth weeks in both groups (all P  &lt; 0.001), more prominent in the neuromuscular electrical stimulation group at the fourth and sixth weeks ( P  = 0.015 and P  = 0.006, respectively). A decrease was observed in the spasticity values in the neuromuscular electrical stimulation group at the fourth and sixth weeks ( P  = 0.002 and P  = 0.001, respectively) and in the control group only at the sixth week ( P  = 0.008). Abilhand-Kids values improved only in the neuromuscular electrical stimulation group ( P  &lt; 0.001). Conclusion Neuromuscular electrical stimulation application in addition to conventional treatments is effective in improving active wrist range of motion, spasticity, and hand functions in cerebral palsy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25011433</pmid><doi>10.1016/j.pediatrneurol.2014.05.009</doi><tpages>5</tpages></addata></record>
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source ScienceDirect Journals
subjects Adolescent
cerebral palsy
Cerebral Palsy - physiopathology
Cerebral Palsy - therapy
Child
Child, Preschool
Electric Stimulation Therapy - instrumentation
Electric Stimulation Therapy - methods
Female
Fingers - physiopathology
functional electrical stimulation
hand functions
Humans
Inpatients
Male
Muscle Spasticity - physiopathology
Muscle Spasticity - therapy
Musculoskeletal Manipulations
Neurology
Occupational Therapy
Orthotic Devices
Pediatrics
Range of Motion, Articular
Severity of Illness Index
spasticity
Treatment Outcome
Wrist - physiopathology
title Effects of Neuromuscular Electrical Stimulation on the Wrist and Finger Flexor Spasticity and Hand Functions in Cerebral Palsy
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