Effectiveness of Functional Electrical Stimulation - Cycling Treatment in Children with Cerebral Palsy

Abstract

Aim
The purpose of this study was to evaluate the effects of functional electrical stimulation (FES) bicycle therapy system on motor
function, gait pattern, spasticity, daily living activities, and aerobic capacity in children with cerebral palsy (CP) and to compare the
results with sham stimulation and standard treatment.
Methods
Patients with cerebral palsy who received botulinum toxin type-A injections to lower extremities and those with Gross Motor Function
Measure Classification System (GMFCS) levels I – III, were included in the study. Twenty-five patients were randomly assigned into
three treatment groups for 4-weeks: Group 1, FES-cycling and standard treatment; Group 2, Sham stimulus FES-cycling and standard
treatment; Group 3, Standard treatment. Clinical assessment tools included the Modified Ashworth Scale (MAS), Modified Tardieu
Scale (MTS), Pediatric Functional Independence Measure (WeeFIM), GMFCS, Gross Motor Function Measure-88 (GMFM-88),
selective motor control tests, 6-minute walk test, and Visual Gait Analysis (VGA).
Results
In all groups, there were significant improvements in MAS, MTS, WeeFIM, GMFM-88, 6-minute walk test, and VGA scores. No
changes in GMFCS levels were observed in any group. At the end of the study, there was no significant difference among the groups
in terms of any clinical assessment parameter.
Conclusions
All groups showed statistically significant improvements in motor function, walking pattern, spasticity, daily living activities, and aerobic
capacity in patients with CP following the rehabilitation period. Although FES-cycling demonstrated no superiority over the other
approaches and provided no additional benefit to the results, FES appears to be safe and well-tolerated in children with CP, at least as
much as standard exercise treatment.