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Journal of Hand Surgery (British and European Volume)
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Articles

Neuromuscular Electrical Stimulation and Dynamic Bracing as a Treatment for Upper-Extremity Spasticity in Children with Cerebral Palsy

L. R. SCHEKER
S. P. CHESHER
S. RAMIREZ

From the Christine M. Kleinert Institute for Hand and Micro Surgery and the University of Louisville School of Medicine, Division of Plastic and Reconstructive Surgery, Louisville KY, USA

Correspondence: L. R. Scheker MD, Kleinert, Kutz and Associates Hand Care Center, One Medical Centre Plaza, Suite 700, Louisville, KY 40202, USA.

We have investigated a therapeutic regimen using neuromuscular electrical stimulation (NMES) and dynamic bracing to assess their effectiveness in reducing upper-extremity spasticity in children with cerebral palsy. Nineteen patients between 4 and 21 years of age with documented diagnoses of spastic cerebral palsy were treated. The patients included in the study followed a regimen of two 30-minute sessions of NMES of the antagonist extensors combined with dynamic orthotic traction during the day. A static brace was used at night. Spasticity of the wrist and fingers was assessed periodically using the Zancolli classification. Treatment ranged from 3 to 43 months. After treatment with electrical stimulation and dynamic bracing, all the patients moved up 1 to 3 levels in the Zancolli classification and showed a marked improvement in upper-extremity function. These results show that combining NMES and dynamic orthotic traction dramatically decreases spasticity of the upper extremity in young patients with cerebral palsy.

Journal of Hand Surgery (British and European Volume), Vol. 24, No. 2, 226-232 (1999)
DOI: 10.1054/JHSB.1998.0002
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[Abstract] [PDF]