How can Electrical Stimulation improve walking in children with cerebral palsy?
MES has been used as an alternative option for children who have problems with walking. MES has the potential to improve a number of different areas including muscle mass and strength, spasticity, passive range of motion,walking speed, positioning of the foot and the way that the ankle moves. In the case of walking, pads are placed on the front of the leg, directly over the muscles that lift the toes up when walking. When the device is turned on, it sends the electrical current to the muscle to flex at the exact time the person is about to take a step. This means the person can take a step without dragging their toes, tripping or falling.
What is the evidence?
Over the past 4 years our research team has conducted and published numerous studies to establish the effect of muscle electrical stimulation on a range of outcomes in children with physical disabilities. We have shown that it is effective in improving walking ability, strength, balance and even muscle size. It was well tolerated and described to be preferable to braces.
The articles that provide this evidence are:
- Pool, D., Blackmore, A. M., Bear, N., & Valentine, J. (2014). Effects of Short-Term Daily Community Walk Aide Use on Children With Unilateral Spastic Cerebral Palsy. Pediatric Physical Therapy, 26(3), 308–317. doi: 10.1097/PEP/0000000000000057
- Pool, D., Valentine J., Blackmore A.Marie., Colegate, J., Bear N., Stannage, K., & Elliott C. (2015). Daily functional electrical stimulation during everyday walking activities improves performance and satisfaction in children with unilateral spastic cerebral palsy: a randomised controlled trial. Archives of Physiotherapy, 5(5), doi:10.1186/s40945-015-0005-x.
- Pool, D., Elliott, C., Bear, N., Donnelly, C.J., Davis, C., Stannage K., & Valentine, J. Forthcoming. Neuromuscular electrical stimulation assisted gait increases muscle strength and volume in children with unilateral spastic cerebral palsy: a randomised controlled trial. Developmental Medicine and Child Neurology.
- Pool, D., Valentine, J., Donnelly, C.J., Bear, N., Elliott C., Stannage, K. Forthcoming. The orthotic and therapeutic effect following daily community applied functional electrical stimulation in children with unilateral spastic cerebral palsy: a randomised controlled trial. BMC Pediatrics.
Effects of Electrical Stimulation on improving participation for children with cerebral palsy.
The effects of muscle electrical stimulation can mean different things to different people. It is important to know this because despite the results we got from the study, how it works for each person and their family is individual as must be reviewed on a case by case basis. Based on previous research by our team some of the most common benefits children who wore the devices reported were:
- Improved running and walking
- Improved comfort with more options to wear different shoes
- Reduction in trips and falls
- Improved confidence
- Increased foot awareness
The NDIS provides funding to participants to purchase a range of supports aimed at increasing their independence, inclusion, and social and economic participation.
Domain: Daily Living- Assistive technology
Composite code: Walking Aid (05_416_0105_1_2) (line item)
Quotes are required from providers for the provision of AT where indicated in this Guide. Participants can then decide whether or not to accept these quotes. Identification of supports in a participant’s plan, and approval of quotes, may require an assessment by a suitable AT assessor. Appropriate assessment by a suitable AT assessor is covered in ‘Therapy Supports’ or ‘Custom Prosthetics’ categories in the Capacity Building budget.
In plan needs at PT or orthotist referral (funding for that Ax)
They need funding set aside for this equipment (foreseen to be put in plan)
Once had Ax upload quote to portal or email through to planner.