Comparison of the Effect of Neuromuscular Electrical Stimulation and Cryotherapy on Spasticity and Hand Function in Patients with Spastic Cerebral Palsy

Abstract

Children with cerebral palsy (CP) often demonstrate poor hand function due to spasticity. Thus spasticity in the wrist and finger flexors poses a great deal of functional limitations. This study was therefore designed to compare the effectiveness of Cryotherapy and Neuromuscular Electrical Stimulation (NMES) on spasticity and hand function in patients with spastic CP. Thirty eight subjects aged 4 to 15 years with diagnosis of mild to moderate spastic CP participated in the study. Twenty of the subjects met the inclusion criteria of the study and were randomly assigned to two groups (A & B) with equal subjects number in each group. Group A were treated with cryotherapy and passive stretching and Group B, treated with NMES and passive stretching. The subjects were treated 3 times a week for 6 weeks. Spasticity and hand function were assessed pre-treatment and post-treatment using the Modified Ashworth Scale (MAS) and the Zancolli classification respectively. The results showed that 7 and 3 subjects in group A respectively and B had a significant reduction in spasticity respectively; while 7 and 8 subjects in group A and B respectively had a significant improvement in hand function. Cryotherapy and NMES were found to be effective and generally well tolerated by the patients. The study revealed that cryotherapy was not superior to NEMS and vice versa in the treatment of patients with spastic CP. Keywords: Spasticity, Cerebral Palsy, Neuromuscular stimulation, Cryotherapy. The Nigerian Medical Practitioner Vol. 51 (6) 2007: pp. 128-132