Effect of Sensory-Level Electrical Stimulation of the Tibialis Anterior Muscle During Physical Therapy on Active Dorsiflexion of the Ankle of Children with Cerebral Palsy

Abstract

The aim of the study was to determine whether add-on electrical stimulation (ES) at the sensory level improves ankle dorsiflexion in children with cerebral palsy. Seventeen children (three to nine years of age) with spastic hemiplegia or diplegia with weak or absent active ankle dorsiflexion received ES therapy applied to the tibialis anterior muscle during ordinary scheduled physical therapy sessions for one month. The ES was given at the sensory level alone with the aim of increasing the child's sensory awareness of the voluntary movement of the ankle. Statistically significant improvement occurred in active ankle dorsiflexion with the knee flexed and extended between the first (pre) test and the subsequent tests (zero, two, and nine months later). Active toe flexion and extension and active inversion and eversion of the feet improved significantly. ES at the sensory level combined with physical therapy improves active and passive motion of the ankle and foot that persists months after stimulation component is removed.