ELECTRICAL STIMULATION AS A PHYSICAL THERAPY TREATMENT MODALITY FOR CHILDREN
Information for Parents of Children with Developmental Diagnoses including Cerebral Palsy, Down Syndrome, Hypotonia, Toe Walking, and Developmental Delay
BY JOVIAL LEWIS, PT, MPT, PCS AND YOCHEVED BENSINGER-BRODY, PT, PHD, PCS
Years of scientific research has shown that the best way for children with developmental diagnoses to achieve and maintain optimal health across all body systems (musculoskeletal, neuromuscular, cardiopulmonary) is to help them engage in age-appropriate play and functional tasks. Pediatric physical therapists work with families to help their children reach their maximum potential in these areas.
One well documented therapeutic modality to achieve these goals is electrical stimulation.1,2 This article will describe this modality and explain how it can be useful for the pediatric population.
WHAT IS THERAPEUTIC ELECTRICAL STIMULATION?
Electrical stimulation (ES) is the application of electrical impulses with sufficient intensity to elicit a muscle contraction during an
exercise program. It can be applied either percutaneously (needles placed through the tissue) or transcutaneously (electrodes placed on top of the skin). This article will only address the transcutaneous application of electrotherapy. Electrodes of different shapes and sizes are applied to the muscles, which are then connected to wires and a control unit. Specific parameters are used for children to keep it comfortable for them. Electrical Stimulation has many applications, but this article will discuss the practical applications of only neuromuscular electrical stimulation (NMES) and functional electrical stimulation (FES).
WHAT IS NMES AND FES?
When NMES is used, the unit is set to cycle to elicit muscle contraction, and then relaxation for a set period of time, as determined by the therapist. For this intervention, the child can be in any position, resting or moving. When FES is used, the unit only turns on to elicit muscle contraction when it is triggered by the therapist with a remote control, while the child is performing a functional task (like walking). This intervention is used to train a muscle to activate at a specific time during the functional task.