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

In Brief Purpose 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. Method 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. Results 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. Conclusion 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. Electrical stimulation applied to produce sensory awareness of muscle function combined with physical therapy was found to improve active and passive motion of the ankle and foot that continued for months following the cessation of treatment.