Pulsed Magnetic Field Therapy for Gait and Spasticity Management in Children With Bilateral Spastic Cerebral Palsy: A Review Article

Background: Bilateral Spastic Cerebral Palsy (BSCP) is one of the most prevalent subtypes of cerebral palsy, affecting approximately 2.11 per 1,000 live births. It results from early brain injury and is characterized by persistent spasticity and impaired gait. Trunk and gluteal muscle stiffness severely impact the quality of life and motor function in affected children. Conventional therapies often provide only limited relief, prompting exploration of newer, non-invasive neuromodulatory treatments such as Pulsed Magnetic Field (PMF) therapy. Objective: This review aimed to systematically evaluate the available evidence regarding the safety and effectiveness of PMF, particularly repetitive peripheral magnetic stimulation (rPMS), in managing spasticity and improving gait performance in pediatric patients with BSCP. Methods: A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar using keywords including "Pulsed Magnetic Field," "Spasticity," "Cerebral Palsy," "Children," and "Gait," combined with Boolean operators. Studies published in English up to 2018 were considered. Inclusion criteria focused on randomized controlled trials, quasi-experimental, and observational studies involving children with BSCP, utilizing PMF therapy as the primary intervention. Primary outcome measures included the Modified Ashworth Scale (MAS) and Gait Outcomes Assessment List (GOAL). Results: Four studies met the inclusion criteria, involving sample sizes ranging from 1 to 38 participants. A 23.7% reduction in soleus tendon reflex amplitude was reported in one study (p < 0.001), while another demonstrated significant upper limb spasticity reduction and EEG-confirmed cortical modulation (p < 0.05). Functional improvements persisted up to 40 days post-intervention in single-subject follow-ups. Conclusion: PMF therapy shows promise as a non-invasive approach to reduce spasticity and enhance gait in BSCP. However, more large-scale, long-term randomized trials with standardized protocols are essential to confirm its efficacy and establish clinical guidelines.