Clinical use of neuromuscular electrical stimulation for children with cerebral palsy, Part 1: Lower extremity.

This report, part 1 of a two-part case report on the clinical use of neuromuscular electrical stimulation (NMES) for children with cerebral palsy, documents the functional changes that occurred with the application of NMES to the lower extremity of three male children, 1.6, 6.7, and 10 years of age, all with hemiplegia due to cerebral palsy. Neuromuscular electrical stimulation was used in conjunction with a dynamic-systems, task-oriented model of motor learning. The children tolerated NMES well and at times demonstrated carryover after the removal of NMES. The youngest child showed immediate change in the ability to walk and run symmetrically. The two older boys demonstrated significant improvement in locomotor efficiency in a short time, although they were of an age when this improvement was not expected. One boy's Physiological Cost Index (PCI) measurement (a measure of locomotor efficiency) improved fourfold, and the other boy's PCI measurement improved by a factor of two. The results show preliminary evidence for the usefulness of NMES as an adjunct to the physical therapy program for improving function in children with cerebral palsy.