Effects of Functional Electrical Stimulation on the Hand-Wrist Spasticity and Hand Functions in Children With Unilateral Spastic Cerebral Palsy / Unilateral Spastik Serebral Palsili Çocuklarda Fonksiyonel Elektrik Stimulasyonunun El-Bilek Spastisitesi ve El Fonksiyonları Üzerine Etkisi

OBJECTIVE: To evaluate the effects of functional electrical stimulation (FES) on range of motion (ROM), spasticity, hand motor functions in children who have unilateral cerebral palsy (CP) with wrist and finger flexor spasticity. MATERIALS-METHODS: 24 cases (14 male, 10 female) between the ages of 5-14 with unilateral spastic CP were included in the study. The cases were randomized into a study group and control group. Neurophysiological and conventional exercises, occupational therapy were applied and static volar hand-wrist splint was given to all cases five days a week for six weeks. Additionally; 30-minute FES sessions were applied to extensor carpi radialis longus/brevis, extensor carpi ulnaris and extensor digitorum brevis muscles of the patients in the study group. Cases were assessed by Zancolli Classification, Jebsen Hand Function Test (JHFT), Manual Ability Classification System (MACS) and Abilhand-Kids Test four times; before the treatment, at the third, fourth and sixth weeks after the treatment. RESULTS: There was no statistically significant difference between the groups regarding age, sex, dominant hand (p>0.05). At the end of the treatment, active hand-wrist extension angle significantly increased in both groups; besides the level of increase was significantly higher in the study group (p<0.017). There was no significant difference in time that spent in JHFT at the third, fourth and sixth weeks after the treatment compared to pretreatment in both groups (p>0.017). In the study group, MACS values at the fourth and sixth weeks were significantly higher than pretreatment values (p<0.001). Furthermore, Abilhand-Kids values at the sixth weeks were significantly higher in the study group (p<0.001). Zancolli spasticity classification values at the fourth and sixth weeks were also significantly lower in the study group than the control group (p<0.001; p=0.016). CONCLUSION: FES treatment in addition to neurophysiologic and conventional exercises, occupational therapy and static volar hand-wrist splint applied to children with unilateral CP is effective on active ROM, spasticity and hand functions.