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Therapeutic Electrical Stimulation - TES

© Sandra Nasser

Once a patient with cerebral palsy has been treated with some form of treatment used for muscle spasticity, strengthening of specific muscles groups will begin. A method used for enhancing muscle function is therapeutic electrical stimulation (TES). Due to the fact that TES is such a new treatment, there is limited research. However, in this research, increased muscle strength in patients has been proven.

What is therapeutic electrical stimulation (TES)? TES is used for treatment of diagnosis of cerebral palsy, nerve injury, stroke and sports injury. Electrodes are placed on the skin in the area of atrophied muscles. Electrical stimulation is then sent through each electrode. The amount of electrical stimulation is controlled through a monitor and then sent through each electrode. TES is benefitted most when given at night when the patient is sleeping. Apparently, the spastic muscles are less active and they will not interfere with the weak muscles. Also, at night there are increased growth factors and nutrients concentrated in the blood. Candidates for this treatment must be two years or older and of average height and weight. TES must be given in combination with physical therapy and/or occupational therapy to achieve the best results and monitored by a therapist certified in TES. Results are seen commonly in patients in approximately six to nine months.

Does TES have side effects? It's not evident TES have permanent side effects. However, some transient side effects may occur. Placement of electrodes must be accurately or spasticity can occur. Not using the correct stimulation as in to high, can cause muscle aches. If this does happen the side effects subside in a couple of days. Also, if a patient has a history of seizures, the seizures will have to be controlled before TES treatment begins.

What about research studies? In 1992, Dr. Paper reported on 61 children who had been treated with TES for more than one year. The study's participant were ambulators who used support such as walkers, crutches or canes. Paper found that 66 percent of the children changed one or more levels on the Progressive Ambulation Scale. Moreover, 21 percent moved into the category of mildly affected and became community ambulators. In 1995, Drs. Steinbok, Reiner, and Kestle of British Columbia presented an independent study at the International Society of Pediatric Neurosurgery in chile. Their study consisted of children who were at least one year post rhizotomy. The researchers randomized the children in two group. The first group received TES for one year, and other did no. The study's results were measured by the Gross Motor Function Measure. The children receiving TES registered significantly better clinical outcomes. Whereas the mean change in the GMFM for TES group was 5.5. percent, it was only 1.9 percent for children who didn't receive TES.