Immediate effect of high-frequency transcutaneous electrical nerve stimulation on muscle tone and range of motion in children with spastic diplegic cerebral palsy: A randomized controlled trial

Title : Immediate effect of high-frequency transcutaneous electrical nerve stimulation on muscle tone and range of motion in children with spastic diplegic cerebral palsy: A randomized controlled trial

Abstract:

Background: Spasticity is a major motor impairment in children with cerebral palsy (CP), limiting functional mobility and joint range of motion. Transcutaneous electrical nerve stimulation (TENS) has been suggested as a non-invasive modality to modulate muscle tone through sensory input and spinal inhibitory mechanisms. However, evidence regarding its immediate clinical effects remains limited.
Objective: This study aimed to investigate the immediate effect of high-frequency TENS on muscle tone and range of motion in children with spastic diplegic cerebral palsy.
Methods: A randomized controlled trial was conducted on 60 children diagnosed with spastic diplegic cerebral palsy, aged 3–10 years. Participants were randomly assigned into two equal groups (n=30 each): a study group receiving active TENS and a control group receiving sham stimulation. Outcome measures included muscle tone assessed using the Modified Ashworth Scale (MAS), range of motion (ROM) measured by goniometry, and neurophysiological assessment using electromyography (EMG) and H-reflex (H/M ratio). All measurements were taken before and immediately after the intervention.
Results: The study group demonstrated a statistically significant reduction in spasticity levels compared to the control group (p < 0.01). Additionally, there was a significant increase in range of motion in the study group compared to controls (p < 0.001). No significant differences were observed in the H/M ratio between groups (p > 0.05). Within-group analysis revealed significant improvements in ROM and MAS in the study group, while no significant changes were detected in the control group.
Conclusion: High-frequency TENS appears to be an effective, safe, and non-invasive modality for immediate reduction of spasticity and improvement of joint range of motion in children with spastic diplegic cerebral palsy. Further research is recommended to investigate long-term effects and optimal dosing parameters in comparison with other spasticity management strategies.

Keywords: Cerebral palsy, TENS, spasticity, pediatric neurorehabilitation, randomized controlled trial

Biography:

Amgad Elwy Ali Hussein is a physiotherapist specialized in pediatric neurorehabilitation. He holds a Bachelor’s and Master’s degree in Physical Therapy from Cairo University and current phd candidate. His research focuses on neuromodulation techniques, particularly transcutaneous electrical nerve stimulation (TENS), in children with cerebral palsy. He has conducted both pilot and randomized controlled trials investigating the effects of TENS on spasticity and motor function. His clinical and research interests include neuroplasticity, motor control, and evidence-based pediatric rehabilitation.