The effect of combined transcranial pulsed current stimulation and transcutaneous electrical nerve stimulation on lower limb spasticity in children with spastic cerebral palsy: a randomized and controlled clinical study

Abstract Background In the current study, we applied a combination of non-invasive neuromodulation modalities concurrently with multiple stimulating electrodes. Specifically, used transcranial pulsed stimulation (tPCS) and transcutaneous electrical nerve (TENS) as novel strategy for improving lower limb spasticity in children spastic cerebral palsy (SCP) categorized on levels III–V Gross Motor Function Classification System (GMFCS) minimal side effects. Methods Sixty-three SCP aged 2–12 years, who were classified GMFCS randomly assigned to one two groups, resulting 32 experimental group 31 control group. The underwent therapy tPCS (400 Hz, 1 mA cerebello-cerebral stimulation) TENS max 10 mA) 30 min, followed by min physiotherapy five times per week 12 weeks. only mins day total, all groups 60 treatment sessions. primary outcome measures Modified Ashworth Scale (MAS) Tardieu (MTS). Evaluations performed 3 days before after treatment. Results We found significant improvement MAS MTS scores limbs compared hip adductors (Left: p = 0.002; Right: 0.002), hamstrings 0.001; Right : < 0.001, gastrocnemius 0.000). Moreover, R1, R2 R2-R1 left right adduction, knee joint, ankle joint showed improvements ( ≤ 0.05). Analysis baseline but declines Conclusion These results are among first demonstrate that can significantly improve effects, presenting addressing challenges severe SCP. Trial registration ChiCTR.org, ChiCTR1800020283, Registration: 22 December 2018 (URL: http://www.chictr.org.cn/showproj.aspx?proj=33953 ).