Electrical simulation in addition to passive stretch has a small effect on spasticity and contracture in children with cerebral palsy: a randomised within-participant controlled trial.

QUESTION Does electrical stimulation in addition to passive stretching reduce spasticity and contracture more than passive stretching alone in children with cerebral palsy? DESIGN Randomised within-participant controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. PARTICIPANTS Eleven (one dropout) children with cerebral palsy and bilateral knee flexor spasticity aged 13 years (SD 1). INTERVENTION One leg in each participant received the experimental intervention for four weeks which consisted of 30 min of electrical stimulation of the quadriceps 3 times per week and passive stretching of the hamstrings 5 times per week. The other leg received the control intervention for four weeks which consisted of passive stretching of the hamstrings 5 times per week. OUTCOME MEASURES Spasticity of the hamstrings was measured using the modified Ashworth scale. Contracture was measured as maximum passive knee extension using goniometry. RESULTS The mean difference in decrease in the modified Ashworth score due to the addition of electrical stimulation to the stretching regimen was 0.8 points (95% CI 0.1 to 1.5). The mean difference in increase in passive knee extension due to the addition of electrical stimulation to the stretching regimen was 4 degrees (95% CI 0 to 7). CONCLUSION Electrical stimulation combined with passive stretching is marginally more effective than passive stretching alone for spastic limbs of children with cerebral palsy.