Efficacy of electrical stimulation after administration of botulinum toxin in children with spastic diplegic cerebral palsy

Objective: The aim of this study was to investigate the effectiveness of electrical stimulation to agonist muscles after administration of botulinum toxin in children with spastic diplegic cerebral palsyMaterial and Method: Children with spastic diplegic cerebral palsy were evaluated. Patients fullfilled the inclusion criteria were determined and randomized into two groups. For both groups, botulinum toxin injection were performed to the gastrosoleus muscles and home exercise programme was given. Electrical stimulation was applied to the gastrocnemius muscle in Group I. Patients were evaluated before treatment, at 2nd week and 3rd month after injection with Penn Spasm Frequency Score, Modified Ashworth Scale, GMFM-88 (Gross Motor Function Measure) (Dimension D and E) and walking velocity.Results: Decrease in spasticity was clear for both groups in early period (p=0,0001) but for left lower extremity at before treatment and 3. month period, decrease in spasticity was more significant for Group I (p=0,0001). Decrease in spasm frequency was significant for only Group I in late period (p=0,011). Improvement in GMFM-88 Dimension D was more significant in Group I (p=0,0001) than Group II (p=0,001) at before treatment and 3 months period; and was not statistically significant for Group II at 2 weeks and 3 months period (p=0,239). There were no statistically significant differences between two groups for all parameters.Conclusion: Patients in both groups generally had benefited from the treatment but no additional effect of administration of electrical stimulation to gastrocnemius motor points determined after botulinum toxin injection to gastrocnemius and soleus muscles applied to the children with diplegic cerebral palsy who have gastrosoleus spasticity.Key Words: Botulinum toxin, electrical stimulation, cerebral palsy, spasticity