Functional electrical stimulation (FES) provides augmentative stimulation as the child actively contracts muscles during functional tasks. Following BTX therapy, the initial intervention occurs approximately 2 weeks after the injection and is used to stimulate weak antagonists and strengthen weak spastic muscles.
The efficacy of FES in conjunction with dynamic splinting was demonstrated by Scheker et al in 19 children with spastic cerebral palsy. Combined modality therapy in this group produced a significant improvement in upper extremity function and decreased spasticity.
Scheker LR, Chesher SP, Ramirez S. Neuromuscular electrical stimulation and dynamic bracing as a treatment for upperextremity spasticity in children with cerebral palsy. J Hand Surg [Br] 1999;24:226-32.
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