Neuromuscular Electrical Stimulation (NMES) and Cerebral Palsy

Cerebral Palsy Therapies

Children with cerebral palsy have the potential to improve their motor functions and quality of life with a variety of alternative therapies. Many forms of electrical stimulation therapy, including neuromuscular electrical stimulation (NMES), treat patients with electrical impulses. Learn more about NMES, discover its typical outcomes, and find out how effective this type of therapy can be for children with cerebral palsy.

What Is Neuromuscular Electrical Stimulation?

Everyone relies on electrical stimulation to move and perform tasks, as neurons constantly send small impulses from the brain to the relevant muscle group. NMES produces artificial electrical impulses that imitate the signals that the nervous system would typically emit.

Like natural nerve impulses, these electrical stimuli target specific muscle groups, causing them to contract. After repeated contractions, blood flow within the muscles may improve, which can help them strengthen and improve functionality.

NMES has the potential to affect patients with neurological conditions and motor disorders, including cerebral palsy. For cerebral palsy patients, NMES therapy typically targets muscle groups with limited abilities or low muscle mass.

How NMES Works

Before offering NMES, healthcare teams usually perform comprehensive examinations to make sure that patients are reasonable candidates for this type of therapy. For cerebral palsy patients, medical teams generally review the patient’s:

  • Musculoskeletal system
  • Cognitive abilities
  • Seizure history

During treatment sessions, therapists generally use neuromuscular stimulator devices. Therapists apply electrodes to the skin near the relevant muscle group, such as on the patient’s calves. The other end of each electrode connects via wire to the neuromuscular stimulator.

Therapists then guide patients through activities that use the specific muscle groups they’re hoping to target. For example, a therapist might help a patient walk, run, or jump. Throughout these activities, the electrodes provide low-level electrical impulses to stimulate the muscles.

For cerebral palsy patients, therapy often continues at home. Many treatment programs provide patients with a list of exercises to practice at home. Parents generally must assist their children with exercises to get the maximum benefit from this type of therapy.

Potential Outcomes of Neuromuscular Electrical Stimulation

With regular sessions of neuromuscular electrical stimulation, cerebral palsy symptoms and patients’ abilities may change. Patients may experience outcomes like:

  • Increased strength
  • More range of motion
  • Improved flexibility
  • Amplified muscle functionality

Although improving strength is one of the most common goals for NMES, many therapy programs can also retrain select muscle groups. As a result, patients may gain more control over their movements and gain an increased range of motion.

For most patients, NMES isn’t painful. Instead, the stimulation is designed to create a minor tingling sensation in the relevant muscle group. This feeling can help patients determine the right muscles to use during the therapy session.

Although the electrodes can cause the skin underneath to redden temporarily, any discoloration typically disappears shortly after the treatment session ends. In the long term, NMES doesn’t lead to any known side effects.

How Effective Is NMES?

Like many alternative treatments for cerebral palsy, no large-scale clinical studies have confirmed the efficacy of NMES. Since it’s an alternative treatment, NMES isn’t considered a substitute for modern medicine. In addition, the required electrical stimulation devices aren’t FDA-approved. However, smaller case studies and critical reviews have demonstrated isolated positive outcomes.

A 2007 study explored whether a combination of NMES, high-force contractions, and low repetitions could improve muscle strength and increase walking speed in children with spastic diplegic cerebral palsy. This study compared the efficacy of NMES to volitional training and determined that the NMES group made greater gains in quadriceps and triceps formation. While the study indicated that NMES could contribute to strength gains in children with cerebral palsy, it also revealed the need for more comprehensive clinical studies.

A 2019 critical review examined research on NMES and cerebral palsy published between 1990 and 2019. Altogether, the review covered 18 studies that included over 200 participants in groups of varying sizes.

Overall, the review revealed evidence that NMES contributed to improved ankle flexibility and control as well as increased walking speed, larger steps, and improved muscle volume in cerebral palsy patients. The review also emphasized the need for additional research related to the effect of NMES on walking patterns and improved mobility in children with cerebral palsy. A similar 2017 critical review also revealed promising outcomes and a need for continued investigation.

Children with cerebral palsy all have individual needs and may respond differently to a variety of mainstream and alternative treatments. If you believe electrical stimulation could address your child’s symptoms, it’s important to seek advice tailored to your child’s individual condition.

There are many reasons children are diagnosed with cerebral palsy, one of which may be the result of a birth injury caused by medical errors or failures. If you have questions about whether medical negligence may have contributed to your child’s cerebral palsy, the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs can help. Contact us today to learn more.



Claire Surles, RN
Reviewed by:
Claire Surles, RN
Registered Nurse

Claire comes to JJS after a 10-year career as a labor and delivery nurse. She dedicated her hospital efforts to advocating for families, providing the safest birthing environment possible as Newborn Admission Nurse at UMMC St. Joseph Medical Center in Towson, Maryland. Her passion for helping those who experienced losses at any stage of gestation led to her appointment as Coordinator of the hospital’s ROOTS perinatal loss program. READ FULL BIO

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