The use of functional electrical stimulation to improve upper limb function in children with hemiplegic cerebral palsy: A feasibility study

Background: Grasping and manipulating objects are common problems for children with hemiplegic cerebral palsy. Multichannel-functional electrical stimulation may help facilitate upper limb movements and improve function. Objective: To evaluate the feasibility of multichannel-functional electrical stimulation to improve grasp and upper limb function in children with hemiplegic cerebral palsy to inform the development of a clinical trial. Methods: A prospective pre-/post-test/follow-up (six months) design with three children, aged 6-13 years, was used. Multichannel-functional electrical stimulation (mFES) was applied to the hemiplegic upper limb for up to 48 sessions over 16 weeks. Feasibility indicators included recruitment of participants and adherence rates, safety, and discomfort/pain. Effectiveness was assessed using the grasp domain of the Quality of Upper Extremity Skills Test, and other secondary clinical outcome measures with success criteria set a priori. Results: Participant recruitment target was not met but adherence was high, and multichannel-functional electrical stimulation was found to be safe and comfortable. Of the three participants, two improved in grasp at post-test, whereas one child's ability deteriorated. Only one child met success criteria on most outcomes at post-test. Conclusions: Feasibility indicators met success criteria, except for participant recruitment. Treatment effectiveness was mixed. A future case comparison investigation with a larger but more selected sample is suggested.