CEREBRAL PALSY
28. Logan, Michael P. Improved mechanical efficiency in cerebral palsy patients treated with cranial electrotherapy stimulator (CES). Unpublished, 1988.
Device: Pain Suppressor, 15,000 Hz, 50mS, 500 - 700 µA, electrodes placed above ears
36 spastic type cerebral palsy pts completed informed consent and were divided into 18 CES and 12 placebo CES in this double-blind study. Both groups performed a graded exercise test on a Tunturi bicycle ergonometer. Pedaling speed was recorded in revolutions per minute (RPM), and the resistance to pedaling in Newton's (N). The workload was started at 0 and increased by 2 N every 2 minutes based on heart rate (HR), blood pressure (BP), and ability to maintain pedal velocity. HR was measured every minute by an EKG. Expired gases were measured every minute, and BP every 2 minutes. 6 pts were dropped from the study because 3 were not able to maintain pedaling motion, while another 3 voluntarily withdrew. The absolute test value differences were subjected to a 2 factor analysis of covariance. The mean poststimulation mechanical efficiency (ME) in the CES group increased by 19.1% (from 50.3 to 59.9), while the placebo group dropped by 9.1% (53.3 to 48.4). Workloads of treated pts improved by an average of 43% (mean of 65.9 to 94.3). This is a remarkable increase, especially when one considers that the placebo retest scores declined by 5.5% (mean of 75 to 70.9). The F statistics for the unit factors in ME was significant at the .0003 level. The authors concluded that the results indicate that CES does, in fact, improve the work performance of cerebral palsy pts and that the most likely explanation is that spacticity was reduced in the actively treated pts. There was no report of side effects. Dr. Logan received the Richmond Award from the American Academy for Cerebral Palsy and Developmental Medicine for this work.
33. Malden, Joan W., Charash, Leon I. Transcranial stimulation for the inhibition of primitive reflexes in children with cerebral palsy. Neurology Report. 9(2):33-38, 1985.
Device: Neurotransmitter Modulator
In this double-blind crossover study 20 children (2.5 months to 15 years old) with normal intelligence and mild to severe spastic cerebral palsy completed informed consent and were then divided into real and placebo CES groups, each having 6 weeks of 2, 10 minute daily treatments and then the groups were reversed. The results were evaluated using the Malden Gross Motor Rating Scales I, II, and III, and the Advanced Gross Motor Skills Scale, which together constitute a total gross motor picture. Group A (active/placebo) had an original assessment of 37.2 measured an average of 13.1 months prior to the study, 52.9 at the start of the study, 79.4 at crossover, and 81 at the end of the study. The mean improvement of 26.5 points for Group A with active treatments was significant compared to the mean value of 1.6 points during the placebo period. Group B (placebo/active) had an original assessment of 36.83 measured an average of 37.16 months prior to the study, 85.4 at the start of the study, 87.9 at crossover, and 102 at the end of the study. The mean of Group B during the placebo period of 2.5 points was not significant compared to the 14.1 gain during the active period. The authors concluded that the results of this study are highly significant and would seem to indicate that the treatment of children with spastic cerebral palsy with CES in addition to physical therapy is superior to conventional treatment offered alone. Placebo treatments have little further effect on conventional treatment. No side effects were reported.
38. Okoye, Renee, Malden, Joan W. Use of neurotransmitter modulation to facilitate sensory integration. Neurology Report. 10(4):67-72, 1986.
Device: Neurotransmitter Modulator
16 pts, from 5 - 25 year old, with neurological diagnoses ranging from minimal cerebral dysfunction to cerebral palsy and spastic quadriplegia having at least borderline intelligence were divided into 3 groups for this 12 week non-blinded study. The CES groups were treated twice daily. Assesments were made using the Southern California Sensory Integration Test, and the Jebsen hand function test. The design copying scores for pts who received CES, without occupational therapy (OT) averaged 59%. Pts receiving OT without CES averaged 35%, and pts receiving both CES and OT averaged 88%. Motor accuracy showed a tremendous improvement in the 2 CES groups over the OT-only group, with the CES only group changing 43% in their dominant hand, and 21% in their non-dominant hand, the OT only group averaging 15% in their dominant hand, and 45% in their non-dominant hand, and the combined therapy group averaging 53% change in their dominant hand, and 68% in their non-dominant hand. In conclusion, the authors stated that CES pts whose scores showed moderate impairment during pretest trials improved to within normal limits in a 12 week period, and that these findings were remarkable. No side effects were reported.