Functional electrical stimulation to lower limb muscles after botox in children with cerebral palsy

Pediatr Phys Ther. 2010 Summer;22(2):199-206. doi: 10.1097/PEP.0b013e3181dbd806.


Purpose: This study examined the effect of lower limb functional electrical stimulation (FES) after botulinum toxin injection in children with cerebral palsy on self-selected walking speed, plantar flexor and dorsiflexor muscle strength, and an optimal time frame for initiating FES after the injection.

Methods: Five subjects participated in a single-subject design. All subjects received a single botulinum toxin injection into the calf muscle, followed by a 4-week FES home program. Three subjects followed the protocol as prescribed; 2 subjects received no FES.

Results: FES after botulinum toxin increased isometric plantar flexor muscle strength, but did not produce changes in self-selected walking speeds or isometric dorsiflexor strength. A 32-day interval between botulinum toxin and the start of FES was most effective.

Conclusions and recommendations for clinical practice: FES after botulinum toxin seems to be effective in improving some gait variables, although further research is needed for substantiation.

MeSH terms

  • Acceleration
  • Algorithms
  • Analysis of Variance
  • Botulinum Toxins, Type A / therapeutic use*
  • Cerebral Palsy / drug therapy
  • Cerebral Palsy / rehabilitation
  • Cerebral Palsy / therapy*
  • Child
  • Child, Preschool
  • Electric Stimulation Therapy*
  • Exercise Test
  • Female
  • Gait
  • Hemiplegia / drug therapy
  • Hemiplegia / rehabilitation
  • Hemiplegia / therapy*
  • Humans
  • Isometric Contraction / drug effects
  • Lower Extremity*
  • Male
  • Muscle Strength / drug effects
  • Muscle Strength Dynamometer
  • Muscle, Skeletal / drug effects*
  • Muscle, Skeletal / innervation
  • Neuromuscular Agents / therapeutic use*
  • Range of Motion, Articular
  • Walking


  • Neuromuscular Agents
  • Botulinum Toxins, Type A