Stochastic resonance stimulation improves balance in children with cerebral palsy: a case control study.
Anastasia Zarkou, Samuel C K Lee, Laura A Prosser and 2 others
PMID 30526617WHAT IT FOUND
A very faint electrical noise at the ankles made standing steadier for children with cerebral palsy, but only when each child's best setting was found.
It tested only quiet standing, not walking or daily function.
Key findings
01In children with cerebral palsy, the optimal ankle electrical noise reduced postural sway velocity and sway area during quiet standing compared with no stimulation.
02Children with cerebral palsy improved more than typically developing peers when the noise was added, especially with eyes open, and for side-to-side velocity with eyes closed.
03The useful noise level had to be found for each child; among four tested subthreshold levels, only the optimal level significantly reduced center-of-pressure velocity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 18 participants were analyzed, with 9 children with cerebral palsy, due to technical problems during data collection. The study tested only immediate effects during quiet standing, not training, walking, falls, or daily activities. Participants could stand independently and had spastic diplegia at GMFCS levels I to III, so results do not show what happens in children who cannot stand independently. Balance was judged from center-of-pressure sway, which measures how much the body shifts under the feet, not how well a child moves in real life. Some children became less stable with stimulation, including 1 child with cerebral palsy and 3 typically developing children. The threshold-finding step produced different optimal intensities across children, reflecting broad differences in motor and sensory function within the cerebral palsy group. Decreased sway was assumed to mean better balance, but some children with cerebral palsy may stiffen or coactivate muscles to stand, and less sway may not always mean better function.
Declared interests
The funding section names Shriners Hospitals for Children and the Alexander S. Onassis Public Benefit Foundation as funders.
The easy way to misread this
Do not conclude that stochastic resonance stimulation improves balance in daily life. This study measured only immediate sway during quiet standing, and some children became less stable.