Noninvasive and Painless Magnetic Stimulation of Nerves Improved Brain Motor Function and Mobility in a Cerebral Palsy Case

• Published in: Archives of physical medicine and rehabilitation Vol. 95; no. 10; pp. 1984 - 1990
• Main Authors: Flamand, Véronique H., Schneider, Cyril
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.10.2014
• Subjects: Ankle Joint - physiopathology; Cerebral palsy; Cerebral Palsy - physiopathology; Cerebral Palsy - rehabilitation; Child; Gait; Gait - physiology; Humans; Lower Extremity - innervation; Magnetic Field Therapy - methods; Male; Muscle spasticity; Neuronal plasticity; Peripheral nerves; Peripheral Nerves - radiation effects; Physical Medicine and Rehabilitation; Rehabilitation; Transcranial magnetic stimulation; Cerebral palsy; Neuronal plasticity; Transcranial magnetic stimulation; Gait; M1; Peripheral nerves; AMT; CP; TA; rPMS; PNS; MEP; Rehabilitation; MVC; TMS; Muscle spasticity; motor-evoked potential; active motor threshold; peripheral nerve stimulation; tibialis anterior; repetitive peripheral magnetic stimulation; maximal voluntary contraction; primary motor cortex
• ISSN: 0003-9993; 1532-821X; 1532-821X
• DOI: 10.1016/j.apmr.2014.05.014

Motor deficits in cerebral palsy disturb functional independence. This study tested whether noninvasive and painless repetitive peripheral magnetic stimulation could improve motor function in a 7-year-old boy with spastic hemiparetic cerebral palsy. Stimulation was applied over different nerves of the lower limbs for 5 sessions. We measured the concurrent aftereffects of this intervention on ankle motor control, gait (walking velocity, stride length, cadence, cycle duration), and function of brain motor pathways. We observed a decrease of ankle plantar flexors resistance to stretch, an increase of active dorsiflexion range of movement, and improvements of corticospinal control of ankle dorsiflexors. Joint mobility changes were still present 15 days after the end of stimulation, when all gait parameters were also improved. Resistance to stretch was still lower than prestimulation values 45 days after the end of stimulation. This case illustrates the sustained effects of repetitive peripheral magnetic stimulation on brain plasticity, motor function, and gait. It suggests a potential impact for physical rehabilitation in cerebral palsy.