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Would you recommend electrical nerve stimulation on a 14 month old who has low muscle tone?

My son has been diagnosed with moderate low muscle tone. My husband and I first noticed his symptoms when he could not sit up at 9 months. He was evaluated by two different neurologists and both concluded that he had overall low muscle tone.
When evaluated his muscles work fine, but it is his reaction that is slow/delayed. He is cognizant, engaging and tries to play with his older sister, so we are not sure what is causing the delayed reactions or signals. We do not know the cause of the low muscle tone. He will be getting an MRI done on his brain and spine mid-February. The second neurologist also requested bloodwork on him to do a chromosomal microarray to determine if he has any abnormal genes. In the meantime, he has been going through physical and occupational therapy. He also recently started speech therapy since he has not started saying words, yet, but he babbles. We've seen improvement in him. Now he is crawling a couple of steps and he is climbing up the stairs. He gets into a sitting position and can hold himself for several seconds. He can also get himself to a standing position, but does not know how to get down (he has fallen flat on his back and hit his head). I would like to try electrical nerve stimulation on him, especially around his core, but heard it can have a negative effect on his growth plates. Any thoughts on this? Are there any therapists and/or doctors that will do electrical nerve stimulation on babies in the northern Virginia area? I appreciate your help.

Maria

10 months ago

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Prof Tim Watson
Prof Tim Watson

Agree with several of the comments made so far. Yes, there is potential for gain but I suspect that to deliver enough stim to enough of the muscle groups to make a difference is likely to be uncomfortable and ? poorly tolerated. It would not be contraindicated and has the potential to be beneficial as others have noted. Might be worth a try but be prepared for poor response from your son and if it were me, I would not be pushing it if his response is negative

Prof Gad Alon
Prof Gad Alon

I am not aware of the source of what appear to be a biased opinions of the above comments. Today's reality is that many children and babies can respond very favorably to neuromuscular electrical stimulation. But whether any baby-toddler is a candidate to stimulation can only be determined by individual screening done by a competent PT or OT familiar with how, why, and when to add stimulation to the training program. Below is selected references published in peer-reviewed journals.

Solopova, I. A. Sukhotina, I. A. Zhvansky, D. S. et al. Effects of spinal cord stimulation on motor functions in children with cerebral palsy. Neurosci Lett. 2017;639:192-198. (mean age 9 yrs) Musselman, K. E. Manns, P. Dawe, J. et al. The Feasibility of Functional Electrical Stimulation to Improve Upper Extremity Function in a Two-year-old Child with Perinatal Stroke: A Case Report. Phys Occup Ther Pediatr. 2017; 10.1080/01942638.2016.1255291 Lazzari, R. D. Politti, F. Belina, S. F. et al. Effect of Transcranial Direct Current Stimulation Combined With Virtual Reality Training on Balance in Children With Cerebral Palsy: A Randomized, Controlled, Double-Blind, Clinical Trial. 2016; 10.1080/00222895.2016.1204266 (mean age 7 yrs 6 month) Karabay, I. Dogan, A. Ekiz, T. et al. Training postural control and sitting in children with cerebral palsy: Kinesio taping vs. neuromuscular electrical stimulation. Complement Ther Clin Pract 2016;24:67-72. (mean age ??) Pool, D. Valentine, J. Bear, N. et al. The orthotic and therapeutic effects following daily community applied functional electrical stimulation in children with unilateral spastic cerebral palsy: a randomised controlled trial. BMC Pediatr 2015;15: 10.1186/s12887-015-0472-y (mean age 10 yrs 3 month)

wellnessproworldwide253
wellnessproworldwide253

Maria, I have a granddaughter that was born with "low muscle tone". She is now 3 years 9 months. Your sons symptoms are very similar to hers. She crawled and walked late, but is walking very good now, although not 100%. She is not talking, but saying some words. She has been in physical therapy, occupational therapy and speech therapy, twice a week, for over 2 years and has that been the absolute best thing to do. Every test imaginable has been done and doctors still cannot give a diagnosis. Low muscle tone is a symptom and she is developmentally delayed. The latest brain imaging showed her brain is different and doesn't have as many folds or neurons as normal ones do. I think the physical therapy, along with you working with him at home is much better than TENS stimulation at this point. Diet and nutritional supplements are also important. I have been waiting for my granddaughter to begin talking so we can try "microcurrent" therapy and see if it might benefit. Microcurrent is similar to TENS, but 1000 times lower, so that it matches the electrical current in our body.

Prof Richard Liebano
Prof Richard Liebano

Dear Maria. I would not reccommend ES for him. It's uncomfortable and a more global intervention would be more appropriated.

Dr Maryam Almandil
Dr Maryam Almandil

Dear Maria Electrical stimulation is an effective treatment, there is massive evidence to support its efficacy with adults. In children, it was used to improve the range of movement, muscle strength and overall motor control. However, this treatment is cautiously advocated to children as young as 1 or 2 years, due to limited evidence. I have come across a couple of studies that have used electrical stimulation with children (between 1-2 years of age) to improve the ability to walk (Carmick, 1993) and to improve sitting posture (Park et al, 2001) and both have shown promising results and changes were seen readily within a short period of time compared to other children. Nevertheless, support is still needed for this age category given that electrical stimulation is not ideal for all children and the feeling during treatment will not be easily accepted by them. Additionally, the stimulation would have to be given at very low intensities which may affect its usefulness. Maryam

hellieju2003336
hellieju2003336

Hi Maria I think he will hate muscle stimulation. He’s too young to understand. Give him masses of stimulation in weight bearing. Standing and kneeling. Weight bearing normalises tone. Remember the more you put in the more he ll give back. Best wishes Helen

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