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Balance training versus reciprocal electrical stimulation on knee joint alignment in spastic diplegic cerebral palsy children

Original article


Background and purpose

Spastic diplegia is the most common pattern of motor impairment in patients with cerebral palsy (CP) because of a number of deficits, including poor muscle control, weakness, impaired balance, and spasticity, which cause malalignment of the knee joint during standing and walking. This study aimed to evaluate the effect of balance training (BT) versus reciprocal electrical stimulation (RES) of knee extensors and flexors on knee joint alignment in spastic diplegic CP children.

Materials and methods

Thirty children with spastic diplegic CP of both sexes were selected, ranging in age from 6 to 8 years. Children were divided randomly into two equal groups (I and II). Evaluation was performed before and after 12 weeks of treatment using a digital goniometer to measure range of motion of the knee joint, tape measurement to measure the distance between the buttock and the heel, and gross motor functional measure to provide functional evaluation of standing and walking abilities. Group I received a BT program on the Biodex balance system in addition to a selected physical therapy program. Group II received RES of knee extensors and flexors in addition to the same selected physical therapy program.


Both BT and RES for 12 weeks in spastic diplegic CP seem to yield a beneficial and statistically significant increase in adjusting knee alignment and improving the functional abilities in standing and walking (P < 0.05). However, BT seems to exert a more beneficially and statistically significant effect than RES.


BT and RES have a significant effect on improving knee alignment in spastic diplegic CP children.


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Correspondence to Wanees M. Badawya.

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Badawya, W.M., Ibrahimb, M.B. Balance training versus reciprocal electrical stimulation on knee joint alignment in spastic diplegic cerebral palsy children. Bull Fac Phys Ther 20, 146–153 (2015).

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  • balance
  • cerebral palsy
  • electrical stimulation
  • knee joint