Can External Neuromodulation Garments Improve Gait and Function in Children With Cerebral Palsy? A Prospective Single-Arm Study.

Introduction: The Exopulse Mollii Suit is an external electrical stimulation garment that is designed to reduce spasticity through electrical stimulation of targeted muscles. Our aims were to study the impact of the garment in improving gait and function in children with cerebral palsy (CP).

Methods: Individuals aged 4-18 years with spastic CP, Gross Motor Function Classification System level I-III were included for a prospective single-arm study from January 2021 to January 2022. Participants wore the suit for 4 weeks 60 min a day. Outcome measures taken pre, post and 1-month-post intervention included: 3D gait analysis (gait profile score, gait deviation index and temporo-spatial parameters), gross motor function measure-88 (GMFM-88), EQ-5D-Y, compliance rate, adverse event and satisfaction. Paired -test was used for data analysis to compare measurement time points.

Results: Twenty children (median age 7 [range: 4-16; interquartile range: 3.1] years, 55% female, 45% male were recruited. Post-intervention results showed there was no improvement in the gait profile but there was an improving trend in temporo-spatial parameters GMFM Domain C improved significantly ( = 0.03). Improvement in EQ-5D- Y was significant ( = 0.04). Compliance rate was 95% and nil major adverse event was reported. The majority (75%,  = 15) of parents and participants perceived overall positive experience.

Conclusion: The positive changes in gait profile and function were no longer significant at 1-month post-intervention. Further studies with a longer intervention period and concurrent strengthening program are required.

Implications For Physiotherapy Practice: Using the Molli Suit for 60 min a day for 4 weeks, may be useful in improving:(1) Gait cadence in children with CP. (2) Gross motor function in terms of crawling and kneeling in children with CP.