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Muscle bulk is apparent three to six months after starting the TES program. During the following months, functional changes can be seen. There have also been reports of improvement in bowel control. This is thought to be due to improved abdominal tone and better ability to push and evacuate the bowels. Some parents of severely involved children report that their children sleep better through the night when they use TES.

The use of TES is relatively new; therefore, research material is limited. One criticism of the TES program is that the majority of research has been done by Dr. Pape. However, as TES has become more popular, other centers have begun formal research studies.

Dr. Pape reported on 61 subjects with the diagnosis of moderate spastic diplegia at the Canadian Congress of Neurological Sciences in Winnipeg in 1992. These children had been treated with TES for one or more years. All participants were ambulators with the help of a walker, crutches or canes. Using the Progressive Ambulation Scale, 66 percent changed one or more levels. Twenty-one percent moved into the category of mildly affected, becoming community ambulators.

An independent peer-reviewed abstract was presented at the American Academy of Physical Medicine and Rehabilitation Annual Meeting in 1995 by Drs. Gaebler-Spira, Richman, Selber and Dias from the Rehabilitation Institute of Chicago and Children's Memorial Hospital. They reported on two children with right hemiplegia who used TES on the quadriceps and anterior tibialis muscles. Using three-dimensional gait analysis, one child demonstrated improved kinematics (movement patterns) of the knee with better leg extension (straightness) in early to mid-stance phases (period leg is bearing body's weight during gait cycle) of walking. The second child demonstrated decreases, inappropriate calf muscle, decreased knee flexion during stance and less tripping. The positive outcome of the above pilot study has prompted a larger, formal research study.

Another independent peer-reviewed abstract was presented at the 23rd annual meeting of the International Society of Pediatric Neurosurgery in Santiago, Chile, in September 1995 by Steinbok, Reiner and Kestle. Children who were at least one year post rhizotomy were randomized into two groups: one group receiving TES for one year, and one group not receiving TES for one year. The outcome measure used was the Gross Motor Function Measure (GMFM). There was a statistically significant and clinically important difference in outcome for the children receiving TES. The mean change in the GMFM in the TES group was 5.5 percent; it was 1.9 percent for the non-TES group. The 3.6 percent difference in the means was clinically significant.