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It is well documented that children with cerebral palsy have atrophy of the muscle fibers. In an individual with disuse atrophy, a contracting muscle uses the strongest fibers, and because the weakened fibers do not get a chance to respond, they deteriorate further. Under microscopic examination, atrophied fibers have decreased cytoplasm (cell substances responsible for function) and little to no actin and myosin (contractile elements of the muscle fiber cell).

In theory, TES attempts to reverse this atrophied process by stimulating the blood flow to atrophied muscles in the area being stimulated. The bloodstream delivers growth factors and nutrients necessary for the body to repair tissue. These substances are most concentrated in the bloodstream during sleep. Stimulating the muscle area at night will increase blood flow, and therefore, more nutrients will be delivered to the targeted muscle fibers. This allows for the atrophied fibers to repair themselves and grow. Under the microscope there is an increased amount of cytoplasm seen and regrowth of actin and myosin after treatment with TES. This new growth of the atrophied fibers takes about three to six months. After that time increased muscle strength and improved functional abilities can be seen.