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Neuromuscular electrical stimulation of upper limbs in patients with cerebral palsy: a systematic review and meta-analysis of randomized controlled trials [with consumer summary] |
Ou CH, Shiue CC, Kuan YC, Liou TH, Chen HC, Kuo TJ |
American Journal of Physical Medicine & Rehabilitation 2023 Feb;102(2):151-158 |
systematic review |
OBJECTIVE: The aim of the study is to assess the effects of neuromuscular electrical stimulation on the upper limbs of patients with cerebral palsy. DESIGN: We searched PubMed, Cochrane, Embase, and Scopus databases for randomized controlled trials examining the effects of neuromuscular electrical stimulation on the upper limbs of children with cerebral palsy. RESULTS: Eight randomized controlled trials (N = 294) were included in the meta-analysis. Compared with traditional physical therapy, sensorimotor training and task-oriented training, constraint-induced movement therapy, dynamic bracing, and conventional robot-assisted therapy, neuromuscular electrical stimulation in combination with these therapies resulted in significantly greater functional scale scores (standardized mean difference = 0.80, 95% confidence interval = 0.54 to 1.06), muscle strength of upper limbs (standardized mean difference = 0.57, 95 % confidence interval = 0.25 to 0.88), and spasticity of upper limbs (relative risk = 2.53, 95% confidence interval = 1.46 to 4.39, standardized mean difference = -0.18, 95 % confidence interval = -0.29 to -0.06) but did not improve the wrist range of motion (standardized mean difference = 0.43, 95 % confidence interval = -0.04 to 0.91). In addition, the effect of neuromuscular electrical stimulation on functional scale scores remained after 3-mo follow-up (standardized mean difference = 0.68 95 % confidence interval = 0.16 to 1.2). CONCLUSIONS: Neuromuscular electrical stimulation effectively improved hand function, muscle strength, and spasticity in patients with cerebral palsy.
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