Neuropediatrics 2023; 54(06): 381-387
DOI: 10.1055/a-2081-1560
Original Article

Electrical Stimulation for Children with Cerebral Palsy: A Meta-analysis for Randomized Controlled Trials

Yu Liu
1   Department of Pediatrics, Xuanwu Hospital Capital Medical University, Beijing, People's Republic of China
,
Hongzhi Li
1   Department of Pediatrics, Xuanwu Hospital Capital Medical University, Beijing, People's Republic of China
› Author Affiliations
Funding None.

Abstract

Background Different types of electrical stimulation (ES) showed diverse effects on children with cerebral palsy (CP). Previous studies reported inconsistent results for effects of ES on children with CP. The present study aimed to conduct a meta-analysis to summarize these diverse results.

Methods We searched for studies exploring effects of ES on children with CP in databases (PubMed and Web of Science) from their inception until December 2022. Standard mean differences (SMDs) and 95% confidence intervals (CIs) were computed using STATA 12.0 software.

Results The meta-analysis included 19 randomized controlled trials (including 265 CP patients in test group and 263 CP patients in corresponding control group). The study showed an increased improvement in gross motor function, walking speed, step length, and daily living activities in ES group compared with corresponding control group with random effects models (gross motor function: SMD = 2.04, 95% CI = 1.43–2.65; walking speed: SMD = 3.71, 95% CI = 1.49–5.92; step length: SMD = 1.89, 95% CI = 0.65–3.13; daily living activities: SMD = 5.18, 95% CI = 3.04–7.31), whereas the study showed no significant difference in change of muscle strength between ES group and the corresponding control group with a random effects model (SMD = 0.42, 95% CI = −0.12 to 0.97).

Conclusion The study demonstrated that ES might be used as therapy to improve gross motor function, gait, and daily living activities in children with CP.

Supplementary Material



Publication History

Received: 01 March 2023

Accepted: 21 April 2023

Accepted Manuscript online:
26 April 2023

Article published online:
24 July 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Oskoui M, Coutinho F, Dykeman J, Jetté N, Pringsheim T. An update on the prevalence of cerebral palsy: a systematic review and meta-analysis. Dev Med Child Neurol 2013; 55 (06) 509-519
  • 2 Keles MN, Elbasan B, Apaydin U, Aribas Z, Bakirtas A, Kokturk N. Effects of inspiratory muscle training in children with cerebral palsy: a randomized controlled trial. Braz J Phys Ther 2018; 22 (06) 493-501
  • 3 Balaban B, Yaşar E, Dal U, Yazicioğlu K, Tan AK, Kalyon TA. Effect of functional level on energy metabolism of children with cerebral palsy. FTR Turk Fizik Rehabil Derg 2006; 52 (01) 11-14
  • 4 van der Linden ML, Hazlewood ME, Aitchison AM, Hillman SJ, Robb JE. Electrical stimulation of gluteus maximus in children with cerebral palsy: effects on gait characteristics and muscle strength. Dev Med Child Neurol 2003; 45 (06) 385-390
  • 5 Armstrong EL, Boyd RN, Horan SA, Kentish MJ, Ware RS, Carty CP. Functional electrical stimulation cycling, goal-directed training, and adapted cycling for children with cerebral palsy: a randomized controlled trial. Dev Med Child Neurol 2020; 62 (12) 1406-1413
  • 6 Pool D, Elliott C, Bear N. et al. Neuromuscular electrical stimulation-assisted gait increases muscle strength and volume in children with unilateral spastic cerebral palsy. Dev Med Child Neurol 2016; 58 (05) 492-501
  • 7 Pool D, Valentine J, Bear N, Donnelly CJ, Elliott C, Stannage K. The orthotic and therapeutic effects following daily community applied functional electrical stimulation in children with unilateral spastic cerebral palsy: a randomised controlled trial. BMC Pediatr 2015; 15: 154
  • 8 Yıldızgören MT, Nakipoğlu Yüzer GF, Ekiz T, Özgirgin N. Effects of neuromuscular electrical stimulation on the wrist and finger flexor spasticity and hand functions in cerebral palsy. Pediatr Neurol 2014; 51 (03) 360-364
  • 9 van der Linden ML, Hazlewood ME, Hillman SJ, Robb JE. Functional electrical stimulation to the dorsiflexors and quadriceps in children with cerebral palsy. Pediatr Phys Ther 2008; 20 (01) 23-29
  • 10 Page MJ, McKenzie JE, Bossuyt PM. et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372 (71) n71
  • 11 Özen N, Unlu E, Karaahmet OZ, Gurcay E, Gundogdu I, Umay E. Effectiveness of functional electrical stimulation - cycling treatment in children with cerebral palsy. Malawi Med J 2021; 33 (03) 144-152
  • 12 Alhusaini AA, Fallatah S, Melam GR, Buragadda S. Efficacy of transcutaneous electrical nerve stimulation combined with therapeutic exercise on hand function in children with hemiplegic cerebral palsy. Somatosens Mot Res 2019; 36 (01) 49-55
  • 13 Mohanty P, Pattnaik M. Effect of neuromuscular electrical stimulation on gluteus maximus and quadriceps in cerebral palsy children with crouch gait. J Neurol Disord 2016; 4 (03) 272-275
  • 14 Karabay İ, Doğan A, Ekiz T, Köseoğlu BF, Ersöz M. Training postural control and sitting in children with cerebral palsy: Kinesio taping vs. neuromuscular electrical stimulation. Complement Ther Clin Pract 2016; 24: 67-72
  • 15 El-Shamy SM, Abdelaal AA. WalkAide efficacy on gait and energy expenditure in children with hemiplegic cerebral palsy: a randomized controlled trial. Am J Phys Med Rehabil 2016; 95 (09) 629-638
  • 16 Xu K, Wang L, Mai J, He L. Efficacy of constraint-induced movement therapy and electrical stimulation on hand function of children with hemiplegic cerebral palsy: a controlled clinical trial. Disabil Rehabil 2012; 34 (04) 337-346
  • 17 Karabay İ, Dogan A, Arslan MD, Dost G, Ozgirgin N. Effects of functional electrical stimulation on trunk control in children with diplegic cerebral palsy. Disabil Rehabil 2012; 34 (11) 965-970
  • 18 Kerr C, McDowell B, Cosgrove A, Walsh D, Bradbury I, McDonough S. Electrical stimulation in cerebral palsy: a randomized controlled trial. Dev Med Child Neurol 2006; 48 (11) 870-876
  • 19 Chan N, Smith AW, Lo SK. Efficacy of neuromuscular electrical stimulation in improving ankle kinetics during walking in children with cerebral palsy. Hong Kong Physiother J 2004; 22 (01) 50-56
  • 20 Park ES, Park CI, Lee HJ, Cho YS. The effect of electrical stimulation on the trunk control in young children with spastic diplegic cerebral palsy. J Korean Med Sci 2001; 16 (03) 347-350
  • 21 Steinbok P, Reiner A, Kestle JR. Therapeutic electrical stimulation following selective posterior rhizotomy in children with spastic diplegic cerebral palsy: a randomized clinical trial. Dev Med Child Neurol 1997; 39 (08) 515-520
  • 22 Pool D, Valentine J, Blackmore AM. et al. Daily functional electrical stimulation during everyday walking activities improves performance and satisfaction in children with unilateral spastic cerebral palsy: a randomized controlled trial. Arch Physiother 2015; 5: 5
  • 23 Stackhouse SK, Binder-Macleod SA, Stackhouse CA, McCarthy JJ, Prosser LA, Lee SC. Neuromuscular electrical stimulation versus volitional isometric strength training in children with spastic diplegic cerebral palsy: a preliminary study. Neurorehabil Neural Repair 2007; 21 (06) 475-485
  • 24 Salazar AP, Pagnussat AS, Pereira GA, Scopel G, Lukrafka JL. Neuromuscular electrical stimulation to improve gross motor function in children with cerebral palsy: a meta-analysis. Braz J Phys Ther 2019; 23 (05) 378-386
  • 25 Chen Y-H, Wang H-Y, Liao C-D, Liou T-H, Escorpizo R, Chen H-C. Effectiveness of neuromuscular electrical stimulation in improving mobility in children with cerebral palsy: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2023; 37 (01) 3-16
  • 26 Zhu Q, Gao G, Wang K, Lin J. Effect of functional electrical stimulation on gait parameters in children with cerebral palsy: a meta-analysis. Comput Math Methods Med 2022; 2022: 3972958
  • 27 El Shemy SA. Trunk endurance and gait changes after core stability training in children with hemiplegic cerebral palsy: a randomized controlled trial. J Back Musculoskeletal Rehabil 2018; 31 (06) 1159-1167
  • 28 Kerr C, McDowell B, McDonough S. Electrical stimulation in cerebral palsy: a review of effects on strength and motor function. Dev Med Child Neurol 2004; 46 (03) 205-213
  • 29 Ito J, Araki A, Tanaka H, Tasaki T, Cho K, Yamazaki R. Muscle histopathology in spastic cerebral palsy. Brain Dev 1996; 18 (04) 299-303