Neuromuscular electrical stimulation to improve gross motor function in children with cerebral palsy: a meta-analysis

• Published in: Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Vol. 23; no. 5; pp. 378 - 386
• Main Authors: Salazar, Ana Paula, Pagnussat, Aline Souza, Pereira, Gabriela Alves, Scopel, Gabriela, Lukrafka, Janice Luisa
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier Editora Ltda 01-09-2019; Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia
• Subjects: Child; Electrical stimulation; Physical therapy modalities; Rehabilitation; Systematic Review; Electrical stimulation; Systematic review; Rehabilitation; Child; Physical therapy modalities
• ISSN: 1413-3555; 1809-9246
• DOI: 10.1016/j.bjpt.2019.01.006

•NMES might be used as adjuvant therapy to improve sitting and standing GMFM dimensions.•NMES is not better than PT alone to improve GMFM walking dimension.•Further research is still necessary to determine the precise effects of NMES on GMFM.
To systematically review the effectiveness of neuromuscular electrical stimulation (NMES) as an adjuvant therapy to improve gross motor function in children with spastic cerebral palsy.
MEDLINE, EMBASE, Cochrane CENTRAL, PEDro and Scopus were searched. We included randomized controlled trials examining the effects of NMES combined with other therapies on gross motor function as assessed by the Gross Motor Function Measure (GMFM) and its functional dimensions. Two reviewers independently screened, extracted data, assessed the risk of bias (PEDro) and quality of the evidence (GRADE).
Six randomized controlled trials (pooled n=174) were included in the meta-analysis. NMES combined with other therapies presented medium effect size to improve gross motor function in children with cerebral palsy in comparison with conventional physical therapy or neurodevelopmental therapy. Our sensitivity analysis showed that NMES combined with other therapies was effective to improve GMFM-sitting and standing dimensions but not GMFM-walking dimension.
Low-quality evidence suggests that NMES may be used as adjuvant therapy to improve sitting and standing dimensions of GMFM in children with spastic cerebral palsy.