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Vol. 23. Issue 5.
Pages 378-386 (01 September 2019)
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Vol. 23. Issue 5.
Pages 378-386 (01 September 2019)
Systematic Review
DOI: 10.1016/j.bjpt.2019.01.006
Neuromuscular electrical stimulation to improve gross motor function in children with cerebral palsy: a meta-analysis
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Ana Paula Salazara,b, Aline Souza Pagnussata,b,c,
Corresponding author
alinespagnussat@gmail.com

Corresponding author at: Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite, 245, CEP: 90050-170, Porto Alegre, RS, Brazil.
, Gabriela Alves Pereirad, Gabriela Scopela, Janice Luisa Lukrafkaa,d
a Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
b Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
c Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
d Pediatrics Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil
Highlights

  • 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.

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Table 1. Summary of included studies.
Table 2. PEDro scores of included studies.
Table 3. Quality of evidence assessment (GRADE).
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Abstract
Objective

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.

Methods

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).

Results

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.

Conclusion

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.

Keywords:
Rehabilitation
Electrical stimulation
Systematic review
Child
Physical therapy modalities

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