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.

中文翻译：

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神经肌肉电刺激改善脑瘫患儿的总体运动功能：一项荟萃分析。

目的

要系统地审查神经肌肉电刺激（NMES）作为改善痉挛性脑瘫患儿总体运动功能的辅助疗法的有效性。

方法

搜索MEDLINE，EMBASE，Cochrane CENTRAL，PEDro和Scopus。我们纳入了随机对照试验，研究了NMES联合其他疗法对总运动功能的影响，并通过总运动功能量度（GMFM）及其功能尺寸进行了评估。两名审查员独立筛选，提取数据，评估偏倚风险（PEDro）和证据质量（GRADE）。

结果

 荟萃分析包括六项随机对照试验（合并n = 174）。与传统的物理疗法或神经发育疗法相比，NMES与其他疗法的结合具有中等效果，可改善脑瘫患儿的总体运动功能。我们的敏感性分析表明，NMES结合其他疗法可有效改善GMFM坐姿和站立姿势，但不能改善GMFM步行姿。

结论

低质量的证据表明，NMES可以用作辅助疗法，以改善痉挛性脑瘫患儿的GMFM坐姿和站立姿势。