Therapeutic effectiveness of functional electrical stimulation of ankle dorsiflexors during gait in children and adolescents with cerebral palsy: a systematic review
Main Article Content
Keywords
Cerebral Palsy, Functional Electrical Stimulation, Gait, Motor Skills
Abstract
Introduction: To quantify the therapeutic effectiveness of functional electrical stimulation (FES) applied to ankle dorsiflexor muscles in ambulatory children and adolescents with cerebral palsy (CP). Materials or Patients and Methods: A systematic review of randomized controlled trials (RCTs) was conducted in March 2022. RCTs including participants aged 2-18 years with spastic CP who received FES to the ankle dorsiflexors were selected, and outcomes were compared with any intervention or no intervention. The outcomes considered included gait speed, step length, balance, and gross motor function. Risk of bias was assessed using RoB 1. Results: The search yielded 427 articles, of which 25 were potentially eligible and were reviewed in full text. Of these 2 studies met the eligibility criteria. No therapeutic effects were observed for gait speed. A transient statistically significant effect favoring FES was observed for step length. For balance, three different analytical approaches were used; among these, statistically and clinically significant effects favoring FES were observed only for the Community Balance and Mobility Scale (CBMS). Conclusion: Current evidence suggests that FES may improve balance, but not other variables such as gait speed or gross motor function, in children with unilateral spastic CP. However, due to the scarcity and low methodological quality of the available studies, firm conclusions regarding its effectiveness cannot be drawn. At present, FES should be considered a potential adjunct rather than a substitute to conventional therapies. Higher-quality research is needed to confirm these findings.
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