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Functional electrical stimulation of the ankle dorsiflexors during walking in spastic cerebral palsy: A systematic review

Developmental Medicine & Child Neurology Aug 22, 2017

Moll I, et al. – This systematic review aimed to evaluate the effect of functional electrical stimulation (FES) of ankle dorsiflexors in children and adolescents with spastic cerebral palsy (CP) during walking. The authors found insufficient data supporting functional gain by FES on activity and participation level. However, in children with spastic CP, evidence pointed towards a role for FES as an alternative to orthoses.

Methods
  • The authors performed a systematic review using the American Academy of Cerebral Palsy and Developmental Medicine methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
  • They searched 6 databases for studies applying interventions to patients aged younger than 20 years.
  • They classified outcomes according to the International Classification of Functioning, Disability and Health (ICF).

Results
  • The authors found 780 abstracts, 35 articles were fully screened, and 14 articles were used for analysis.
  • Only 5 articles (three studies) were of level I to III evidence.
  • There was limited evidence for a decrease in self-reported frequency of toe-drag and falls at ICF participation and activity level.
  • There was clear evidence (I–III) that FES increased (active) ankle dorsiflexion angle, strength, and improved selective motor control, balance, and gait kinematics, but decreased walking speed at ICF body structure and function level.
  • Skin irritation, toleration, and acceptation issues were included as adverse events.
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