Neuromuscular Electrical Stimulation Improves Muscle Strength, Biomechanics of Movement, and Functional Mobility in Children With Chronic Neurological Disorders: A Systematic Review and Meta-Analysis

Abstract

Objective Chronic neurological disorders (CND) generally produce deleterious effects on the musculoskeletal system and can affect physical activity and increase sedentary behavior in children, hindering the execution of training programs and the attainment of a correct dose of exercise. The purpose of this systematic review is to analyze the effect of NMES on skeletal muscle and then on biomechanics of movement, functional mobility, strength, spasticity, muscle architecture, and body composition of children and adolescents with CND and chronic diseases. Methods The search was conducted in April 2020 on PubMed, MEDLINE, Scopus, the Cochrane Library, and Web of Science, without publication period restriction. Publications investigating the effect of NMES on children and adolescents with CND and other chronic diseases were independently selected by 2 researchers. One author independently extracted data from the studies selected, and a second author cross-checked. Eighteen studies with 595 participants aged between 3 and 14 years were included. Quality assessment showed that 50% of the studies presented a low risk of bias. The pooled effect of NMES on gross motor functional measure (GMFM), calculated as a standardized mean difference (SMD) using a random effects model, was 0.41 (95% CI = 0.19 to 0.64). Conclusion The use of NMES programs for children diagnosed with cerebral palsy, spinal muscular atrophy, and obstetric injury of the brachial plexus were effective in improving muscle strength, biomechanics of movement, and functional mobility. Impact Neuromuscular electrical stimulation (NMES) can be a useful tool to prevent the reduction of mobility that results from CND.

Efficacy of neuromuscular electrical stimulation and interrupted serial casting in children with spastic diplegia

“…Applying NMES during the casting periods in our study helped counteract the significant decrease in strength, thus resulting in improved gait function. These findings are further supported by Cobo-Vicente et al., 42 who have reported that NMES enhances muscle strength, functional mobility, and movement biomechanics in children with CP. Furthermore, recent evidence from systematic reviews and other studies supports using NMES for strengthening in individuals with spastic CP, to improve mobility and gross motor function, and safely induce restorative changes.…”

Determining the Algorithm of Rehabilitation Procedures in Patients with Brachial Plexus Injuries Based on the Prospective Single-Centre Clinical Neurophysiology Studies: Preliminary Results

“…Rehabilitation should incorporate the treatment supporting nerve regeneration, muscle strengthening, and maintaining functional ranges of motion of the injured extremities. It comprises the neuromuscular electrical stimulation (NMES) [12,34,35]. Contemporary researches show that NMES increases the strength of stimulated muscles, thereby preventing atrophy while waiting for the results of axonal regeneration.…”

Effects of Peripheral Electromagnetic Fields on Spasticity: A Systematic Review

“…When compared to other types of electrotherapy that have been shown to be effective in improving spasticity such as neuromuscular electrical stimulation NMES [55,56], RPMSinduced pain is significantly less than NMES-induced pain, even when using the same stimulation intensity [57]. Therefore, RPMS simultaneously provides stronger stimulation than NMES and limits pain [58].…”