Functional electrical stimulation of the ankle dorsiflexors during walking in spastic cerebral palsy: a systematic review
Aim To assess the effect of functional electrical stimulation (FES) of ankle dorsiflexors in children and adolescents with spastic cerebral palsy (CP) during walking. Method A systematic review was performed using the American Academy of Cerebral Palsy and Developmental Medicine methodology and the...
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| Veröffentlicht in: | Developmental medicine and child neurology 2017-12, Vol.59 (12), p.1230-1236 |
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| creator | Moll, Irene Vles, Johannes S H Soudant, Dan L H M Witlox, Adhiambo M A Staal, Heleen M Speth, Lucianne A W M Janssen‐Potten, Yvonne J M Coenen, Marcel Koudijs, Suzanne M Vermeulen, R Jeroen |
| description | Aim
To assess the effect of functional electrical stimulation (FES) of ankle dorsiflexors in children and adolescents with spastic cerebral palsy (CP) during walking.
Method
A systematic review was performed using the American Academy of Cerebral Palsy and Developmental Medicine methodology and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Six databases were searched for studies applying interventions to patients aged younger than 20 years. Outcomes were classified according to the International Classification of Functioning, Disability and Health (ICF).
Results
Seven hundred and eighty s were found, 35 articles were fully screened, and 14 articles were used for analysis. Only five articles (three studies) were of level I to III evidence. At ICF participation and activity level, there is limited evidence for a decrease in self‐reported frequency of toe‐drag and falls. At ICF body structure and function level, there is 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. Adverse events include skin irritation, toleration, and acceptation issues.
Interpretation
There are insufficient data supporting functional gain by FES on activity and participation level. However, evidence points towards a role for FES as an alternative to orthoses in children with spastic CP.
What this paper adds
Effects of functional electrical stimulation (FES) point towards a potential role as an alternative to orthoses for patients with spastic cerebral palsy (CP).
Some evidence for a decrease in self‐reported frequency of toe‐drag and falls with the use of FES in spastic CP.
Limited evidence for improvements in activity and participation in patients with spastic CP using FES.
Resumen
Estimulación eléctrica funcional de los dorsiflexores del tobillo durante la marcha en parálisis cerebral: una revisión sistemática
Objetivo
Evaluar el efecto de la estimulación eléctrica funcional (FES) de los dorsiflexores de tobillo en niños y adolescentes con parálisis cerebral espástica, durante la marcha.
Método
Se realizo una revisión sistémica utilizando la metodología de la Academia Americana de Parálisis Cerebral y Medicina del Desarrollo (AACPDM), y las pautas de las guías para revisiones sistemáticas y meta análisis (PRISMA). Se realizaron búsqueda en seis bases de datos de estudios que aplicaban intervenciones a paci |
| doi_str_mv | 10.1111/dmcn.13501 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1930486111</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1930486111</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3651-8bbce5047ebcc22934c904826ad72082298d0d83a0f022ed56b5d93ab8c674f3</originalsourceid><addsrcrecordid>eNp9kMtOwzAQRS0EoqWw4QOQlwgpxXZeDjtUKCDx2HQfOfYETJ2k2Aklf49DCku8uZbn-Gh0ETqlZE79uVSVrOc0jAndQ1MaJVnA0yjbR1NCKAtowtgEHTn3TggJkzg6RBPGOY3jlE5Rv-xq2eqmFgaDAdlaLf3VtbrqjBgGuClx-wZY1GsDWDXW6dLAl0-sOqvrV7wVZj2krrHbCP9VYgkWCutFG2Fcf4UFdr1roRLD0MKnhu0xOij9EE52OUOr5e1qcR88vtw9LK4fA-mXpQEvCgkxiVIopGQsCyOZkYizRKiUEe5fuCKKh4KUhDFQcVLEKgtFwWWSRmU4Q-ejdmObjw5cm1faSTBG1NB0LqdZ6HWJ79GjFyMqbeOchTLfWF0J2-eU5EPT-dB0_tO0h8923q6oQP2hv9V6gI7AVhvo_1HlN0-L51H6DeyaixU</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1930486111</pqid></control><display><type>article</type><title>Functional electrical stimulation of the ankle dorsiflexors during walking in spastic cerebral palsy: a systematic review</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Wiley Free Content</source><creator>Moll, Irene ; Vles, Johannes S H ; Soudant, Dan L H M ; Witlox, Adhiambo M A ; Staal, Heleen M ; Speth, Lucianne A W M ; Janssen‐Potten, Yvonne J M ; Coenen, Marcel ; Koudijs, Suzanne M ; Vermeulen, R Jeroen</creator><creatorcontrib>Moll, Irene ; Vles, Johannes S H ; Soudant, Dan L H M ; Witlox, Adhiambo M A ; Staal, Heleen M ; Speth, Lucianne A W M ; Janssen‐Potten, Yvonne J M ; Coenen, Marcel ; Koudijs, Suzanne M ; Vermeulen, R Jeroen</creatorcontrib><description>Aim
To assess the effect of functional electrical stimulation (FES) of ankle dorsiflexors in children and adolescents with spastic cerebral palsy (CP) during walking.
Method
A systematic review was performed using the American Academy of Cerebral Palsy and Developmental Medicine methodology and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Six databases were searched for studies applying interventions to patients aged younger than 20 years. Outcomes were classified according to the International Classification of Functioning, Disability and Health (ICF).
Results
Seven hundred and eighty s were found, 35 articles were fully screened, and 14 articles were used for analysis. Only five articles (three studies) were of level I to III evidence. At ICF participation and activity level, there is limited evidence for a decrease in self‐reported frequency of toe‐drag and falls. At ICF body structure and function level, there is 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. Adverse events include skin irritation, toleration, and acceptation issues.
Interpretation
There are insufficient data supporting functional gain by FES on activity and participation level. However, evidence points towards a role for FES as an alternative to orthoses in children with spastic CP.
What this paper adds
Effects of functional electrical stimulation (FES) point towards a potential role as an alternative to orthoses for patients with spastic cerebral palsy (CP).
Some evidence for a decrease in self‐reported frequency of toe‐drag and falls with the use of FES in spastic CP.
Limited evidence for improvements in activity and participation in patients with spastic CP using FES.
Resumen
Estimulación eléctrica funcional de los dorsiflexores del tobillo durante la marcha en parálisis cerebral: una revisión sistemática
Objetivo
Evaluar el efecto de la estimulación eléctrica funcional (FES) de los dorsiflexores de tobillo en niños y adolescentes con parálisis cerebral espástica, durante la marcha.
Método
Se realizo una revisión sistémica utilizando la metodología de la Academia Americana de Parálisis Cerebral y Medicina del Desarrollo (AACPDM), y las pautas de las guías para revisiones sistemáticas y meta análisis (PRISMA). Se realizaron búsqueda en seis bases de datos de estudios que aplicaban intervenciones a pacientes menores de 20 años, los resultados fueron clasificados de acuerdo a la Clasificación Internacional del funcionamiento de la discapacidad y de la Salud (CIF).
Resultados
Se encontraron 780 resúmene, se revisaron 35 artículos y 14 fueron utilizados para el análisis. Solo 5 artículos (3 estudios) fueron de nivel I a III de evidencia. En el nivel de estructura corporal y de función de la CIF, hay evidencia clara (nivel I‐II) de que la FES aumentó el ángulo de dorsiflexión del tobillo, la fuerza y el control motor selectivo, equilibrio y la cinemática de la marcha, pero disminuyo la velocidad de la marcha. Los eventos adversos incluyen irritación de la piel, problemas de aceptación y tolerancia .
Interpretación
No hay suficientes datos que apoyen la ganancia funcional en actividad y nivel de participación por la FES. Sin embargo, la evidencia apunta hacia un papel de la FES como alternativa a las prótesis en niños con parálisis cerebral espástica.
Resumo
Estimulação elétrica funcional dos dorsiflexores do tornozelo durante a marcha na paralisia cerebral espástica: uma revisão sistemática
Objetivo
Avaliar o efeito da estimulação elétrica funcional (FES) dos dorsiflexores do tornozelo em crianças e adolescentes com Paralisia Cerebral (PC) espástica, durante a marcha.
Método
Uma revisão sistemática foi realizada de acordo com a metodologia da Academia Americana de Paralisia Cerebral e Medicina do Desenvolvimento (AACPDM) e com as diretrizes do PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses). Seis bases de dados foram pesquisadas para identificar estudos que aplicaram intervenções em pacientes com idade inferior a 20 anos. Os resultados foram classificados de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF).
Resultados
780 resumos foram encontrados, 35 artigos foram selecionados para leitura na íntegra e 14 artigos foram utilizados para a análise. Apenas cinco artigos (três estudos) apresentaram nível de evidência de I a III. No domínio de Atividade e Participação da CIF, há evidência limitada de uma diminuição na freqüência auto‐relatada no arrastar a ponta do pé e nas quedas. No domínio de Estrutura e Função do Corpo da CIF, há evidência clara (I‐III) de que o FES aumentou o ângulo de dorsiflexão do tornozelo (ativa) e a força, melhorou o controle motor seletivo, o equilíbrio e a cinemática da marcha, mas diminuiu a sua velocidade. Eventos adversos incluem problemas como irritação de pele, tolerância e aceitação.
Interpretação
Os dados existentes são insuficientes para apoiar o ganho funcional, com o uso do FES, no domínio de Atividade e Participação. No entanto, evidências apontam para o papel do FES como uma alternativa às órteses em crianças com PC espástica.
What this paper adds
Effects of functional electrical stimulation (FES) point towards a potential role as an alternative to orthoses for patients with spastic cerebral palsy (CP).
Some evidence for a decrease in self‐reported frequency of toe‐drag and falls with the use of FES in spastic CP.
Limited evidence for improvements in activity and participation in patients with spastic CP using FES.
This article's has been translated into Spanish and Portuguese.
Follow the links from the to view the translations.
Video Podcast: https://www.youtube.com/watch?v=gaNaZnW4t00&t=1s</description><identifier>ISSN: 0012-1622</identifier><identifier>EISSN: 1469-8749</identifier><identifier>DOI: 10.1111/dmcn.13501</identifier><identifier>PMID: 28815571</identifier><language>eng</language><publisher>England</publisher><subject>Adolescent ; Ankle - physiopathology ; Cerebral Palsy - therapy ; Child ; Electric Stimulation Therapy - adverse effects ; Electric Stimulation Therapy - methods ; Humans ; Muscle, Skeletal - physiopathology ; Walking - physiology</subject><ispartof>Developmental medicine and child neurology, 2017-12, Vol.59 (12), p.1230-1236</ispartof><rights>2017 Mac Keith Press</rights><rights>2017 Mac Keith Press.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3651-8bbce5047ebcc22934c904826ad72082298d0d83a0f022ed56b5d93ab8c674f3</citedby><cites>FETCH-LOGICAL-c3651-8bbce5047ebcc22934c904826ad72082298d0d83a0f022ed56b5d93ab8c674f3</cites><orcidid>0000-0001-8465-675X ; 0000-0002-3908-4104</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdmcn.13501$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdmcn.13501$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,1428,27905,27906,45555,45556,46390,46814</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28815571$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moll, Irene</creatorcontrib><creatorcontrib>Vles, Johannes S H</creatorcontrib><creatorcontrib>Soudant, Dan L H M</creatorcontrib><creatorcontrib>Witlox, Adhiambo M A</creatorcontrib><creatorcontrib>Staal, Heleen M</creatorcontrib><creatorcontrib>Speth, Lucianne A W M</creatorcontrib><creatorcontrib>Janssen‐Potten, Yvonne J M</creatorcontrib><creatorcontrib>Coenen, Marcel</creatorcontrib><creatorcontrib>Koudijs, Suzanne M</creatorcontrib><creatorcontrib>Vermeulen, R Jeroen</creatorcontrib><title>Functional electrical stimulation of the ankle dorsiflexors during walking in spastic cerebral palsy: a systematic review</title><title>Developmental medicine and child neurology</title><addtitle>Dev Med Child Neurol</addtitle><description>Aim
To assess the effect of functional electrical stimulation (FES) of ankle dorsiflexors in children and adolescents with spastic cerebral palsy (CP) during walking.
Method
A systematic review was performed using the American Academy of Cerebral Palsy and Developmental Medicine methodology and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Six databases were searched for studies applying interventions to patients aged younger than 20 years. Outcomes were classified according to the International Classification of Functioning, Disability and Health (ICF).
Results
Seven hundred and eighty s were found, 35 articles were fully screened, and 14 articles were used for analysis. Only five articles (three studies) were of level I to III evidence. At ICF participation and activity level, there is limited evidence for a decrease in self‐reported frequency of toe‐drag and falls. At ICF body structure and function level, there is 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. Adverse events include skin irritation, toleration, and acceptation issues.
Interpretation
There are insufficient data supporting functional gain by FES on activity and participation level. However, evidence points towards a role for FES as an alternative to orthoses in children with spastic CP.
What this paper adds
Effects of functional electrical stimulation (FES) point towards a potential role as an alternative to orthoses for patients with spastic cerebral palsy (CP).
Some evidence for a decrease in self‐reported frequency of toe‐drag and falls with the use of FES in spastic CP.
Limited evidence for improvements in activity and participation in patients with spastic CP using FES.
Resumen
Estimulación eléctrica funcional de los dorsiflexores del tobillo durante la marcha en parálisis cerebral: una revisión sistemática
Objetivo
Evaluar el efecto de la estimulación eléctrica funcional (FES) de los dorsiflexores de tobillo en niños y adolescentes con parálisis cerebral espástica, durante la marcha.
Método
Se realizo una revisión sistémica utilizando la metodología de la Academia Americana de Parálisis Cerebral y Medicina del Desarrollo (AACPDM), y las pautas de las guías para revisiones sistemáticas y meta análisis (PRISMA). Se realizaron búsqueda en seis bases de datos de estudios que aplicaban intervenciones a pacientes menores de 20 años, los resultados fueron clasificados de acuerdo a la Clasificación Internacional del funcionamiento de la discapacidad y de la Salud (CIF).
Resultados
Se encontraron 780 resúmene, se revisaron 35 artículos y 14 fueron utilizados para el análisis. Solo 5 artículos (3 estudios) fueron de nivel I a III de evidencia. En el nivel de estructura corporal y de función de la CIF, hay evidencia clara (nivel I‐II) de que la FES aumentó el ángulo de dorsiflexión del tobillo, la fuerza y el control motor selectivo, equilibrio y la cinemática de la marcha, pero disminuyo la velocidad de la marcha. Los eventos adversos incluyen irritación de la piel, problemas de aceptación y tolerancia .
Interpretación
No hay suficientes datos que apoyen la ganancia funcional en actividad y nivel de participación por la FES. Sin embargo, la evidencia apunta hacia un papel de la FES como alternativa a las prótesis en niños con parálisis cerebral espástica.
Resumo
Estimulação elétrica funcional dos dorsiflexores do tornozelo durante a marcha na paralisia cerebral espástica: uma revisão sistemática
Objetivo
Avaliar o efeito da estimulação elétrica funcional (FES) dos dorsiflexores do tornozelo em crianças e adolescentes com Paralisia Cerebral (PC) espástica, durante a marcha.
Método
Uma revisão sistemática foi realizada de acordo com a metodologia da Academia Americana de Paralisia Cerebral e Medicina do Desenvolvimento (AACPDM) e com as diretrizes do PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses). Seis bases de dados foram pesquisadas para identificar estudos que aplicaram intervenções em pacientes com idade inferior a 20 anos. Os resultados foram classificados de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF).
Resultados
780 resumos foram encontrados, 35 artigos foram selecionados para leitura na íntegra e 14 artigos foram utilizados para a análise. Apenas cinco artigos (três estudos) apresentaram nível de evidência de I a III. No domínio de Atividade e Participação da CIF, há evidência limitada de uma diminuição na freqüência auto‐relatada no arrastar a ponta do pé e nas quedas. No domínio de Estrutura e Função do Corpo da CIF, há evidência clara (I‐III) de que o FES aumentou o ângulo de dorsiflexão do tornozelo (ativa) e a força, melhorou o controle motor seletivo, o equilíbrio e a cinemática da marcha, mas diminuiu a sua velocidade. Eventos adversos incluem problemas como irritação de pele, tolerância e aceitação.
Interpretação
Os dados existentes são insuficientes para apoiar o ganho funcional, com o uso do FES, no domínio de Atividade e Participação. No entanto, evidências apontam para o papel do FES como uma alternativa às órteses em crianças com PC espástica.
What this paper adds
Effects of functional electrical stimulation (FES) point towards a potential role as an alternative to orthoses for patients with spastic cerebral palsy (CP).
Some evidence for a decrease in self‐reported frequency of toe‐drag and falls with the use of FES in spastic CP.
Limited evidence for improvements in activity and participation in patients with spastic CP using FES.
This article's has been translated into Spanish and Portuguese.
Follow the links from the to view the translations.
Video Podcast: https://www.youtube.com/watch?v=gaNaZnW4t00&t=1s</description><subject>Adolescent</subject><subject>Ankle - physiopathology</subject><subject>Cerebral Palsy - therapy</subject><subject>Child</subject><subject>Electric Stimulation Therapy - adverse effects</subject><subject>Electric Stimulation Therapy - methods</subject><subject>Humans</subject><subject>Muscle, Skeletal - physiopathology</subject><subject>Walking - physiology</subject><issn>0012-1622</issn><issn>1469-8749</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRS0EoqWw4QOQlwgpxXZeDjtUKCDx2HQfOfYETJ2k2Aklf49DCku8uZbn-Gh0ETqlZE79uVSVrOc0jAndQ1MaJVnA0yjbR1NCKAtowtgEHTn3TggJkzg6RBPGOY3jlE5Rv-xq2eqmFgaDAdlaLf3VtbrqjBgGuClx-wZY1GsDWDXW6dLAl0-sOqvrV7wVZj2krrHbCP9VYgkWCutFG2Fcf4UFdr1roRLD0MKnhu0xOij9EE52OUOr5e1qcR88vtw9LK4fA-mXpQEvCgkxiVIopGQsCyOZkYizRKiUEe5fuCKKh4KUhDFQcVLEKgtFwWWSRmU4Q-ejdmObjw5cm1faSTBG1NB0LqdZ6HWJ79GjFyMqbeOchTLfWF0J2-eU5EPT-dB0_tO0h8923q6oQP2hv9V6gI7AVhvo_1HlN0-L51H6DeyaixU</recordid><startdate>201712</startdate><enddate>201712</enddate><creator>Moll, Irene</creator><creator>Vles, Johannes S H</creator><creator>Soudant, Dan L H M</creator><creator>Witlox, Adhiambo M A</creator><creator>Staal, Heleen M</creator><creator>Speth, Lucianne A W M</creator><creator>Janssen‐Potten, Yvonne J M</creator><creator>Coenen, Marcel</creator><creator>Koudijs, Suzanne M</creator><creator>Vermeulen, R Jeroen</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8465-675X</orcidid><orcidid>https://orcid.org/0000-0002-3908-4104</orcidid></search><sort><creationdate>201712</creationdate><title>Functional electrical stimulation of the ankle dorsiflexors during walking in spastic cerebral palsy: a systematic review</title><author>Moll, Irene ; Vles, Johannes S H ; Soudant, Dan L H M ; Witlox, Adhiambo M A ; Staal, Heleen M ; Speth, Lucianne A W M ; Janssen‐Potten, Yvonne J M ; Coenen, Marcel ; Koudijs, Suzanne M ; Vermeulen, R Jeroen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3651-8bbce5047ebcc22934c904826ad72082298d0d83a0f022ed56b5d93ab8c674f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Ankle - physiopathology</topic><topic>Cerebral Palsy - therapy</topic><topic>Child</topic><topic>Electric Stimulation Therapy - adverse effects</topic><topic>Electric Stimulation Therapy - methods</topic><topic>Humans</topic><topic>Muscle, Skeletal - physiopathology</topic><topic>Walking - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moll, Irene</creatorcontrib><creatorcontrib>Vles, Johannes S H</creatorcontrib><creatorcontrib>Soudant, Dan L H M</creatorcontrib><creatorcontrib>Witlox, Adhiambo M A</creatorcontrib><creatorcontrib>Staal, Heleen M</creatorcontrib><creatorcontrib>Speth, Lucianne A W M</creatorcontrib><creatorcontrib>Janssen‐Potten, Yvonne J M</creatorcontrib><creatorcontrib>Coenen, Marcel</creatorcontrib><creatorcontrib>Koudijs, Suzanne M</creatorcontrib><creatorcontrib>Vermeulen, R Jeroen</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Developmental medicine and child neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moll, Irene</au><au>Vles, Johannes S H</au><au>Soudant, Dan L H M</au><au>Witlox, Adhiambo M A</au><au>Staal, Heleen M</au><au>Speth, Lucianne A W M</au><au>Janssen‐Potten, Yvonne J M</au><au>Coenen, Marcel</au><au>Koudijs, Suzanne M</au><au>Vermeulen, R Jeroen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Functional electrical stimulation of the ankle dorsiflexors during walking in spastic cerebral palsy: a systematic review</atitle><jtitle>Developmental medicine and child neurology</jtitle><addtitle>Dev Med Child Neurol</addtitle><date>2017-12</date><risdate>2017</risdate><volume>59</volume><issue>12</issue><spage>1230</spage><epage>1236</epage><pages>1230-1236</pages><issn>0012-1622</issn><eissn>1469-8749</eissn><abstract>Aim
To assess the effect of functional electrical stimulation (FES) of ankle dorsiflexors in children and adolescents with spastic cerebral palsy (CP) during walking.
Method
A systematic review was performed using the American Academy of Cerebral Palsy and Developmental Medicine methodology and the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Six databases were searched for studies applying interventions to patients aged younger than 20 years. Outcomes were classified according to the International Classification of Functioning, Disability and Health (ICF).
Results
Seven hundred and eighty s were found, 35 articles were fully screened, and 14 articles were used for analysis. Only five articles (three studies) were of level I to III evidence. At ICF participation and activity level, there is limited evidence for a decrease in self‐reported frequency of toe‐drag and falls. At ICF body structure and function level, there is 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. Adverse events include skin irritation, toleration, and acceptation issues.
Interpretation
There are insufficient data supporting functional gain by FES on activity and participation level. However, evidence points towards a role for FES as an alternative to orthoses in children with spastic CP.
What this paper adds
Effects of functional electrical stimulation (FES) point towards a potential role as an alternative to orthoses for patients with spastic cerebral palsy (CP).
Some evidence for a decrease in self‐reported frequency of toe‐drag and falls with the use of FES in spastic CP.
Limited evidence for improvements in activity and participation in patients with spastic CP using FES.
Resumen
Estimulación eléctrica funcional de los dorsiflexores del tobillo durante la marcha en parálisis cerebral: una revisión sistemática
Objetivo
Evaluar el efecto de la estimulación eléctrica funcional (FES) de los dorsiflexores de tobillo en niños y adolescentes con parálisis cerebral espástica, durante la marcha.
Método
Se realizo una revisión sistémica utilizando la metodología de la Academia Americana de Parálisis Cerebral y Medicina del Desarrollo (AACPDM), y las pautas de las guías para revisiones sistemáticas y meta análisis (PRISMA). Se realizaron búsqueda en seis bases de datos de estudios que aplicaban intervenciones a pacientes menores de 20 años, los resultados fueron clasificados de acuerdo a la Clasificación Internacional del funcionamiento de la discapacidad y de la Salud (CIF).
Resultados
Se encontraron 780 resúmene, se revisaron 35 artículos y 14 fueron utilizados para el análisis. Solo 5 artículos (3 estudios) fueron de nivel I a III de evidencia. En el nivel de estructura corporal y de función de la CIF, hay evidencia clara (nivel I‐II) de que la FES aumentó el ángulo de dorsiflexión del tobillo, la fuerza y el control motor selectivo, equilibrio y la cinemática de la marcha, pero disminuyo la velocidad de la marcha. Los eventos adversos incluyen irritación de la piel, problemas de aceptación y tolerancia .
Interpretación
No hay suficientes datos que apoyen la ganancia funcional en actividad y nivel de participación por la FES. Sin embargo, la evidencia apunta hacia un papel de la FES como alternativa a las prótesis en niños con parálisis cerebral espástica.
Resumo
Estimulação elétrica funcional dos dorsiflexores do tornozelo durante a marcha na paralisia cerebral espástica: uma revisão sistemática
Objetivo
Avaliar o efeito da estimulação elétrica funcional (FES) dos dorsiflexores do tornozelo em crianças e adolescentes com Paralisia Cerebral (PC) espástica, durante a marcha.
Método
Uma revisão sistemática foi realizada de acordo com a metodologia da Academia Americana de Paralisia Cerebral e Medicina do Desenvolvimento (AACPDM) e com as diretrizes do PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses). Seis bases de dados foram pesquisadas para identificar estudos que aplicaram intervenções em pacientes com idade inferior a 20 anos. Os resultados foram classificados de acordo com a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF).
Resultados
780 resumos foram encontrados, 35 artigos foram selecionados para leitura na íntegra e 14 artigos foram utilizados para a análise. Apenas cinco artigos (três estudos) apresentaram nível de evidência de I a III. No domínio de Atividade e Participação da CIF, há evidência limitada de uma diminuição na freqüência auto‐relatada no arrastar a ponta do pé e nas quedas. No domínio de Estrutura e Função do Corpo da CIF, há evidência clara (I‐III) de que o FES aumentou o ângulo de dorsiflexão do tornozelo (ativa) e a força, melhorou o controle motor seletivo, o equilíbrio e a cinemática da marcha, mas diminuiu a sua velocidade. Eventos adversos incluem problemas como irritação de pele, tolerância e aceitação.
Interpretação
Os dados existentes são insuficientes para apoiar o ganho funcional, com o uso do FES, no domínio de Atividade e Participação. No entanto, evidências apontam para o papel do FES como uma alternativa às órteses em crianças com PC espástica.
What this paper adds
Effects of functional electrical stimulation (FES) point towards a potential role as an alternative to orthoses for patients with spastic cerebral palsy (CP).
Some evidence for a decrease in self‐reported frequency of toe‐drag and falls with the use of FES in spastic CP.
Limited evidence for improvements in activity and participation in patients with spastic CP using FES.
This article's has been translated into Spanish and Portuguese.
Follow the links from the to view the translations.
Video Podcast: https://www.youtube.com/watch?v=gaNaZnW4t00&t=1s</abstract><cop>England</cop><pmid>28815571</pmid><doi>10.1111/dmcn.13501</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8465-675X</orcidid><orcidid>https://orcid.org/0000-0002-3908-4104</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0012-1622 |
| ispartof | Developmental medicine and child neurology, 2017-12, Vol.59 (12), p.1230-1236 |
| issn | 0012-1622 1469-8749 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1930486111 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Wiley Free Content |
| subjects | Adolescent Ankle - physiopathology Cerebral Palsy - therapy Child Electric Stimulation Therapy - adverse effects Electric Stimulation Therapy - methods Humans Muscle, Skeletal - physiopathology Walking - physiology |
| title | Functional electrical stimulation of the ankle dorsiflexors during walking in spastic cerebral palsy: a systematic review |
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