神经肌肉电刺激改善脑瘫儿童粗大运动功能的Meta 分析。
Neuromuscular electrical stimulation to improve gross motor function in children with cerebral palsy: a meta-analysis.
机构信息
Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
出版信息
Braz J Phys Ther. 2019 Sep-Oct;23(5):378-386. doi: 10.1016/j.bjpt.2019.01.006. Epub 2019 Jan 23.
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.
目的
系统评价神经肌肉电刺激（NMES）作为辅助治疗手段，改善痉挛型脑瘫儿童粗大运动功能的疗效。
方法
检索 MEDLINE、EMBASE、Cochrane 中心、PEDro 和 Scopus。我们纳入了评估 NMES 联合其他治疗对粗大运动功能影响的随机对照试验，采用粗大运动功能测量量表（GMFM）及其功能维度进行评估。两位评审员独立筛选、提取数据、评估偏倚风险（PEDro）和证据质量（GRADE）。
结果
纳入的 6 项随机对照试验（汇总 n=174）进行了荟萃分析。与常规物理疗法或神经发育疗法相比，NMES 联合其他疗法对脑瘫儿童粗大运动功能的改善具有中等效应量。我们的敏感性分析表明，NMES 联合其他疗法对 GMFM-坐位和站位维度的改善有效，但对 GMFM-行走维度无效。
结论
低质量证据表明，NMES 可作为辅助治疗手段，改善痉挛型脑瘫儿童 GMFM 的坐位和站位维度。
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