Electrical stimulation treatment on cerebral palsy: gross motor function measure, passive activity of ankle joint and foot dorsiflexion angle

doi:10.3969/j.issn.2095-4344.2015.09.027

Abstract

Abstract:

BACKGROUND: There are a variety of therapeutic strategies for cerebral palsy, electrical stimulation has been regarded as a potential treatment of cerebral palsy. However, systemic evaluation of electrical stimulation in treatment of cerebral palsy is rarely reported.
OBJECTIVE: To evaluate the effect of electrical stimulation on gross motor function measure, passive activity of ankle joint and foot dorsiflexion angle of cerebral palsy patients.
METHODS: A computer-based online retrieval of Wanfang Database, VIP Database for Chinese Technical Periodicals, CNKI Database, Chinese Biomedical Literature Database, PubMed Database, and Ovid Database was performed for randomized controlled trials with comparable baseline and clear diagnosis. The quality of the literatures was strictly evaluated using RevMan5.1 software according to the Cochrane Reviewer’s Handbook.
RESULTS AND CONCLUSION: Eventually 8 papers were included in the Meta analysis. Meta analysis results showed that, electrical stimulation treatment was better than simple rehabilitation in the improvement of patient’s sialorrhea (OR=8.37, 95%CI: 2.86-24.51, P=0.000 1), the degree of gastrocnemius spasm (OR=-0.62, 95%CI: -0.84 to -0.41, P < 0.000 01), gross motor function score in D area (standing) (OR=9.86, 95%CI: 1.70-18.02, P=0.02), gross motor function score in E area (going, running, jumping) (OR=9.54, 95%CI: 7.47-11.62, P < 0.000 01), and the ability to walk (OR=6.12, 95%CI: 3.65-8.58, P < 0.000 01). Our findings indicate that, electrical stimulation is an effective treatment on cerebral palsy, it could improve gross motor function measure, passive activity of ankle joint and foot dorsiflexion angle of cerebral palsy patients. The therapeutic effect is more obvious combined with rehabilitation therapy.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: Cerebral Palsy, Electrical Stimulation, Treatment, Recovery, Meta Analysis

CLC Number:

R318

Miao Wei, Lu Xia, Mu Ta Li-fu, Ai Ke Bai-er, Mai Er A-ba, Yan Bao-feng, Luan Xin-ping. Electrical stimulation treatment on cerebral palsy: gross motor function measure, passive activity of ankle joint and foot dorsiflexion angle[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(9): 1470-1476.

Figures/Tables 5

2.3 Meta分析结果 2.3.1 流涎情况的改善符合纳入标准的8篇文献中，郑钦等[14]与段华林等[12]的研究报道对比了电刺激+常规康复治疗与单纯常规康复治疗患者流涎的改善情况，共108例，其中实验组有55例，对照组有53例，各研究间无异质性(χ2=0.50，P=0.48)。因此采用固定效应模式，合并结果显示，有电刺激的实验组治疗患者流涎评分(TDS)的改善率要高于单纯康复治疗的对照组，两者比较差异有显著性意义(OR=8.37，95%CI：2.86-24.51，P=0.000 1)，见图1。 2.3.2 腓肠肌痉挛程度的改善符合纳入标准的8篇文献中，张进华等[11]、高晶等[13]、原黎君等[15]和李靖婕等[17]的研究报道对比了电刺激+常规康复治疗与单纯常规康复治疗患者的腓肠肌肌张力改善情况，共145例，其中实验组有74例，对照组有71例，各研究间存在异质性(χ2=11.71，P=0.008)。各研究间存在异质性，因此采用随机效应模式，合并结果显示，有电刺激的实验组治疗患者腓肠肌肌张力的改善率要高于单纯康复治疗的对照组，两者比较差异有显著性意义(OR=0.62，95%CI：-0.84至-0.41，P < 0.000 01)，见图2。 2.3.3 粗大运动(GMFM)的改善情况符合纳入标准的8篇文献中，张进华等[11]、原黎君等[15]和李靖婕等[17]的研究报道对比了电刺激+常规康复治疗与单纯常规康复治疗患者粗大运动功能中的D区(站立)功能及E区(走跑跳)功能改善情况，共121例患者，其中实验组有62例，对照组有59例。粗大运动功能中的D区(站立)功能评分的研究之间存在异质性(χ2=23.78，P < 0.000 01)，因此采用随机效应模式；粗大运动功能中的E区(走跑跳)功能评分的研究之间无异质性(χ2=1.02，P=0.60)，因此采用固定效应模式。两者的合并结果最终显示，有电刺激的实验组治疗患者粗大运动能力的改善率要高于单纯康复治疗的对照组，两者的实验组与对照组比较差异均有显著性意义，D区(站立)功能评分(OR=9.86，95%CI：1.70-18.02，P=0.02)，见图3；E区(走跑跳)功能评分(OR=9.54，95%CI：7.47-11.62，P < 0.000 01)，见图4。"

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