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There is low level evidence to support the use of functional electric stimulation to enhance function in the upper limb of children with neurological conditions

Prepared by:

Erin Cleary, Alison Waite and Kathryn Asher
Occupational Therapy Department, Sydney Children’s Hospital
Network, Randwick Campus

Date:

May 2011

Review Date:

May 2013

Clinical Question:

What is the evidence that functional electrical stimulation/ electrical stimulation is effective in improving upper limb function in children with neurological conditions?

Clinical Scenario:

There are a range of neurological conditions that affect upper limb function in children including: stroke, cerebral palsy, brain injury, brain tumour and spinal cord injury. These conditions impact a child’s ability to perform activities of daily living and participate independently in age appropriate occupations. Current upper limb rehabilitation interventions for children include, but are not limited to, constraint induced therapy, bimanual treatment, goal directed training, neurodevelopmental therapy, functional retraining and reconditioning (Sakzewski, Ziviani & Boyd, 2009).

Functional electrical stimulation (FES) has been used widely in adult populations for upper limb retraining and is considered best practice for adults following stroke (National Stroke Foundation, 2010). Interestingly, FES is not routinely used in upper limb rehabilitation for children. There is however, emerging evidence to support the use of FES for children in the lower limb (Kang, Bang & Jung, 2007; Van der Linden, Hazlewood, Hillman & Robb, 2008). We aimed to evaluate the evidence for FES to promote upper limb function in children with neurological conditions.

Clinical Bottom Line:

There is no evidence to support or refute the use of FES to improve upper limb function in children with neurological conditions. Only one study (Wright, 2000) provided preliminary support for the use of FES to increase strength and range of movement in the upper limb for children. Further research is required to determine whether this improvement translates to increased functional performance.

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