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Is electrical stimulation effective in preventing and/or reducing shoulder subluxation in children following stroke?

Prepared by:

Ashlee Doidge

Date:

January 2013

Review Date:

January 2015

Clinical Question:

Is electrical stimulation effective in preventing or reducing shoulder subluxation in children following stroke? 

Clinical Scenario:

Shoulder subluxation is reported to occur in up to 81% of adults following a stroke (Ada & Foongchomcheay, 2002, pg 257).  Limited literature currently exists regarding the prevalence of shoulder subluxation in children following an acquired brain injury. Based on clinical experience however, shoulder subluxation does occur in some children following a stroke and has a significant, and potentially long-term, impact on function. Therefore, it is of clinical importance to determine the best practice for prevention and management of shoulder subluxation in children.

Electrical stimulation (ES) is the use of an electrical current to stimulate a muscle contraction and produce movement. There is some evidence to support the use of ES to reduce shoulder subluxation in adults however less information exists regarding the use of ES with children.

The aim of this CAT was to review the current evidence for the use of ES in preventing or reducing shoulder subluxation in children.  

Clinical Bottom Line:

While strong evidence exists to support the use of ES in preventing shoulder subluxation in adults when applied in the first two months post stroke, no evidence was found that specifically addressed the effectiveness of ES in preventing and reducing shoulder subluxation in children. Additionally, less information is available about the aetiology of shoulder subluxation in children following stroke and the impact of ES on developing neurological and musculoskeletal systems. Therefore, results should be generalised with caution.

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