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Effectiveness of Electrical Stimulation on Upper Limb Function in Children and Young People with Hemiplegic Cerebral
Omar Nahhas1,2, Sarah L Astill1, Samit Chakrabarty1
1School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK.
Insights
Electrical stimulation (ES) may aid upper limb rehabilitation for children with hemiplegic cerebral palsy (HCP). While some techniques show promise, more research is needed to confirm effectiveness and long-term benefits.
Area of Science:
- Neurorehabilitation
- Pediatric Physical Therapy
- Biomedical Engineering
Background:
- Hemiplegic cerebral palsy (HCP) significantly impacts upper limb function in children and young people (CYP).
- Electrical stimulation (ES) is an emerging therapeutic modality for motor function recovery.
Purpose of the Study:
- To systematically review the effectiveness of various electrical stimulation (ES) techniques for improving upper limb function in CYP with HCP.
- To assess the current evidence base and identify research gaps in ES for HCP rehabilitation.
Main Methods:
- A systematic literature search was performed up to May 2025.
- Included studies compared functional electrical stimulation (FES), TENS, NMES, TSCS, and tDCS for upper limb function in CYP with HCP.
- Eighteen studies (12 RCTs, 6 non-RCTs) were selected and quality assessed.
Main Results:
- Functional electrical stimulation (FES) showed potential for improving upper limb function, but requires more rigorous research.
- Transcutaneous electrical nerve stimulation (TENS) and neuromuscular electrical stimulation (NMES) may enhance upper limb function, especially with combined therapies.
- Variability in reporting transcranial direct current stimulation (tDCS) outcomes limits assessment of its efficacy.
Conclusions:
- Electrical stimulation (ES) shows promise as an adjunct therapy for upper limb rehabilitation in CYP with HCP.
- The overall evidence is limited due to small, underpowered studies lacking long-term follow-up.
- ES should be used cautiously within comprehensive rehabilitation plans.
Abstract:
Objectives: This review seeks to evaluate the effectiveness of electrical stimulation (ES) in improving upper limb function in children and young people (CYP) with hemiplegic cerebral palsy (HCP). Methods: A systematic literature search from inception until May 2025 was conducted. Various study designs comparing the effect of different ES techniques such as functional electrical stimulation (FES), transcutaneous electrical nerve stimulation (TENS), neuromuscular electrical stimulation (NMES), transcutaneous spinal cord stimulation (TSCS), and transcranial direct current stimulation (tDCS) on upper limb function in CYP with HCP were included. Results: Eighteen studies were selected for review and quality assessment, comprising twelve randomised controlled trials (RCTs) and six non-RCTs. FES was shown to improve upper limb function, though more rigorous and controlled research is needed. Both TENS and NMES demonstrate potential to improve upper limb function, particularly when combined with other interventions. The analysis suggests that variability in reporting tDCS outcomes hinders assessment of its potential benefits for improving upper limb function. Conclusions: Current research suggests ES may support upper limb rehabilitation in CYP with HCP, though the overall evidence remains limited. Most studies are small, underpowered, and lack long-term follow-up, limiting confident conclusions. ES should therefore be applied cautiously and only as part of a comprehensive rehabilitation plan.
