Electrical Stimulation Therapy in Children with Obstetric Brachial Plexus Injury: A Systematic Review

To provide an evidence-based review of the effects of electrical stimulation (ES) in children with obstetric brachial plexus injury (OBPI).A systematic literature search and review was performed using Medline, Embase, PEDro, and manual citation searching. Studies using ES applied to the skin resulting in muscle contraction in children (0-18 years) with OBPI were included. Quality assessment was performed using the Cochrane Collaboration Risk of Bias tool and the National Institute of Health Quality Assessment Tool. Outcomes were reported as range of motion, active movement scale, Mallet grading system, and side effects.Ten studies with a total of 388 participants were included: Five randomized controlled trials, three prospective interventional studies, and two retrospective studies. In most of them, ES was combined with conventional physiotherapy. No side effects were reported, and ES was well adhered. Improvements in at least one outcome measure were reported across the included studies following ES therapy. However, substantial heterogeneity existed regarding study design, ES application protocols, and reported outcomes.ES is well tolerated in children with OBPI. It may have a positive effect as part of a rehabilitation program, especially in combination with physiotherapy.