# Effectiveness of Electrical Stimulation on Upper Limb Function in Children and Young People with Hemiplegic Cerebral Palsy: A Systematic Review

## TL;DR

This review examines how electrical stimulation techniques may help improve upper limb function in children and young people with hemiplegic cerebral palsy.

## Contribution

The study systematically evaluates multiple types of electrical stimulation and their effectiveness in this specific patient group.

## Key findings

- Functional electrical stimulation (FES) shows potential for improving upper limb function.
- Transcutaneous electrical nerve stimulation (TENS) and neuromuscular electrical stimulation (NMES) also demonstrate potential, especially when combined with other interventions.
- Transcranial direct current stimulation (tDCS) outcomes are inconsistent due to variability in reporting.

## 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.