The role of transcutaneous electrical nerve stimulation (TENS) in rehabilitation of cerebral palsy: a systematic review

Cerebral palsy (CP) is one of the most important causes of disability across the globe. Transcutaneous electrical nerve stimulation (TENS) has been proposed as a potential adjunct therapy. This systematic review aims to explore the application of TENS in the rehabilitation of individuals with CP. Methods: A comprehensive literature search was conducted across multiple databases for studies published up to December 2023. Inclusion criteria encompassed clinical studies that evaluated the effects of TENS on rehabilitation outcomes in individuals with CP. Data were extracted and synthesized in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of the included studies was assessed using the appropriate Joanna Briggs Institute (JBI) checklist based on the study design. A total of 11 studies were eligible for entering this systematic review. Studies reported the application of TENS for different CP-induced conditions, including motor function, spasticity, and gait. Following the administration of TENS in CP patients, an overall favorable trend with few to no side effects was reported. Nevertheless, most of the included studies were of low to moderate quality. Although this review offers a comprehensive examination of the use of TENS in CP rehabilitation, the scarcity of high-quality studies indicates that further research is necessary to confirm its efficacy in this population.脑瘫（Cerebral palsy, CP）是全球范围内导致残疾的最重要原因之一。经皮神经电刺激（Transcutaneous electrical nerve stimulation, TENS）被提出作为一种潜在的辅助治疗手段。本系统综述旨在探讨经皮神经电刺激在脑瘫患者康复治疗中的应用价值。研究方法：本研究通过多数据库全面检索截至2023年12月发表的相关文献，纳入标准为评估经皮神经电刺激对脑瘫患者康复结局影响的临床研究。研究数据的提取与合成严格遵循《系统综述与荟萃分析优先报告条目》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses, PRISMA）规范，并根据研究设计类型，采用乔安娜·布里格斯研究所（Joanna Briggs Institute, JBI）对应的质量评价量表对纳入研究的方法学质量进行评估。最终共有11项研究符合纳入标准，进入本次系统综述。纳入研究涵盖了经皮神经电刺激针对脑瘫引发的不同功能障碍的应用场景，包括运动功能、痉挛状态与步态。脑瘫患者接受经皮神经电刺激治疗后，整体呈现出积极的康复趋势，且不良反应极少甚至未出现。但值得注意的是，大部分纳入研究的方法学质量处于低至中等水平。尽管本综述全面梳理了经皮神经电刺激在脑瘫康复中的应用现状，但由于高质量研究较为匮乏，仍需开展更多相关研究以证实其在该人群中的临床疗效。