Use of Neuromuscular Electrical Stimulation in the Treatment of Neonatal Brachial Plexus Palsy: A Literature Review

Abstract

Background: The purpose of this study was to conduct a review of current literature on the effectiveness of neuromuscular electrical stimulation (NMES) for restoring motion and function in neonatal brachial plexus palsy (NBPP). Method: A database search was conducted for NMES articles published between 1947 and 2015. Pre and post-treatment data were extracted for muscle power, active range of motion (AROM), and morphometric measurements. Results: An initial search yielded 2,721 articles. A further title/abstract review produced 27 articles; of these, four met the inclusion criteria. Treatment protocols varied. There were no changes in average Medical Research Council (MRC) scores following treatment for elbow flexion, shoulder abduction, or wrist extension. Shoulder flexion increased from MRC 1 to 4. AROM improved following treatment. Conclusions: Evidence for improved muscle strength after NMES is mixed. Improvement in AROM is more consistent. Due to variations in treatment modalities, patient profiles, and adjunct treatment, a clinical trial to isolate the effects of NMES in NBPP is required. Since improved motion and function has been reported, NMES in NBPP therapy remains reasonable.

Keywords

• neonatal brachial plexus palsy
• neuromuscular electrical stimulation
• peripheral nerve injury
• systematic review