{rfName}
Ne

License and Use

Icono OpenAccess

Altmetrics

Impact on the Sustainable Development Goals (SDGs)

Analysis of institutional authors

San Juan, AfCorresponding AuthorPerez-Ruiz, MAuthor

Share

January 8, 2026
Publications
>
Review

Neuromuscular Electrical Stimulation Improves Muscle Strength, Biomechanics of Movement, and Functional Mobility in Children With Chronic Neurological Disorders: A Systematic Review and Meta-Analysis

Publicated to: PHYSICAL THERAPY. 101 (10): - 2021-10-01 101(10), DOI: 10.1093/ptj/pzab170

Authors:

Cobo-Vicente, F; San Juan, AF; Larumbe-Zabala, E; Estévez-González, AJ; Donadio, MVF; Pérez-Ruiz, M
[+]

Affiliations

Pontificia Univ Catolica Rio Grande Sul PUCRS, Ctr Infant, Lab Pediat Phys Act, Porto Alegre - Author
Univ Europea Madrid, Fac Sport Sci - Author
Univ Politecn Madrid, Fac Phys Act & Sport Sci INEF, Dept Hlth & Human Performance, Sport Biomech Lab - Author
See more

Abstract

Objective: Chronic neurological disorders (CNDs) generally produce deleterious effects on the musculoskeletal system and can affect physical activity and increase sedentary behavior in children, hindering the execution of training programs and the attainment of a correct dose of exercise. The purpose of this systematic review was to analyze the effect of neuromuscular electrical stimulation (NMES) on skeletal muscle and then on biomechanics of movement, functional mobility, strength, spasticity, muscle architecture, and body composition of children and adolescents with CNDs and chronic diseases. Methods: The search was conducted in April 2020 in PubMed, MEDLINE, Scopus, the Cochrane Library, and Web of Science, without publication period restriction. Publications investigating the effect of NMES on children and adolescents with CNDs and other chronic diseases were independently selected by 2 researchers. One author independently extracted data from the studies selected, and a second author cross-checked. Results: Eighteen studies with 595 participants aged between 3 and 14 years were included. Quality assessment showed that 50% of the studies presented a low risk of bias. The pooled effect of NMES on gross motor functional measure, calculated as a standardized mean difference using a random effects model, was 0.41 (95% CI = 0.19-0.64). Conclusion: The use of NMES programs for children diagnosed with cerebral palsy, spinal muscular atrophy, and obstetric injury of the brachial plexus was effective in improving muscle strength, biomechanics of movement, and functional mobility. Impact: NMES can be a useful tool to prevent the reduction of mobility that results from CNDs.
[+]

Keywords

botulinum-toxin-acerebral-palsychildchronic diseaseelectric stimulation therapyexercisegaitmanagementmotor competencemuscle strengthpostural controlAdolescentBiomechanical phenomenaBotulinum-toxin-aCerebral-palsyChildChild, preschoolChronic diseaseElectric stimulation therapyExerciseFemaleGaitGood health and well-beingHumansMaleManagementMuscle strengthMuscle weaknessNervous system diseasesPostural controlTreatment outcomeUpper-extremity spasticity

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal PHYSICAL THERAPY due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2021, it was in position 15/68, thus managing to position itself as a Q1 (Primer Cuartil), in the category Rehabilitation.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations from Scopus Elsevier, it yields a value for the Field-Weighted Citation Impact from the Scopus agency: 1.2, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 13, 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2026-04-27, the following number of citations:

  • WoS: 7
  • Scopus: 11
[+]

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-27:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 165.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 163 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 7.
  • The number of mentions on the social network X (formerly Twitter): 10 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
  • Assignment of a Handle/URN as an identifier within the deposit in the Institutional Repository: https://oa.upm.es/87413/

As a result of the publication of the work in the institutional repository, statistical usage data has been obtained that reflects its impact. In terms of dissemination, we can state that, as of

  • Views: 161
  • Downloads: 100
Continuing with the social impact of the work, it is important to emphasize that, due to its content, it can be assigned to the area of interest of ODS 3 - Ensure healthy lives and promote well-being for all at all ages, with a probability of 48% according to the mBERT algorithm developed by Aurora University.
[+]

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Brazil.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: Last Author (PEREZ RUIZ, MARGARITA).

the author responsible for correspondence tasks has been SAN JUAN FERRER, ALEJANDRO.

[+]

Project objectives

El presente estudio persigue los siguientes objetivos: analizar el efecto de la estimulación eléctrica neuromuscular (NMES) sobre el músculo esquelético en niños y adolescentes con trastornos neurológicos crónicos (CNDs); evaluar el impacto de NMES en la biomecánica del movimiento; determinar su influencia en la movilidad funcional y la fuerza muscular; caracterizar los efectos sobre la espasticidad, la arquitectura muscular y la composición corporal; y revisar sistemáticamente la evidencia disponible hasta abril de 2020 para establecer la eficacia de NMES en mejorar la función motora y prevenir la reducción de movilidad asociada a CNDs.
[+]

Most relevant results

Esta aportación consolida, con un enfoque sistemático y cuantitativo, un conocimiento previamente disperso sobre la estimulación eléctrica neuromuscular (EENM) en población pediátrica con trastornos neurológicos crónicos (TNC), un colectivo donde el deterioro musculoesquelético, la reducción de actividad física y el aumento del sedentarismo dificultan la prescripción de ejercicio. La revisión y metaanálisis demuestran mejoras significativas en la fuerza muscular, la biomecánica del movimiento y la movilidad funcional, aportando evidencia utilizable cuando el ejercicio voluntario es limitado. La innovación reside en integrar neurociencia, fisiología del ejercicio y tecnología aplicada para proponer una intervención segura, no invasiva y accesible, ampliando el paradigma de la rehabilitación pediátrica hacia soluciones tecnológicas transferibles al ámbito clínico y domiciliario. Prioridad temática. Los TNC en la infancia impactan la función motora, la participación y la calidad de vida, generando necesidades asistenciales de alto interés clínico y social. Este trabajo responde a esa prioridad al ofrecer una alternativa terapéutica factible que puede complementar o sustituir parcialmente programas de entrenamiento cuando existen barreras para el esfuerzo voluntario. Sus hallazgos sustentan decisiones en pediatría, rehabilitación y neurorrehabilitación, con potencial para reducir discapacidad, mejorar la participación escolar y familiar y promover estrategias de intervención temprana y equitativas. La relevancia se refuerza por su aplicabilidad práctica y por abrir líneas de investigación orientadas a optimizar parámetros de dosificación y a evaluar efectos sostenidos.
[+]

Awards linked to the item

The study was funded by Catedra Fundacion Asisa-UEM (2018/UEM50) and the 7th edition of the Neumomadrid Award. F. Cobo-Vicente and E. Larumbe-Zabala were supported by Santander FoundationEuropean University Foundation 2020. M.V.F. Donadio was supported by Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES) (001) and Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq).
[+]