A systematic review of electrical stimulation for pressure ulcer prevention and treatment in people with spinal cord injuries

The Journal of Spinal Cord Medicine, 2014 · DOI: 10.1179/2045772314Y.0000000226 · Published: January 1, 2014

Spinal Cord Injury Neurology Dermatology

Simple Explanation

Electrical stimulation (ES) may help prevent and treat pressure ulcers (PUs) in people with spinal cord injuries (SCIs). However, there aren't clear guidelines on how to use ES for PU management in SCI. This review looks at research on ES for PU prevention and treatment in SCI. It evaluates the devices and ES settings used, and how well ES works. The review found that ES can enhance PU healing, but the quality of the studies was generally poor. The variability in ES parameters makes it hard to recommend a standard approach.

Study Duration

Not specified

Participants

27 studies included in the review

Evidence Level

Systematic Review

Key Findings

1
ES enhanced PU healing in all 11 therapeutic studies, suggesting a positive effect of ES on wound closure.
2
The review identified two types of ES modalities used in therapeutic studies: surface electrodes and anal probes.
3
Four types of ES modalities were identified in preventive studies, including surface electrodes, ES shorts, sacral anterior nerve root implants, and neuromuscular ES implants.

Research Summary

This systematic review examined 27 studies on electrical stimulation (ES) for pressure ulcer (PU) prevention and treatment in people with spinal cord injuries (SCI). The review found that ES enhanced PU healing in therapeutic studies, but the methodological quality of the studies, particularly prevention studies, was generally poor. Due to the variability in ES parameters, stimulation locations, and outcome measures, the review concluded that it is difficult to advocate a standard approach for PU therapy or prevention and suggested future research to improve ES devices and standardize parameters.

Practical Implications

Enhancement of PU healing

ES can be considered as a therapeutic modality for enhancing pressure ulcer healing in SCI patients.

Need for standardized parameters

Future research should focus on determining optimal ES parameters and stimulation locations to confirm the beneficial effect on PU healing.

Improvement of ES devices

Future research should focus on improving the design of ES devices, particularly for PU prevention.

Study Limitations

1
Methodological quality of the studies was generally weak.
2
Great variability in ES parameters, stimulating locations, and outcome measures.
3
Limited Grade I evidence, particularly for prevention studies.

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