Electrical stimulation therapy for the treatment of pressure ulcers in individuals with spinal cord injury: a systematic review and meta-analysis

International Wound Journal, 2016 · DOI: 10.1111/iwj.12446 · Published: January 1, 2016

Spinal Cord Injury Neurology Dermatology

Simple Explanation

This study investigates the effectiveness of electrical stimulation therapy (EST) in healing pressure ulcers in individuals with spinal cord injury (SCI). It compares EST to standard wound care (SWC) or sham EST. The researchers analyzed multiple studies to determine if EST helps in decreasing the size of pressure ulcers and increasing the likelihood of wound healing in SCI patients. The aim was also to understand patient adherence, impact on quality of life and pain relief, and economic impact of EST on the healthcare system.

Study Duration

Not specified

Participants

More than 500 persons with SCI were included in these reports

Evidence Level

Systematic Review and Meta-Analysis

Key Findings

1
EST significantly decreased pressure ulcer size by 1.32%/day compared to standard wound care or sham EST.
2
EST increased the risk of wound healing by 1.55 times compared with standard wound care or sham EST.
3
The overall methodological quality of the studies included in the meta-analysis was identified as low.

Research Summary

This systematic review and meta-analysis assessed the effect of electrical stimulation therapy (EST) on pressure ulcer healing in individuals with spinal cord injury (SCI). The meta-analysis, including eight controlled clinical trials, revealed that EST significantly decreased pressure ulcer size and increased the likelihood of wound closure compared to standard wound care (SWC) or sham EST. Despite the positive findings, the review highlights limitations such as low methodological quality and high heterogeneity across studies, suggesting caution in interpreting the results and a need for further research to optimize EST protocols.

Practical Implications

Adjunctive Therapy

EST can be used as an effective adjunctive therapy to accelerate and increase pressure ulcer closure in individuals with SCI.

Clinical Practice

Regulated health care providers can adapt to different EST programs depending on a patient's needs, as various treatment schedules can enhance pressure ulcer healing.

Future Research

Researchers should investigate the ideal EST treatment protocol, device-related adverse events, compliance rates, cost-effectiveness, and implications for pain relief and quality of life.

Study Limitations

1
Relatively limited number of studies met the inclusion criteria.
2
Small sample size of pressure ulcers and participants in each study.
3
Considerable variation in the EST intervention used, including stimulus parameters and treatment scheduling.

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