Purpose: The incidence and mortality rates of arterial ischemic stroke (AIS) among pediatric patients have been frequently reported. While pediatric stroke can have multiple severe effects, its risk factors have not been methodically examined. This systematic review and meta-analysis were completed to summarize the existing evidence regarding risk factors for AIS in pediatric patients. Methods: To gather relevant articles published in the past 15 years, searches were conducted of PubMed and Scopus. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) were analyzed using Review Manager 5.4. Results: From the initial screening of 507 articles, five articles comprising a total of 1,423 participants were selected for qualitative analysis. Two of these additionally underwent quantitative analysis. Among the total participants, 1,108 children with AIS (77.9%) had arteriopathy as the underlying disease. Types of arteriopathy included moyamoya disease (24.28%), arterial dissection (23.29%), focal cerebral arteriopathy (16.16%), and vasculitis (14.71%). The meta-analysis revealed that being between 6 and 9 years of age (OR, 2.19; 95% CI, 1.76 to 2.73; P<0.00001) and having sickle cell disease (OR, 3.46; 95% CI, 2.38 to 5.05; P<0.00001) were associated with arteriopathy in pediatric AIS. Conclusion Arteriopathy is the most common risk factor for AIS in pediatric patients, and in turn, an age of 6 to 9 years and sickle cell disease are risk factors for arteriopathy within this demographic.

EMG-TRIGGERED NEUROMUSCULAR ELECTRICAL STIMULATION FOR MUSCULOSKELETAL REHABILITATION OF STROKE A decline in stroke-related mortality has led to an increased prevalence of post-stroke complications, globally. One of the most significant clinical effects of stroke are musculoskeletal problems. Musculoskeletal issues are typically induced by hemiplegia and they occur on the affected side. They also may not appear for weeks or months after a stroke. The most frequent musculoskeletal complications of stroke include motor loss, spasticity, shoulder discomfort, and wrist flexion contracture. Neuromuscular electrical stimulation (NMES) is a rehabilitation technique advised for stroke patients. NMES contracts muscles innervated by an external electrical stimulus, with or without patient participation (active or passive). There is evidence that NMES can strengthen muscles, reduce spasticity, increase corticospinal neural circuit excitability, and improve neuroplasticity. Electromyogram (EMG)-triggered NMES is a device that identifies subtle electrical EMG signals that remain discernible in paralyzed muscles after a stroke and utilizes these signals to trigger electrical stimulation impulses to the same paralyzed muscles, resulting in muscle movement. A study found that EMG-triggered NMES was superior to cyclic-NMES for increasing wrist extension and grip strength following the intervention.