{"title":"Peripheral electrical stimulation on motor function and activities of daily living after stroke: A systematic review and network meta-analysis.","authors":"Yihao Zhou, Siyu Yang, Dongxia Li, Wenqiang Li, Chen Yang, Hong Huo, Shaojie Cai, Xingyan Zhu, Ruwen Zheng, Xu Dong, Dongyan Wang","doi":"10.1016/j.apmr.2025.01.466","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To compare the effects of different peripheral electrical stimulation protocols and current frequencies for post-stroke motor function and activities of daily living (ADL).</p><p><strong>Data sources: </strong>Seven databases (PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Database, Wan-Fang Database and Chinese Biomedical Database) were searched from inception to August 2024.</p><p><strong>Study selection: </strong>Two reviewers independently performed the literature selection. The included studies were randomized controlled trials providing peripheral electrical stimulation for patients with stroke.</p><p><strong>Data extraction: </strong>Two reviewers independently extracted data following a pre-developed Excel data collection sheet, including trial characteristics, intervention and comparator details, and outcome data. Risk of bias was evaluated by RoB2, PRISMA guidelines were followed for reporting.</p><p><strong>Data synthesis: </strong>A total of 106 trials with 7,513 participants were included. Meta-analysis showed that neuromuscular electrical stimulation (NMES) could be the optimal electrical stimulation protocol for improving the Fugl-Meyer Assessment (FMA) score (SMD = 1.67, 95% CI (1.14, 2.21)) and improving the Modified Barthel Index (MBI) score (SMD = 1.73, 95% CI (1.10, 2.37)). Results showed that different frequencies of electrical stimulation ranked the top five in descending order for improving FMA scores as 20-30Hz_NMES (SUCRA = 87.5%) > 100Hz_NMES (SUCRA = 75.4%) > 100Hz_functional electrical stimulation (FES) (SUCRA = 70.9%) > 20/35Hz_transcutaneous electrical acupoint stimulation (TEAS) (SUCRA = 69.8%) > 1-4Hz_electrical acupuncture (EA) (SUCRA = 69.6%), and ranked the top five in descending order for improving MBI scores as 100Hz_transcutaneous electrical nerve stimulation (TENS) (SUCRA = 77.3%) > 5/15Hz_NMES (SUCRA = 68.3%) > 100Hz_TEAS (SUCRA = 65.6%) > 35-50Hz_FES (SUCRA = 64.8%) > 1-4Hz_EA (SUCRA = 60.0%).</p><p><strong>Conclusions: </strong>Adding electrical stimulation on the basis of routine rehabilitation training can improve the motor dysfunction and ADL of patients with stroke. Specifically, NMES with 20-30 Hz improves motor function best, while 100 Hz TENS improves ADL best.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.apmr.2025.01.466","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To compare the effects of different peripheral electrical stimulation protocols and current frequencies for post-stroke motor function and activities of daily living (ADL).
Data sources: Seven databases (PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Database, Wan-Fang Database and Chinese Biomedical Database) were searched from inception to August 2024.
Study selection: Two reviewers independently performed the literature selection. The included studies were randomized controlled trials providing peripheral electrical stimulation for patients with stroke.
Data extraction: Two reviewers independently extracted data following a pre-developed Excel data collection sheet, including trial characteristics, intervention and comparator details, and outcome data. Risk of bias was evaluated by RoB2, PRISMA guidelines were followed for reporting.
Data synthesis: A total of 106 trials with 7,513 participants were included. Meta-analysis showed that neuromuscular electrical stimulation (NMES) could be the optimal electrical stimulation protocol for improving the Fugl-Meyer Assessment (FMA) score (SMD = 1.67, 95% CI (1.14, 2.21)) and improving the Modified Barthel Index (MBI) score (SMD = 1.73, 95% CI (1.10, 2.37)). Results showed that different frequencies of electrical stimulation ranked the top five in descending order for improving FMA scores as 20-30Hz_NMES (SUCRA = 87.5%) > 100Hz_NMES (SUCRA = 75.4%) > 100Hz_functional electrical stimulation (FES) (SUCRA = 70.9%) > 20/35Hz_transcutaneous electrical acupoint stimulation (TEAS) (SUCRA = 69.8%) > 1-4Hz_electrical acupuncture (EA) (SUCRA = 69.6%), and ranked the top five in descending order for improving MBI scores as 100Hz_transcutaneous electrical nerve stimulation (TENS) (SUCRA = 77.3%) > 5/15Hz_NMES (SUCRA = 68.3%) > 100Hz_TEAS (SUCRA = 65.6%) > 35-50Hz_FES (SUCRA = 64.8%) > 1-4Hz_EA (SUCRA = 60.0%).
Conclusions: Adding electrical stimulation on the basis of routine rehabilitation training can improve the motor dysfunction and ADL of patients with stroke. Specifically, NMES with 20-30 Hz improves motor function best, while 100 Hz TENS improves ADL best.
期刊介绍：
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
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