Comparative Efficacy of Electrical Stimulation Therapies for Bone Healing: A Network Meta-analysis of Randomized Controlled Trials.

IF 2.3 4区医学 Q1 REHABILITATION

American Journal of Physical Medicine & Rehabilitation Pub Date : 2026-10-07 DOI:10.1097/PHM.0000000000003169

Guangtao Liu, Jianfeng Sun, Wenqing Xie, Hengzhen Li, Guang Yang, Bingzhou Ji, Yuming Yao, Yusheng Li, Xucheng Yang, Wenfeng Xiao

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引用次数: 0

Abstract

Objective: This network meta-analysis aimed to evaluate the effectiveness of electrical stimulation (ES) in promoting bone healing and to identify the optimal modality.

Design: This network meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA, Supplemental Digital Content 4, https://links.lww.com/PHM/D49) guidelines. PubMed, Cochrane, Embase, and Web of Science were searched up to January 2, 2025 for relevant RCTs. Study quality was assessed by two independent reviewers. Data were analyzed using R 4.3.1 and Stata 15.1.

Results: A total of 37 RCTs (3,325 subjects) were included. Overall, ES therapy improved bone healing rates compared to controls (RR 1.18, 95% CI 1.09-1.28), with pulsed electromagnetic fields (PEMF; RR 1.20, 95% CI 1.02-1.41) and combined magnetic fields (CMF; RR 1.49, 95% CI 1.14 -1.95) being particularly effective. For functional recovery, non-invasive interactive neurostimulation (NIN) ranked highest, with a surface under the cumulative ranking curve (SUCRA) value of 95.32%, followed by PEMF (SUCRA 64.64%) and transcutaneous electrical acupoint stimulation (TEAS; SUCRA 60.54%).

Conclusions: ES therapy promotes bone healing, with PEMF appearing the most effective modality. However, additional high-quality RCTs are needed to confirm these findings and guide clinical application.

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电刺激治疗骨愈合的比较疗效：随机对照试验的网络荟萃分析。

目的：本网络荟萃分析旨在评估电刺激（ES）促进骨愈合的有效性，并确定最佳模式。设计：该网络荟萃分析遵循系统评价和荟萃分析的首选报告项目（PRISMA，补充数字内容4，https://links.lww.com/PHM/D49）指南。PubMed, Cochrane， Embase和Web of Science检索到2025年1月2日的相关rct。研究质量由两名独立评审员评估。数据分析采用R 4.3.1和Stata 15.1。结果：共纳入37项rct（3325名受试者）。总体而言，与对照组相比，ES治疗提高了骨愈合率（RR 1.18, 95% CI 1.09-1.28），其中脉冲电磁场（PEMF; RR 1.20, 95% CI 1.02-1.41）和联合磁场（CMF; RR 1.49, 95% CI 1.14 -1.95）特别有效。在功能恢复方面，无创互动神经刺激（NIN）效果最好，其累积排序曲线下表面积（SUCRA）值为95.32%，其次是PEMF (SUCRA) 64.64%和经皮穴位电刺激（TEAS； SUCRA） 60.54%。结论：ES治疗促进骨愈合，其中PEMF是最有效的治疗方式。然而，需要更多高质量的随机对照试验来证实这些发现并指导临床应用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Physical Medicine & Rehabilitation 医学-康复医学

CiteScore

4.60

自引率

6.70%

发文量

423

审稿时长

1 months

期刊介绍： American Journal of Physical Medicine & Rehabilitation focuses on the practice, research and educational aspects of physical medicine and rehabilitation. Monthly issues keep physiatrists up-to-date on the optimal functional restoration of patients with disabilities, physical treatment of neuromuscular impairments, the development of new rehabilitative technologies, and the use of electrodiagnostic studies. The Journal publishes cutting-edge basic and clinical research, clinical case reports and in-depth topical reviews of interest to rehabilitation professionals. Topics include prevention, diagnosis, treatment, and rehabilitation of musculoskeletal conditions, brain injury, spinal cord injury, cardiopulmonary disease, trauma, acute and chronic pain, amputation, prosthetics and orthotics, mobility, gait, and pediatrics as well as areas related to education and administration. Other important areas of interest include cancer rehabilitation, aging, and exercise. The Journal has recently published a series of articles on the topic of outcomes research. This well-established journal is the official scholarly publication of the Association of Academic Physiatrists (AAP).