电刺激治疗脑卒中后足下垂的效果：系统评价和网络meta分析。

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-03-07 DOI:10.1016/j.jstrokecerebrovasdis.2025.108279

Wang He MD , Li Yaning MD , Yu Shaohong DD

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引用次数: 0

摘要

目的：系统评价电刺激（ES）治疗脑卒中后足下垂（FD）的疗效，并比较不同电刺激方式的疗效。数据来源：我们检索了5个英文数据库（PubMed、Web of Science、Embase、Cochrane Library和Scopus）和4个中文数据库（CNKI、SinoMed、VIP和万方数据），检索时间为成立至2024年6月。数据综合：采用RevMan5.4软件进行传统meta分析，采用Stata 14.0软件进行网络meta分析。共纳入37项rct，涉及2309例患者。传统meta分析结果显示，与CRT相比，ES联合CRT能有效改善FD患者脑卒中后踝关节背屈的活动范围（ROM），显著提高下肢fugl-meyer评估（FMA-LE）评分。对于不同病程的FD患者，亚组分析结果显示，ES改善恢复期（1-6个月）患者踝关节背屈的ROM优于急性期（≤1个月）和后遗症期（≥6个月），但三组总体结果无显著差异。ES对恢复期患者下肢运动功能的改善效果优于急性期患者，而对后遗症期患者的改善效果不显著（P < 0.05）。网络meta分析结果显示，改善踝关节背屈角度的最佳概率为：电针（EA）、>经颅直流电刺激（tDCS）、>经皮神经电刺激（TENS）、>功能电刺激（FES）、>神经肌肉电刺激（NMES）、>肌电生物反馈疗法（EMGBFT）、>常规康复疗法（CRT）；改善踝关节背屈角度的最佳可能性为EA > EMGBFT > tDCS > FES > TENS > NMES > CRT。结论：目前有证据表明，ES联合CRT能有效改善脑卒中后FD患者的踝关节背屈活动度和下肢运动功能，尤其是恢复期患者。在不同类型的ES中，EA比其他类型的ES效果最好。

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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Effect of electrical stimulation in the treatment on patients with foot drop after stroke: a systematic review and network meta-analysis

Objective

To systematically evaluate the efficacy of electrical stimulation (ES) in the treatment of patients with foot drop (FD) after stroke, and to compare the efficacy of different types of ES.

Data sources

We searched 5 English database (PubMed, Web of Science, Embase, Cochrane Library and Scopus) and 4 Chinese databases (China National Knowledge Infrastructure (CNKI), SinoMed (CBM), VIP and Wanfang Data) from inception to June, 2024.

Data synthesis

Traditional meta-analysis and network meta-analysis were performed using RevMan5.4 software and Stata 14.0 software respectively. A total of 37 RCTs were included, involving 2309 patients. The results of the traditional meta-analysis showed that compared with CRT, ES combined with CRT was effective in improving the range of motion (ROM) of ankle dorsiflexion in patients with FD after stroke and significantly improved the fugl-meyer assessment of lower extremity (FMA-LE) scores. For patients with FD with different disease duration, the subgroup analysis results showed that the ES improved the ROM of ankle dorsiflexion of patients in recovery phases (1-6 months) better than those in the acute phases (≤ 1 month) and sequelae phases (≥ 6 months), but the overall results of the three groups were not significantly different. The ES improved the lower limb motor function of patients in the recovery phases better than those in the acute phases, and the efficacy was not significant in patients in the sequelae phases (P > 0.05). The results of network meta-analysis showed that the best probability of improving the dorsiflexion angle of the ankle was electroacupuncture (EA) > transcranial direct current stimulation (tDCS) > transcutaneous electrical nerve stimulation (TENS) > functional electrical stimulation (FES) > neuromuscular electrical stimulation (NMES) > electromyographic biofeedback therapy (EMGBFT) > conventional rehabilitation therapy (CRT); the best probability of improving the dorsiflexion angle of the ankle was EA > EMGBFT > tDCS > FES > TENS > NMES > CRT.

Conclusions

The current evidence showed that the ES combined with CRT can effectively improve the ROM of ankle dorsiflexion and lower limb motor function in patients with FD after stroke, especially the patients in recovery phases. Among the different types of ES, EA had the best effect than other types of ES.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.