Tao Qin, Tiantian Hu, Yuzhuo Dan, Cheng Qiu, Mei Chen, Fanjing Kong, Sha Huang, Zhenwei Zhai, Ying Xu, Tao Sun
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The systematic review protocol is available on the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42023493979).</p><p><strong>Results: </strong>A total of eight studies (341 participants) were included. LFES showed significant therapeutic effects on shoulder pain scores (SMD = -0.68; 95% CI: [-1.18, -0.18], <i>Z</i> = 2.69, <i>p</i> = 0.006, <i>I</i> <sup>2</sup> = 76%). However, the improvement in upper limb motor function (MD = 8.50; 95% CI: [5.12, 11.88], <i>Z</i> = 4.93, <i>p</i> < 0.001, <i>I</i> <sup>2</sup> = 16%) was influenced by a single study with lower methodological quality. Subgroup analyses examined factors such as control group type, stimulation type, duration, frequency, pulse width, and stimulation area. 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引用次数: 0
摘要
目的：明确低频电刺激（LFES）治疗偏瘫肩痛（HSP）的有效性，确定不同治疗参数的治疗效果，并提供循证建议。方法：检索至2023年10月的PubMed、EMBASE、Web of Science、Cochrane Library、中国国家知识基础设施、万方数据、中国科技期刊数据库。随机对照试验（rct）将LFES与可比的单一康复干预、安慰剂/假治疗或常规康复进行比较。纳入的结果是上肢疼痛强度和运动功能。该系统评价方案可在国际前瞻性系统评价登记册（PROSPERO）上获得（注册号：CRD42023493979）。结果：共纳入8项研究（341名受试者）。LFES对肩部疼痛评分有显著的治疗效果(SMD = -0.68；95%置信区间:[-1.18,-0.18],Z = 2.69,p = 0.006,我2 = 76%)。然而，上肢运动功能的改善(MD = 8.50；95% CI: [5.12, 11.88], Z = 4.93,p I 2 = 16%)受到单一研究方法质量较低的影响。亚组分析考察了诸如对照组类型、刺激类型、持续时间、频率、脉冲宽度和刺激面积等因素。通过亚组分析，进一步探讨LFES在不同治疗参数、不同偏瘫侧、不同刺激区域治疗效果的变化。结论：meta分析结果显示，LFES对缓解HSP有显著的积极作用，但其对改善运动功能的作用需谨慎解读，可能存在偏倚。系统评价注册：国际前瞻性系统评价注册（PROSPERO），标识符：CRD42023493979。
The effectiveness of low-frequency electrical stimulation in treating hemiplegic shoulder pain: a systematic review and meta-analysis.
Objective: To clarify the effectiveness of Low-frequency electrical stimulation (LFES) in treating Hemiplegic shoulder pain (HSP), identify the therapeutic effects of different treatment parameters, and provide evidence-based recommendations.
Methods: We searched PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, and China Science and Technology Journal Database up to October 2023. Randomized controlled trials (RCTs) comparing LFES with comparable single rehabilitation interventions, placebo/sham treatments, or conventional rehabilitation were included. The included outcomes were pain intensity and motor function in the upper extremities. The systematic review protocol is available on the International Prospective Register of Systematic Reviews (PROSPERO) (registration number: CRD42023493979).
Results: A total of eight studies (341 participants) were included. LFES showed significant therapeutic effects on shoulder pain scores (SMD = -0.68; 95% CI: [-1.18, -0.18], Z = 2.69, p = 0.006, I2 = 76%). However, the improvement in upper limb motor function (MD = 8.50; 95% CI: [5.12, 11.88], Z = 4.93, p < 0.001, I2 = 16%) was influenced by a single study with lower methodological quality. Subgroup analyses examined factors such as control group type, stimulation type, duration, frequency, pulse width, and stimulation area. The variations in therapeutic effects of LFES across different treatment parameters, different hemiplegic sides, and different stimulation areas were further explored by subgroup analysis.
Conclusion: The meta-analysis results indicate that LFES has significant positive effects on alleviating HSP, but its effect on improving motor function requires cautious interpretation due to potential bias.
Systematic review registration: International Prospective Register of Systematic Reviews (PROSPERO), identifier: CRD42023493979.
期刊介绍：
The section Stroke aims to quickly and accurately publish important experimental, translational and clinical studies, and reviews that contribute to the knowledge of stroke, its causes, manifestations, diagnosis, and management.
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