Abstract
Objective
To investigate the effectiveness of neuromuscular electrical stimulation (NMES) with
or without other interventions in improving lower limb activity after chronic stroke.
Data Sources
Electronic databases, including PubMed, EMBase, Cochrane Library, PEDro (Physiotherapy
Evidence Database), and PsycINFO, were searched from the inception to January 2017.
Study Selection
We selected the randomized controlled trials (RCTs) involving chronic stroke survivors
with lower limb dysfunction and comparing NMES or combined with other interventions
with a control group of no electrical stimulation treatment.
Data Extraction
The primary outcome was defined as lower limb motor function, and the secondary outcomes
included gait speed, Berg Balance Scale, timed Up and Go, 6-minute walk test, Modified
Ashworth Scale, and range of motion.
Data Synthesis
Twenty-one RCTs involving 1481 participants were identified from 5759 retrieved articles.
Pooled analysis showed that NMES had a moderate but statistically significant benefit
on lower limb motor function (standard mean difference 0.42, 95% confidence interval
0.26–0.58), especially when NMES was combined with other interventions or treatment
time within either 6 or 12 weeks. NMES also had significant benefits on gait speed,
balance, spasticity, and range of motion but had no significant difference in walking
endurance after NMES.
Conclusions
NMES combined with or without other interventions has beneficial effects in lower
limb motor function in chronic stroke survivors. These data suggest that NMES should
be a promising therapy to apply in chronic stroke rehabilitation to improve the capability
of lower extremity in performing activities.
Keywords
List of abbreviations:
6MWT (6-minute walk test), 10MWT (10-meter walk test), AFO (ankle-foot orthosis), BBS (Berg Balance Scale), CI (confidence interval), ES (electrical stimulation), FDS (foot drop stimulator), FES (functional electrical stimulation), GA (gait analysis), MAS (Modified Ashworth Scale), NMES (neuromuscular electrical stimulation), PNS (peroneal nerve stimulation), RCT (randomized controlled trials), ROM (range of motion), SMD (standard mean difference), TENS (transcutaneous electrical nerve stimulation), TUG (Timed Up and Go)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 19, 2018
Footnotes
Supported by grants from the National Natural Science Foundation of China (grant no. 81301676) and the Natural Science Foundation of Guangdong Province (grant no. 2017A030313663).
Disclosures: None.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
