Abstract
Objectives
(1) To determine the effect of transcutaneous electrical nerve stimulation (TENS)
on poststroke spasticity. (2) To determine the effect of different parameters (intensity,
frequency, duration) of TENS on spasticity reduction in adults with stroke. (3) To
determine the influence of time since stroke on the effectiveness of TENS on spasticity.
Data Sources
PubMed, PEDro, CINAHL, Web of Science, CENTRAL, and EMBASE databases were searched
from inception to March 2017.
Study Selection
Randomized controlled trial (RCT), quasi-RCT, and non-RCT were included if (1) they
evaluated the effects of TENS for the management of spasticity in participants with
acute or subacute or chronic stroke using clinical and neurophysiological tools; and
(2) TENS was delivered either alone or as an adjunct to other treatments.
Data Extraction
Two authors independently screened and extracted data from 15 of the 829 studies retrieved
through the search using a pilot tested pro forma. Disagreements were resolved through
discussion with other authors. Quality of studies was assessed using Cochrane risk
of bias criteria.
Data Synthesis
Meta-analysis was performed using a random-effects model that showed (1) TENS along
with other physical therapy treatments was more effective in reducing spasticity in
the lower limbs compared to placebo TENS (SMD −0.64; 95% confidence interval [95%
CI], −0.98 to −0.31; P=.0001; I2=17%); and (2) TENS, when administered along with other physical therapy treatments,
was effective in reducing spasticity when compared to other physical therapy interventions
alone (SMD −0.83; 95% CI, −1.51 to −0.15; P=.02; I2=27%). There were limited studies to evaluate the effectiveness of TENS for upper
limb spasticity.
Conclusion
There is strong evidence that TENS as an adjunct is effective in reducing lower limb
spasticity when applied for more than 30 minutes over nerve or muscle belly in chronic
stroke survivors (review protocol registered at PROSPERO: CRD42015020151).
Keywords
List of abbreviations:
95% CI (95% confidence interval), EMG (electromyogram), RCT (randomized controlled trial), SMD (standardized mean difference), TENS (transcutaneous electrical nerve stimulation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 16, 2018
Footnotes
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
