TY - JOUR
T1 - Upper Extremity Contralaterally Controlled Functional Electrical Stimulation Versus Neuromuscular Electrical Stimulation in Post-Stroke Individuals
T2 - A Meta-Analysis of Randomized Controlled Trials
AU - Loh, Mei Sean
AU - Kuan, Yi Chun
AU - Wu, Chin Wen
AU - Liao, Chun De
AU - Hong, Jia Pei
AU - Chen, Hung Chou
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2022
Y1 - 2022
N2 - Background: Electrical stimulation has been employed as a safe and effective therapy for improving arm function after stroke. Contralaterally controlled functional electrical stimulation (CCFES) is a unique method that has progressed from application in small feasibility studies to implementation in several randomized controlled trials. However, no meta-analysis has been conducted to summarize its efficacy. Objective: To summarize the effect size of CCFES through measures of upper extremity motor recovery compared with that of neuromuscular electrical stimulation (NMES). Methods: The PubMed, Cochrane Library, EMBASE, Scopus, and Google Scholar databases were searched. Randomized controlled trials (RCTs) were selected and subjected to meta-analysis and risk of bias assessment. Results: 6 RCTs were selected and 267 participants were included. The Upper Extremity Fugl-Meyer assessment (UEFMA) was included in all studies, the Box and Blocks test (BBT) and active range of motion (AROM) were included in 3 and 4 studies, respectively. The modified Barthel Index (mBI) and Arm Motor Abilities Test (AMAT) were included in 2 and 3 studies, respectively. The CCFES group demonstrated greater improvement than the NMES did in UEFMA (SMD =.42, 95% CI =.07–.76), BBT (SMD =.48, 95% CI =.10–.86), AROM (SMD =.54, 95% CI =.23–.86), and mBI (SMD =.54, 95% CI =.12–.97). However, the results for AMAT did not differ significantly (SMD =.34, 95% CI = −.03–.72). Conclusion: Contralaterally controlled functional electrical stimulation produced greater improvements in upper extremity hemiplegia in people with stroke than NMES did. PROSPERO registration number: CRD42021245831
AB - Background: Electrical stimulation has been employed as a safe and effective therapy for improving arm function after stroke. Contralaterally controlled functional electrical stimulation (CCFES) is a unique method that has progressed from application in small feasibility studies to implementation in several randomized controlled trials. However, no meta-analysis has been conducted to summarize its efficacy. Objective: To summarize the effect size of CCFES through measures of upper extremity motor recovery compared with that of neuromuscular electrical stimulation (NMES). Methods: The PubMed, Cochrane Library, EMBASE, Scopus, and Google Scholar databases were searched. Randomized controlled trials (RCTs) were selected and subjected to meta-analysis and risk of bias assessment. Results: 6 RCTs were selected and 267 participants were included. The Upper Extremity Fugl-Meyer assessment (UEFMA) was included in all studies, the Box and Blocks test (BBT) and active range of motion (AROM) were included in 3 and 4 studies, respectively. The modified Barthel Index (mBI) and Arm Motor Abilities Test (AMAT) were included in 2 and 3 studies, respectively. The CCFES group demonstrated greater improvement than the NMES did in UEFMA (SMD =.42, 95% CI =.07–.76), BBT (SMD =.48, 95% CI =.10–.86), AROM (SMD =.54, 95% CI =.23–.86), and mBI (SMD =.54, 95% CI =.12–.97). However, the results for AMAT did not differ significantly (SMD =.34, 95% CI = −.03–.72). Conclusion: Contralaterally controlled functional electrical stimulation produced greater improvements in upper extremity hemiplegia in people with stroke than NMES did. PROSPERO registration number: CRD42021245831
KW - contralaterally controlled functional electrical stimulation
KW - meta-analysis
KW - neuromuscular electrical stimulation
KW - stroke
KW - systematic review
KW - upper extremities
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U2 - 10.1177/15459683221092647
DO - 10.1177/15459683221092647
M3 - Article
C2 - 35574940
AN - SCOPUS:85130533302
VL - 36
SP - 472
EP - 482
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
SN - 1545-9683
IS - 7
ER -