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Meta-Analysis
. 2006 Apr 19;2006(2):CD003241.
doi: 10.1002/14651858.CD003241.pub2.

Electrostimulation for promoting recovery of movement or functional ability after stroke

V M Pomeroy  1 , L King, A Pollock, A Baily-Hallam, P Langhorne
Affiliations
Meta-Analysis

Electrostimulation for promoting recovery of movement or functional ability after stroke

V M Pomeroy et al. Cochrane Database Syst Rev. .

Abstract

Background: Electrostimulation might improve motor recovery after stroke by providing neuromuscular re-training.

Objectives: To find if electrostimulation improved functional motor ability, and the ability to undertake activities of daily living.

Search strategy: We searched the Cochrane Stroke Group Trials Register (last searched August 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 1, 2004), MEDLINE (1966 to January 2004), EMBASE (1980 to January 2004), CINAHL (1982 to January 2004), AMED - Allied and Complementary Medicine Database (1985 to January 2004), Physiotherapy Evidence Database (PEDro), REHABDATA and the ISI Science Citation Index (1981 to 2003). We placed a request on the PHYSIO e-mail discussion list and contacted authors of relevant studies to elicit any unpublished or ongoing studies, searched the reference lists of included trials and contacted trialists.

Selection criteria: Randomised controlled trials of electrostimulation delivered to the peripheral neuromuscular system which was designed to improve voluntary movement control, functional motor ability and activities of daily living.

Data collection and analysis: Two review authors independently selected trials for inclusion, assessed trial quality and extracted the data.

Main results: Of the 2077 references identified, 24 trials were included in this review. For electrostimulation compared with no treatment this review found that electrostimulation improved some aspects of functional motor ability and some aspects of motor impairment and normality of movement. In addition, there was a significant difference in favour of no treatment compared with electrostimulation for an aspect of functional motor ability. For electrostimulation compared with placebo this review found that electrostimulation improved an aspect of functional motor ability. For electrostimulation compared with conventional physical therapy this review found that electrostimulation improved an aspect of motor impairment. There were no statistically significant differences between electrostimulation and control treatment for all other outcomes. However, these results need to be interpreted with reference to the following: (1) the majority of analyses only contained one trial; (2) variation was found between included trials in time after stroke, level of functional deficit, and dose of electrostimulation; and (3) the possibility of selection and detection bias in the majority of included trials.

Authors' conclusions: At present, there are insufficient robust data to inform clinical use of electrostimulation for neuromuscular re-training. Research is needed to address specific questions about the type of electrostimulation that might be most effective, in what dose and at what time after stroke.

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Conflict of interest statement

None known

Figures

1.1
1.1. Analysis
Comparison 1 Electrostimulation versus no treatment, Outcome 1 Motor impairment ‐ muscle tone.
1.2
1.2. Analysis
Comparison 1 Electrostimulation versus no treatment, Outcome 2 Motor impairment ‐ muscle function.
1.3
1.3. Analysis
Comparison 1 Electrostimulation versus no treatment, Outcome 3 Motor impairment ‐ active joint range of movement.
1.4
1.4. Analysis
Comparison 1 Electrostimulation versus no treatment, Outcome 4 Motor impairment ‐ physiological cost index.
1.5
1.5. Analysis
Comparison 1 Electrostimulation versus no treatment, Outcome 5 Motor impairment ‐ Fugl Meyer Assessment.
1.6
1.6. Analysis
Comparison 1 Electrostimulation versus no treatment, Outcome 6 Normality of movement.
1.7
1.7. Analysis
Comparison 1 Electrostimulation versus no treatment, Outcome 7 Functional motor ability.
1.8
1.8. Analysis
Comparison 1 Electrostimulation versus no treatment, Outcome 8 Global ADL.
2.1
2.1. Analysis
Comparison 2 Electrostimulation versus placebo, Outcome 1 Motor impairment ‐ muscle function.
2.2
2.2. Analysis
Comparison 2 Electrostimulation versus placebo, Outcome 2 Motor impairment ‐ Fugl Meyer Assessment.
2.3
2.3. Analysis
Comparison 2 Electrostimulation versus placebo, Outcome 3 Normality of movement.
2.4
2.4. Analysis
Comparison 2 Electrostimulation versus placebo, Outcome 4 Functional motor ability.
2.5
2.5. Analysis
Comparison 2 Electrostimulation versus placebo, Outcome 5 Global ADL.
3.1
3.1. Analysis
Comparison 3 Electrostimulation versus conventional therapy, Outcome 1 Motor impairment ‐ muscle tone.
3.2
3.2. Analysis
Comparison 3 Electrostimulation versus conventional therapy, Outcome 2 Motor impairment ‐ physiological cost index.
3.3
3.3. Analysis
Comparison 3 Electrostimulation versus conventional therapy, Outcome 3 Motor impairment ‐ Fugl Meyer Assessment.
3.4
3.4. Analysis
Comparison 3 Electrostimulation versus conventional therapy, Outcome 4 Normality of movement.
3.5
3.5. Analysis
Comparison 3 Electrostimulation versus conventional therapy, Outcome 5 Functional motor ability.
3.6
3.6. Analysis
Comparison 3 Electrostimulation versus conventional therapy, Outcome 6 Global ADL.
4.1
4.1. Analysis
Comparison 4 Acceptability of electrostimulation, Outcome 1 Electrostimulation versus no treatment. Number of withdrawals (surrogate adverse events).
4.2
4.2. Analysis
Comparison 4 Acceptability of electrostimulation, Outcome 2 Electrostimulation versus placebo. Number of withdrawals (surrogate adverse events).
4.3
4.3. Analysis
Comparison 4 Acceptability of electrostimulation, Outcome 3 ES versus conventional. No of withdrawals (surrogate adverse events) ‐ assume Francisco withdrawals control.
4.4
4.4. Analysis
Comparison 4 Acceptability of electrostimulation, Outcome 4 ES versus conventional. No of withdrawals (surrogate adverse events) ‐ assume Francisco withdrawals treatment.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD003241

References

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