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. 2022 Nov 9:13:1003723.
doi: 10.3389/fneur.2022.1003723. eCollection 2022.

The difference between the effectiveness of body-weight-supported treadmill training combined with functional electrical stimulation and sole body-weight-supported treadmill training for improving gait parameters in stroke patients: A systematic review and meta-analysis

Jiaqi Wang  1 , Liangyu Zhao  1 , Yan Gao  1 , Chenchen Liu  2 , Xiaosheng Dong  1 , Xiqian He  3
Affiliations

The difference between the effectiveness of body-weight-supported treadmill training combined with functional electrical stimulation and sole body-weight-supported treadmill training for improving gait parameters in stroke patients: A systematic review and meta-analysis

Jiaqi Wang et al. Front Neurol. .

Abstract

Background: Body-weight-supported treadmill training (BWSTT) combined with functional electrical stimulation (FES) is considered an effective intervention method to improve gait parameters in stroke patients. In this article, we compared the effect of BWSTT combined with FES and BWSTT only on gait parameters in stroke patients.

Methods: Two researchers searched for literature published before January 5, 2021, in seven Chinese and English databases including PubMed, Web of Science, Cochrane Library, Ovid, CNKI, Wanfang Data, and VIP. Meta-analysis was then performed on various data collected, namely, 10 Meters Walking Test (10MWT), gait speed, Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), Modified Barthel Index (MBI), Comprehensive Spasticity Scale (CSS), Functional Ambulation Category (FAC), and Ankle Range of Motion (AROM).

Results: A total of 14 studies were included in the meta-analysis, in which 945 stroke patients participated. In these 14 studies, the participants were randomly divided into a test group and a control group. The test group received BWSTT combined with FES, while the control group received BWSTT only. Meta-analysis showed that when compared to BWSTT, BWSTT combined with FES had a better effect on FAC, AROM, 10MWT, CSS, MBI, FMA, gait speed, and BBS of stroke patients. However, the effect of BWSTT combined with FES on BBS was not significant in the medium exercise group when compared to that of BWSTT. Also, the effect of BWSTT combined with FES on gait speed was not significant in the large exercise group when compared to that of BWSTT only.

Conclusion: BWSTT combined with FES is more effective than BWSTT only for improving gait parameters in stroke patients.

Systematic review registration: https://www.crd.york.ac.uk/prospero/#recordDetails, CRD42022299636.

Keywords: body weight support; functional electrical stimulation; randomized controlled trials; stroke patients; treadmill training.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of study selection and identification.
Figure 2
Figure 2
Risk of bias graph: judgements about each risk of bias item presented as percentages across all included studies.
Figure 3
Figure 3
Risk of bias summary: judgements about each risk of bias item for each included study.
Figure 4
Figure 4
Forest plot showing the effect on 10 Meters Walking Test (10MWT) of body weight support treadmill training combined with functional electrical stimulation (BWSTT+FES) vs. body weight support treadmill training (BWSTT). CI, confidence interval; SD, standard deviation.
Figure 5
Figure 5
Forest plot showing the effect on Fugl-Meyer Assessment (FMA) of body weight support treadmill training combined with functional electrical stimulation (BWSTT+FES) vs. body weight support treadmill training (BWSTT). CI, confidence interval; SD, standard deviation.
Figure 6
Figure 6
Forest plot showing the effect on Modified Barthel Index (MBI) of body weight support treadmill training combined with functional electrical stimulation (BWSTT+FES) vs. body weight support treadmill training (BWSTT). CI, confidence interval; SD, standard deviation.
Figure 7
Figure 7
Forest plot showing the effect on Ankle Range of Motion (AROM) of body weight support treadmill training combined with functional electrical stimulation (BWSTT+FES) vs. body weight support treadmill training (BWSTT). CI, confidence interval; SD, standard deviation.
Figure 8
Figure 8
Forest plot showing the effect on Functional Ambulation Category (FAC) of body weight support treadmill training combined with functional electrical stimulation (BWSTT+FES) vs. body weight support treadmill training (BWSTT). CI, confidence interval; SD, standard deviation.
Figure 9
Figure 9
Forest plot showing the effect on Berg Balance Scale (BBS) of body weight support treadmill training combined with functional electrical stimulation (BWSTT+FES) vs. body weight support treadmill training (BWSTT). CI, confidence interval; SD, standard deviation.
Figure 10
Figure 10
Forest plot showing the effect on gait speed of body weight support treadmill training combined with functional electrical stimulation (BWSTT+FES) vs. body weight support treadmill training (BWSTT). CI, confidence interval; SD, standard deviation.
Figure 11
Figure 11
Forest plot showing the effect on Comprehensive Spasticity Scale (CSS) of body weight support treadmill training combined with functional electrical stimulation (BWSTT+FES) vs. body weight support treadmill training (BWSTT). CI, confidence interval; SD, standard deviation.
Figure 12
Figure 12
Funnel chart of body weight support treadmill training combined with functional electrical stimulation intervention and body weight support treadmill training in Fugl-Meyer Assessment (FMA).
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