Effect of electrical stimulation on musculoskeletal systems; a meta-analysis of controlled clinical trials

This study was a meta-analysis to examine whether electrical stimulation has specific effects in the healing of musculoskeletal repair process and in the diminution of symptoms with bone and joint disorders. Using MEDLINE (1966-1999) and EMBASE (1985-1999) a search for articles was carried out with four medical subject headings. Data were extracted from all the accessed articles and additionally collected from appropriate journal lists. A total of 20 randomized controlled trials on bones was identified which assessed healing of fractures, bone graft, and other conditions; and 29 randomized controlled trials on soft tissues and joints were also found, dealing with healing of skin wounds or dermal ulcers, soft tissue injury, and other conditions. Using criteria through which the quality of studies was assessed, the content of the articles was reorganized into a tabular form. The majority of the identified articles reported positive findings, but all the trials showed methodological flaws to some extent. Because of heterogeneity of the studies and the various outcome measurements, pooling of only part of the data was performed. The combined results of 12 trials on bones and 16 trials on soft tissues, the cases in which major endpoints were mainly union or healing rate, revealed statistically significant effects. The studies in this review had some methodological limitations, and the selected pooled trials do not constitute acceptable proof that electrical stimulation has specific effects on health. However, one cannot ignore the statistically significant positive findings reported in the trials, from which extracted data were able to be combined.