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Functional electrical stimulation improves activity after stroke: a systematic review with meta-analysis.

Owen A Howlett1, Natasha A Lannin2, Louise Ada3

  • 1Department of Occupational Therapy, La Trobe University, Bundoora, VIC, Australia; Bendigo Health, Bendigo, VIC, Australia.

Archives of Physical Medicine and Rehabilitation
|January 31, 2015
PubMed
Summary

Functional electrical stimulation (FES) moderately improves activity in stroke rehabilitation compared to no intervention or training alone. This suggests FES is a valuable tool for enhancing patient function and recovery.

Keywords:
Meta-analysis [publication type]Occupational therapyRehabilitationReview [publication type]

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Area of Science:

  • Neurorehabilitation
  • Biomedical Engineering
  • Physical Therapy

Background:

  • Stroke survivors often experience significant activity limitations.
  • Functional electrical stimulation (FES) is a technique used to assist movement and improve function.
  • The comparative effectiveness of FES versus other interventions requires systematic evaluation.

Purpose of the Study:

  • To assess the impact of FES on improving activity levels in individuals.
  • To determine if FES is superior to conventional training alone for enhancing activity.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
  • Searches included multiple databases (e.g., Cochrane, Medline, PEDro) up to June 2014.
  • Methodological quality was assessed using the PEDro scale, with data extracted independently by two reviewers.

Main Results:

  • Eighteen trials involving 19 comparisons met the inclusion criteria.
  • FES demonstrated a moderate effect on improving activity compared to placebo or no intervention (SMD = 0.40).
  • FES also showed a moderate effect on activity when compared to training alone (SMD = 0.56), with a large effect on upper-limb activity and a small effect on walking speed.

Conclusions:

  • Functional electrical stimulation (FES) offers a moderate benefit for improving activity in stroke patients.
  • The findings support the integration of FES into stroke rehabilitation protocols to enhance functional outcomes.
  • FES is recommended as an adjunct therapy to improve the performance of daily activities post-stroke.