Enhancing motor function after stroke: a systematic review and meta-analysis of bioelectrical feedback interventions

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Stroke is a primary cause of long-term disability, with hemiplegia affecting most survivors.
• Conventional rehabilitation methods offer limited efficacy for post-stroke recovery.
• Electromyographic (EMG)-based bioelectrical feedback presents a potential adjunctive therapy for hemiplegia.

Purpose of the Study:

• To systematically evaluate the effectiveness of EMG-based bioelectrical feedback as an adjunct to conventional therapy for post-stroke hemiplegia.
• To synthesize evidence from controlled clinical studies on functional and neurophysiological outcomes.
• To assess the impact on complication rates in stroke survivors.

Main Methods:

• A systematic review and meta-analysis adhering to PRISMA 2020 guidelines.
• Searches conducted across Cochrane Library, PubMed, EMbase, Web of Science, and CNKI (2010-2025).
• Inclusion of controlled clinical studies (randomized and non-randomized), with risk of bias assessed using RoB 2 and ROBINS-I tools.

Main Results:

• Eight studies (549 patients) indicated significant improvements in Fugl-Meyer Assessment (total and motor subscale) and Activities of Daily Living scores.
• Neurophysiological outcomes, including EMG amplitude and active range of motion, showed significant enhancement.
• A significant reduction in complications was observed, though high heterogeneity and limited study numbers necessitate cautious interpretation.

Conclusions:

• EMG-based bioelectrical feedback may enhance motor function, daily living activities, and reduce complications in hemiplegic stroke patients.
• High heterogeneity, limited studies, and geographic concentration warrant cautious interpretation of findings.
• Further adequately powered randomized controlled trials with blinded outcome assessment are crucial for clinical recommendations.