Electrical Stimulation for hemiplegic shoulder function: A systematic review and meta-analysis of 15 randomized controlled trials

Publication date: Available online 11 May 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Ping Gu, Juan-juan Ran, Lei Yu
ObjectivesThe objective of this meta-analysis was to review the evidence for the effect of FES on shoulder subluxation, pain, upper arm motor function, daily function and quality of life in stroke patients, when added to conventional therapy.Data SourcesPubMed, Cochrane library, Google Scholar and Embase databases were searched for all relevant studies published before February 20, 2016.Study SelectionKeywords included "subluxation" or "pain", "stroke" or "hemiplegia" and "electrical stimulation" or "FES" or "NMES". Trials examining the effect of FES on shoulder and upper arm outcomes were included.Data ExtractionFrom the 1307 retrieved articles, 15 RCTs were selected for final analysis and were rated based on the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0 and the Sackett's levels of evidence. A meta-analysis was performed for all considered outcomes.Data SynthesisThe results of this meta-analyses showed a significant difference in shoulder subluxation in FES groups compared to Placebo groups, only if FES was applied early after stroke. And a significant difference was observed Post-Tx in Fugl-Meyer motor assessment in FES groups compared to Placebo groups. No effects were found on pain, upper arm motor function, daily function and quality of life outcomes.ConclusionsFES can be used to prevent or reduce shoulder subluxation early after stroke. However, findings did not support the efficacy of use of FES for pain reduction, improvement in arm strength, movement, functional use, daily function or quality of life after stroke.



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