Electrotherapy in stroke rehabilitation can improve lower limb muscle characteristics: a systematic review and meta-analysis
Creators: name: Debeuf, Ruben
name: De Vlieger, Daan
name: Defour, Arne
name: Feyen, Karen
name: Guida, Stefania
name: Cuypers, Lotte
name: Firouzi, Mahyar
name: Tassenoy, An
name: Swinnen, Eva
name: Beckwée, David
name: Leemans, Lynn
Publisher: name: Taylor & Francis
Year: 2024
Subjects: subject: Space Science
subject: Medicine
subject: Physiology
subject: FOS: Biological sciences
subject: Biotechnology
subject: Biological Sciences not elsewhere classified
subject: Science Policy

description: This review assesses the effect of electrotherapy (e.g. functional electrical stimulation (FES), motor and sensor therapeutic electrical stimulation (TES)) on muscle strength and skeletal muscle characteristics in individuals post-stroke compared to conventional or sham therapy. A systematic literature search was conducted in MEDLINE, SCOPUS, and Web of Science, focusing on randomized controlled trials investigating the effect of electrotherapy. Data of interest was extracted from eligible studies, and risk of bias was assessed. In total, 23 studies (933 people post-stroke) were included, of which 17, which mainly focus on patients in a chronic stage of stroke recovery and the implementation of FES, were incorporated in the meta-analysis. A significant increase in muscle strength was found favoring electrotherapy over conventional therapy (SMD 0.63, 95% CI 0.34–0.91, <i>I</i><sup>2</sup> = 37%, <i>p</i> = 0.07) and over sham therapy (SMD 0.44, 95% CI 0.20–0.68, <i>I</i><sup>2</sup> = 38%, <i>p</i> = 0.08). Three studies investigated the effect on muscle thickness and found a significant increase in favor of electrostimulation when compared to conventional therapy (MD 0.11 cm, 95% CI 0.06–0.16, <i>I</i><sup>2</sup> = 0%, <i>p</i> = 0.50). Current evidence suggests electrotherapy in combination with physiotherapy has positive effects on lower limb muscle strength and skeletal muscle characteristics in patients recovering from stroke. As stroke is known to cause long term disability, the implementation of strengthening interventions in rehabilitation becomes an indispensable part to optimize recovery.Peripheral electrical stimulation might be a useful intervention since it has the potential to repetitively activate the sensory-motor system via electrical pulses to nerves and muscles of the paretic limb.Results of the meta-analysis indicate a beneficial effect of electrotherapy on muscle strength when compared to conventional and sham therapy, and muscle thickness when compared to conventional therapy. As stroke is known to cause long term disability, the implementation of strengthening interventions in rehabilitation becomes an indispensable part to optimize recovery. Peripheral electrical stimulation might be a useful intervention since it has the potential to repetitively activate the sensory-motor system via electrical pulses to nerves and muscles of the paretic limb. Results of the meta-analysis indicate a beneficial effect of electrotherapy on muscle strength when compared to conventional and sham therapy, and muscle thickness when compared to conventional therapy.