Browse > Article
http://dx.doi.org/10.21598/JKPNFA.2022.20.2.147

Effect of Electrical Stimulation on Upper Extremity Function in Stroke Patients: A Systematic Review Based on Randomized Controlled Trials  

Hwang, Su-jin (Department of Physical Therapy, Graduate School of Health and Welfare, Baekseok University)
Seo, Yeon-ju (Department of Physical Therapy, Graduate School of Health and Welfare, Baekseok University)
Publication Information
PNF and Movement / v.20, no.2, 2022 , pp. 147-156 More about this Journal
Abstract
Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.
Keywords
Electrical stimulation; Randomized controlled trials; Stroke; Upper extremity;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Yang J, Liao C, Huang S, et al. Effectiveness of electrical stimulation therapy in improving arm function after stroke: a systematic review and a meta-analysis of randomized controlled trials. Clinical Rehabilitation. 2019;33(8):1286-1297.   DOI
2 Yun D, Choi J. Relationships among person-centered care environment, patient engagement, and patient outcomes in stroke rehabilitation patients: A Path Model Analysis. Korean Journal of Adult Nursing. 2021;33(6):576-587.   DOI
3 An H, Kim D. Effects of activities of daily living-based dual-task training on upper extremity function, cognitive function, and quality of life in stroke patients. Osong Public Health and Research Perspectives. 2021;12(5):304-313.   DOI
4 Karakus D, Ersoz M, Koyuncu G, et al. Effects of functional electrical stimulation on wrist function and spasticity in stroke: A randomized controlled study. Turkish Journal of Physical Medicine and Rehabilitation. 2013;59(2):97-102.
5 Burridge J, Ladouceur M. Clinical and therapeutic applications of neuromuscular stimulation: a review of current use and speculation into future. Neuromodulation: Journal of the International Neuromodulation Society. 2001;4(4):147-154.   DOI
6 Eraifej J, Clark W, France B, et al. Effectiveness of upper limb function electrical stimulation after stroke for the improvement of activities of daily living and motor function: A systematic review and meta-analysis. Systematic Reviews. 2017;6(40):1-21.   DOI
7 Hatem SM, Saussez G, Faille MD, et al. Rehabilitation of Motor function after Stroke: A Multiple Systematic Review Focused on Techniques to Stimulate Upper Extremity. Frontiers in Human Neuroscience. 2016;10(442):1-22.
8 Korean Statistical Information Service (KOSIS). Annual report on the cause of death statistics. 2022.
9 Persson H, Opheim A, Lundgren-Nilsson A, et al. Upper extremity recovery after ischaemic and haemorrhagic stroke: Part of the SALGOT study. European Stroke Journal. 2016;1(4):310-319.   DOI
10 Niu C, Bao Y, Zhuang C, et al. Synergy-based FES for post-stoke rehabilitation of upper-limb motor functions. IEEE Transactions on Neural Systems and Rehabilitation Engineering. 2019;27(2):256-264.   DOI
11 Sin H, Lee G. Additional virtual reality training using Xbox Kinect in stroke survivors with hemiplegia. American Journal of Physical Medicine & Rehabilitation. 2013;92(10):871-880.   DOI
12 Yuzer G, Kose Donmez B, Ozgirgin N. A Randomized controlled study: effectiveness of functional electrical stimulation on wrist and finger flexor spasticity in hemiplegia. Journal of Stroke and Cerebrovascular Diseases. 2017;26(7):1467-1471.   DOI
13 Zhang C, Li-Tsang C, Au R. Robotic approaches for the rehabilitation of upper limb recovery after stroke: a systematic review and meta-analysis. International Journal of Rehabilitation Research. 2017;40(1):19-28.   DOI
14 de Kroon J, Ijzerman M, Chae J, et al. Relation between stimulation characteristics and clinical outcome in studies using electrical stimulation to improve motor control of the upper extremity in stroke. Journal of Rehabilitation Medicine. 2005;37(2):65-74.   DOI
15 Au-Yeung S, Hui-Chan C. Electrical acupoint stimulation of the affected arm in acute stroke: A placebo-controlled randomized clinical trial. Clinical Rehabilitation. 2014;28(2):149-158.   DOI
16 Bae SC, Khan A, Song R, et al. Rewiring the lesioned brain: electrical stimulation for post-stroke motor restoration. Journal of Stroke. 2020;22(1):47-63.   DOI
17 Chan C. A Preliminary Study of Functional Electrical Stimulation in Upper Limb Rehabilitation After Stroke: An Evidence-Based Review. Hong Kong Journal of Occupational Therapy. 2008;18(2):52-58.   DOI
18 Fletcher-Smith J, Walker D, Allatt K, et al. The ESCAPS study: a feasibility randomized controlled trial of early electrical stimulation to the wrist extensors and flexors to prevent post-stroke complications of pain and contractures in the paretic arm. Clinical Rehabilitation. 2019;33(12):1919-1930.   DOI
19 Howlett O, Lannin N, Ada L, et al. Functional electrical stimulation improves activity after stroke: A systematic review with meta-analysis. Archives of Physical Medicine and Rehabilitation. 2015;96(5):934-943.   DOI
20 Freeman C, Hughes A, Burridge J, et al. A model of the upper extremity using FES for stroke rehabilitation. Journal of Biomechanical Engineering. 2009;131(3):1-12.
21 Raghavan P. Upper limb motor impairment after stroke. Physical Medicine and Rehabilitation Clinics of North America. 2015;26(4):599-610.   DOI
22 Jung A, Balzer J, Braun T, et al. Identification of tools used to assess the external validity of randomized controlled trials in reviews: a systematic review of measurement properties. BMC Medical Research Methodology. 2022;22:100.   DOI
23 Kim D, Kim K. The effects of virtual reality training with upper limb functional electrical stimulation to improve on muscle strength, AROM, and function of upper limb joints in patient with chronic stroke. Journal of The Korea Society of Integrative Medicine. 2020;8(2):211-220.
24 Kim JY, Bae HJ. Stroke statistics in Korea. Weekly Health and Disease, 2018;12(43):1845-1860.
25 Lee S, Cha H. The effect of motor imagery and mirror therapy on upper extremity function according to the level of cognition in stroke patients. International Journal of Rehabilitation Research. 2019;42(4):330-336.   DOI
26 Lin Z, Yan T. Long-term effectiveness of neuromuscular electrical stimulation for promoting motor recovery of the upper extremity. Journal of Rehabilitation Medicine. 2011;43(6):506-510.   DOI
27 Park J. The systematic consideration about study on how to apply functionally electric stimulation therapy for improving upper extremity of domestic patients. The Journal of Korea Aging Friendly Industry Association. 2013;5(1):81-88.
28 Park S, Cho K, Cho Y. Effect of exercise with functional electrical stimulation and transcutaneous electrical nerve stimulation on muscle tone, stiffness of calf muscle, and balance ability in patients with stroke. Journal of the Korean Society of Physical Medicine. 2017;12(2):43-52.
29 Rand D, Eng J. Predicting daily use of the affected upper extremity 1 year after stroke. Journal of Stroke and Cerebrovascular Diseases. 2015;24(2):274-283.   DOI