Effectiveness of upper limb functional electrical stimulation after stroke for the improvement of activities of daily living and motor function: a systematic review and meta-analysis

Objective: To evaluate the current evidence on the effectiveness of simultaneous combination of mirror therapy and electrical stimulation in the recovery of upper limb motor function after stroke, compared with conventional therapy, mirror therapy or electrical stimulation isolated. Data sources: Articles published in PubMed, Web of Science, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Central register of controlled trials and ScienceDirect up to July 2020. Review methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Methodological quality was assessed using the PEDro tool. The RevMan 5.4 statistical software was used to obtain the meta-analysis, through the standardized mean difference and 95% confidence intervals (CI), and to evaluate the risk of bias. The GRADE approach was employed to assess the certainty of evidence. Results: Eight articles were included in this systematic review, seven were included in the meta-analysis. A total of 314 participants were analyzed. The overall quality of the articles included in this review was good. There was no overall significant mean difference on upper limb motor function after stroke using the Upper-Extremity Fugl-Meyer Assessment by 1.56 (95% CI = –2.08, 5.20; P = 0.40; moderate-certainty evidence) and the Box and Block Test results by 1.39 (95% CI = –2.14, 4.92; P = 0.44; high-certainty evidence). There was overall significant difference in the Action Research Arm Test by 3.54 (95% CI = 0.18, 6.90; P = 0.04; high-certainty evidence). Conclusion: Direct scientific evidence about the effectiveness of the combined therapy of mirror therapy and electrical stimulation simultaneously for the improvement of the upper limb motor function after stroke is lacking. Further high-quality and well-designed research is needed.

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Effects of Virtual Reality-Based Intervention on Cognition, Motor Function, Mood, and Activities of Daily Living in Patients With Chronic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.766525 ◽

2021 ◽

Vol 13 ◽

Author(s):

Yong Gao ◽

Lu Ma ◽

Changsheng Lin ◽

Shizhe Zhu ◽

Lingling Yao ◽

...

Keyword(s):

Systematic Review ◽

Virtual Reality ◽

Activities Of Daily Living ◽

Motor Function ◽

Daily Living ◽

Meta Analysis ◽

Chronic Stroke ◽

Controlled Trials ◽

Randomized Controlled ◽

Global Cognition

Background: The efficacy of virtual reality (VR)-based intervention for improving cognition in patients with the chronic stage of stroke is controversial. The aims of this meta-analysis were to evaluate the effect of VR-based training combined with traditional rehabilitation on cognition, motor function, mood, and activities of daily living (ADL) after chronic stroke.Methods: The search was performed in the Cochrane Library (CENTRAL), EBSCO, EMBASE, Medline (OVID), Web of Science databases, PubMed, CINAHL Ovid, and Scopus from inception to May 31, 2021. All included studies were randomized controlled trials (RCTs) examining VR-based intervention combined with traditional rehabilitation for chronic stroke. The main outcomes of this study were cognition, including overall cognition (combined with all cognitive measurement results), global cognition (measured by the Montreal Cognitive Assessment, MoCA, and/or Mini-Mental State Examination, MMSE), and attention/execution. The additional outcomes were motor function, mood, and ADL. Subgroup analyses were conducted to verify the potential factors for heterogeneity.Results: Six RCTs including 209 participants were included for systematic review, and five studies of 177 participants were included in meta-analyses. Main outcome analyses showed large and significant effect size (ES) of VR-based training on overall cognition (g = 0.642; 95% CI = 0.134–1.149; and P = 0.013) and attention/execution (g = 0.695; 95% CI = 0.052–1.339; and P = 0.034). Non-significant result was found for VR-based intervention on global cognition (g = 0.553; 95% CI = −0.273–1.379; and P = 0.189). Additional outcome analyses showed no superiority of VR-based intervention over traditional rehabilitation on motor function and ADL. The ES of VR-based intervention on mood (g = 1.421; 95% CI = 0.448–2.393; and P = 0.004) was large and significant. In the subgroup analysis, large effects for higher daily intensity, higher weekly frequency, or greater dose of VR intervention were found.Conclusion: Our findings indicate that VR-based intervention combined with traditional rehabilitation showed better outcomes for overall cognition, attention/execution, and depressive mood in individuals with chronic stroke. However, VR-based training combined with traditional rehabilitation showed a non-significant effect for global cognition, motor function, and ADL in individuals with chronic stroke.

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Systematic review with network meta-analysis of randomized controlled trials of robotic-assisted arm training for improving activities of daily living and upper limb function after stroke

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-020-00715-0 ◽

2020 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Jan Mehrholz ◽

Alex Pollock ◽

Marcus Pohl ◽

Joachim Kugler ◽

Bernhard Elsner

Keyword(s):

Systematic Review ◽

Activities Of Daily Living ◽

Randomized Controlled Trials ◽

Upper Limb ◽

Daily Living ◽

Meta Analysis ◽

Controlled Trials ◽

Robotic Assisted ◽

Randomized Controlled ◽

Upper Limb Function

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Efficacy evaluation of different stimulation types with transcranial direct current stimulation on upper limb motor function and activities of daily living in patients after stroke: A network Meta-analysis

10.37766/inplasy2020.12.0021 ◽

2020 ◽

Author(s):

Ruo-wei Li ◽

Yuan Xia ◽

Yong-jie Li ◽

Yue Lu ◽

Sheng Hu

Keyword(s):

Activities Of Daily Living ◽

Motor Function ◽

Upper Limb ◽

Direct Current ◽

Transcranial Direct Current Stimulation ◽

Daily Living ◽

Meta Analysis ◽

Efficacy Evaluation ◽

Direct Current Stimulation

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Effect of kinesio taping on hemiplegic shoulder pain: A systematic review and meta-analysis of randomized controlled trials

Clinical Rehabilitation ◽

10.1177/0269215520964950 ◽

2020 ◽

pp. 026921552096495

Author(s):

Peilin Deng ◽

Zhengen Zhao ◽

Shaojun Zhang ◽

Ting Xiao ◽

Yi Li

Keyword(s):

Activities Of Daily Living ◽

Shoulder Pain ◽

Motor Function ◽

Upper Limb ◽

Daily Living ◽

Meta Analysis ◽

Risk Of Bias ◽

Post Intervention ◽

Randomized Controlled ◽

Kinesio Taping

Objective: The aim of this study was to evaluate the effectiveness of kinesio taping for the management of hemiplegic shoulder pain. Data sources: MEDLINE, EMBASE, Web of Science, CENTRAL, CNKI, Wan Fang databases and the grey literature research were searched from inception to July 2020. Methods: We considered randomized controlled trials in English or Chinese that used kinesio taping for the treatment of hemiplegic shoulder pain. Two reviewers independently screened the articles, scored the methodological quality using the PEDro scale, assessed risk of bias using the Cochrane’s risk of bias tool and extracted the data. The outcomes included pain, motor function of the upper limb, magnitude of shoulder subluxation and activities of daily living post-intervention. Results: A total of nine studies ( n = 424) met the inclusion criteria. A meta-analysis demonstrated a significant effect of kinesio taping on pain (mean difference(MD)= −1.45, 95% confidence interval(CI): −1.98 to–0.92 cm, p < 0.0001), motor function of upper limb (MD = 4.22,95%CI: 3.49 to 4.95, p < 0.00001), magnitude of shoulder subluxation (standardized mean difference(SMD) = −0.65, 95%CI: −0.95 to −0.35, p < 0.0001) and activities of daily living (MD = 6.86, 95% CI: 3.99 to 9.73, p < 0.00001) post-intervention. Conclusion: This meta-analysis suggests a beneficial effect of kinesio taping for reducing shoulder subluxation, improving motor function of the upper limb and activities of daily living in patients with hemiplegic shoulder pain post-intervention, which could not be interpreted simply as a placebo effect. And it was associated with reduced pain for patients with chronic stroke.

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