The effectiveness of neuromuscular electrical stimulation on swallowing rehabilitation in patients with post-stroke acute and chronic dysphagia : a systematic review

Background. Clinical trials have demonstrated some benefits of electromyogram-triggered/controlled neuromuscular electrical stimulation (EMG-NMES) on motor recovery of upper limb (UL) function in patients with stroke. However, EMG-NMES use in clinical practice is limited due to a lack of evidence supporting its effectiveness. Objective. To perform a systematic review and meta-analysis to determine the effects of EMG-NMES on stroke UL recovery based on each of the International Classification of Functioning, Disability, and Health (ICF) domains. Methods. Database searches identified clinical trials comparing the effect of EMG-NMES versus no treatment or another treatment on stroke upper extremity motor recovery. A meta-analysis was done for outcomes at each ICF domain (Body Structure and Function, Activity and Participation) at posttest (short-term) and follow-up periods. Subgroup analyses were conducted based on stroke chronicity (acute/subacute, chronic phases). Sensitivity analysis was done by removing studies rated as poor or fair quality (PEDro score <6). Results. Twenty-six studies (782 patients) met the inclusion criteria. Fifty percent of them were considered to be of high quality. The meta-analysis showed that EMG-NMES has a robust short-term effect on improving UL motor impairment in the Body Structure and Function domain. No evidence was found in favor of EMG-NMES for the Activity and Participation domain. EMG-NMES had a stronger effect for each ICF domain in chronic (≥3 months) compared to acute/subacute phases. Conclusion. EMG-NMES is effective in the short term in improving UL impairment in individuals with chronic stroke.

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The effects of cycling with and without functional electrical stimulation on lower limb dysfunction in patients post-stroke: A systematic review with meta-analysis

Neurorehabilitation ◽

10.3233/nre-182671 ◽

2019 ◽

Vol 44 (3) ◽

pp. 389-412 ◽

Cited By ~ 4

Author(s):

Ardalan Shariat ◽

Mahboubeh Ghayour Najafabadi ◽

Noureddin Nakhostin Ansari ◽

Joshua A. Cleland ◽

Maria A. Fiatarone Singh ◽

...

Keyword(s):

Systematic Review ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Lower Limb ◽

Meta Analysis ◽

Post Stroke

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Effectiveness of neuromuscular electrical stimulation for management of shoulder subluxation post-stroke: a systematic review with meta-analysis

Clinical Rehabilitation ◽

10.1177/0269215517700696 ◽

2017 ◽

Vol 31 (11) ◽

pp. 1431-1444 ◽

Cited By ~ 10

Author(s):

Jae-Hyoung Lee ◽

Lucinda L Baker ◽

Robert E Johnson ◽

Julie K Tilson

Keyword(s):

Electrical Stimulation ◽

Shoulder Pain ◽

Treatment Duration ◽

Meta Analysis ◽

Neuromuscular Electrical Stimulation ◽

Chronic Stroke ◽

Daily Treatment ◽

Post Stroke ◽

Subacute Stroke ◽

Arm Function

Objectives: To examine the effectiveness of neuromuscular electrical stimulation (NMES) for the management of shoulder subluxation after stroke including assessment of short (1 hour or less) and long (more than one hour) daily treatment duration. Data sources: MEDLINE, CENTRAL, CINAHL, WOS, KoreaMed, RISS and reference lists from inception to January 2017 Review methods: We considered randomized controlled trials that reported neuromuscular electrical stimulation for the treatment of shoulder subluxation post-stroke. Two reviewers independently selected trials for inclusion, assessed trial quality, and extracted data. Results: Eleven studies were included (432 participants); seven studies were good quality, four were fair. There was a significant treatment effect of neuromuscular electrical stimulation for reduction of subluxation for persons with acute and subacute stroke (SMD:–1.11; 95% CI:–1.53, –0.68) with either short (SMD:–0.91; 95% CI:–1.43, –0.40) or long (SMD:–1.49; 95% CI:–2.31, –0.67) daily treatment duration. The effect for patients with chronic stroke was not significant (SMD:–1.25; 95% CI:–2.60, 0.11). There was no significant effect of neuromuscular electrical stimulation on arm function or shoulder pain. Conclusion: This meta-analysis suggests a beneficial effect of neuromuscular electrical stimulation, with either short or long daily treatment duration, for reducing shoulder subluxation in persons with acute and subacute stroke. No significant benefits were observed for persons with chronic stroke or for improving arm function or reducing shoulder pain.

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