A Randomized Controlled Study: Effectiveness of Functional Electrical Stimulation on Wrist and Finger Flexor Spasticity in Hemiplegia

Yüzer, Güldal Funda Nakipoğlu; Donmez, Burcu Kose; Özgirgin, Neşe

doi:10.1016/j.jstrokecerebrovasdis.2017.03.011

Cited by 22 publications

(9 citation statements)

References 6 publications

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“…The results of bias risk assessment are illustrated in Figures 2 and 3, and the detailed assessment results are shown in Additional file 4. The results indicated that 5 trials were not classified into high-risk category by standard random allocation method, 4 trials of which 56,58,61,64 were allocated according to the order of inclusion, and one of which 37 was grouped according to the wishes of patients and their families. 5 trials 44,51,55,62,63 were classified as high risk due to the inappropriate adopted blinding method.…”

Section: Literature Researchmentioning

confidence: 99%

Optimal Method of Electrical Stimulation for the Treatment of Upper Limb Dysfunction After Stroke: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials

Tang¹,

Wang²,

He³

et al. 2021

NDT

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Background The obstacle of limb motor caused by stroke, especially the decline of motor function of upper limbs, can directly affect the activities of daily living of stroke patients with hemiplegia. Based on long-term clinical practice, the treatment effect of electrical stimulation methods for stroke limb dysfunction has been widely recognized and supported by authoritative guidelines and systematic reviews. However, which electrical stimulation method is the optimum in the treatment of stroke limb dysfunction is still a controversial issue. Objective In this paper, we adopted Network Meta-Analysis (NMA) to rank the priorities of various electrical stimulation methods, so as to select the optimal electrical stimulation method and discuss its rationality in guiding clinical practice. Methods We carried out a systematic review by searching a total of 6806 studies from 8 databases and 2 clinical trial registries, and finally screened out 34 studies for further investigation. Then, pairwise meta-analysis and Bayesian network meta-analysis were employed to evaluate the effectiveness and ranking of various interventions. The primary outcome measure was Fugl-Meyer Assessment Upper Extremity (FMA-UE), and the secondary outcome measures were Modified Barthel Index (MBI) and Modified Ashworth Scale (MAS). Finally, the risk of bias, publication bias and sensitivity of the Randomized Controlled Trials (RCTs) were evaluated. Results On the basis of comprehensive rehabilitation treatment (RT), the Functional Electrical Stimulation (FES) was superior than other electrical stimulation methods in improving both FMA-UE and MBI. Meanwhile, the results indicated that the Transcutaneous Electrical Acupoint Stimulation (TEAS) was the only electrical stimulation method that showed treatment advantages in reducing MAS. Conclusion The study showed that FES had the optimal overall rehabilitation effect on upper limb dysfunction of stroke patients based on the comprehensive RT, while the treatment effect of TEAS on upper limb spasticity after stroke was the most significant.

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Section: Literature Researchmentioning

confidence: 99%

Optimal Method of Electrical Stimulation for the Treatment of Upper Limb Dysfunction After Stroke: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials

Tang¹,

Wang²,

He³

et al. 2021

NDT

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“…In neuro-rehabilitaion, NMES is commonly applied to the finger extensor muscles of the affected hand because the affected hand usually shows flexor spasticity in hemiparetic patients with brain injury (Nakipğlu Yuzer et al, 2017 ; Pundik et al, 2018 ). Therefore, NMES was applied to the finger extensor muscles in this study.…”

Section: Discussionmentioning

confidence: 99%

Effect of Neuromuscular Electrical Stimulation Training on the Finger Extensor Muscles for the Contralateral Corticospinal Tract in Normal Subjects: A Diffusion Tensor Tractography Study

Jang

Seo

2018

Front. Hum. Neurosci.

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Objectives: Neuromuscular electrical stimulation (NMES) is a popular rehabilitative modality to improve motor function of the extremities and trunk. In this study, we investigated changes of hand function and the contralateral corticospinal tract (CST) with treatment by NMES on the finger extensor muscles for 2 weeks, using serial diffusion tensor tractography (DTT).Methods: Thirteen right handed normal subjects were recruited. Treatment was applied to the left hand (the NMES side), and the right hand was the control side. NMES was applied for 30 min/day, 7 days per week, for 2 weeks. Hand motor function was evaluated twice at pre-NMES and post-NMES training using grip strength (GS), Purdue pegboard test (PPT) and tip pinch. The fractional anisotropy (FA), mean diffusivity (MD) and tract volume (TV) of the CST in both hemispheres were measured using DTT.Results: On the control side, the clinical scores did not differ significantly between pre- and post-NMES training (p > 0.05). However, on the NMES side, PPT and tip pinch improved significantly (p < 0.05), although GS did not. TV of the right CST increased significantly at post-NMES training (p < 0.05) whereas FA and MD did not differ significantly (p > 0.05). By contrast, FA, MD and TV on the left CST did not change significantly (p > 0.05).Conclusion: We demonstrated facilitation of the contralateral CST with improvement of fine motor activity by 2 weeks of NMES training of peripheral muscles in normal subjects. We think our results can be applied to the normal subjects and patients with brain injury to improve the fine motor function of the hand and facilitate the normal CST or healing of the injured CST.

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“…Filter by title, abstract, repetition, and content, most of the unqualified articles have been filtered out. Careful assessment of 21 full-text articles led to the exclusion of 2 studies 20, 21 because of lacking a control group, another 3 studies [22][23][24] were excluded due to incomplete data. Therefore, a total of 16 randomized controlled trials (RCTs) with 691 acute or chronic individuals fulfilled the inclusion criteria and were applied to this meta-analysis.…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

Effects of Neuromuscular Electrical Stimulation on Hemiplegic Upper Limb of Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials

Zhang¹,

Pei²,

Huang³

et al. 2019

Preprint

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Background: Whether NMES helps the recovery of upper limb function in patients with hemiparesis has not been confirmed. We conducted this meta-analysis to examine the effectiveness of neuromuscular electrical stimulation (NMES) for upper limb hemiparesis after stroke.Methods: Data sources such as Pubmed, Embase and Cochrane library databases were searched for all relevant studies that were carried out before December 1, 2018.We selected the randomized controlled trials (RCTs) which included chronic and acute stroke patients with upper extremity dysfunction. Then the intervention group which applied NMES was compared with a control group without NMES. Results: A total of 16 RCTs involving 691 patients were discerned from 248 searched articles. According to the forest plot ,NMES had a significant benefit on FMA-ue scale(SMD=0.44,95%CI 0.13 to 0.74,P=0.006).Also, NMES was positive for ARAT(SMD=0.31,95%CI 0.05 to 0.58,P=0.019)and MAL-AOU(SMD=0.59,95%CI 0.15 to1.04,P=0.009),but not for wrist MAS(SMD=-0.12,95%CI -0.43 to 0.19,P=0.434) or BI(SMD=0.51,95%CI -0.65 to 1.66,P=0.392).Conclusion: NMES application has beneficial impacts on upper extremity motor function in patients with stroke. This study suggests that NMES ought to be applied as a beneficial rehabilitation means in improving the upper function.

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A Randomized Controlled Study: Effectiveness of Functional Electrical Stimulation on Wrist and Finger Flexor Spasticity in Hemiplegia

Cited by 22 publications

References 6 publications

Optimal Method of Electrical Stimulation for the Treatment of Upper Limb Dysfunction After Stroke: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials

Optimal Method of Electrical Stimulation for the Treatment of Upper Limb Dysfunction After Stroke: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials

Effect of Neuromuscular Electrical Stimulation Training on the Finger Extensor Muscles for the Contralateral Corticospinal Tract in Normal Subjects: A Diffusion Tensor Tractography Study

Effects of Neuromuscular Electrical Stimulation on Hemiplegic Upper Limb of Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials

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