Electroestimulación funcional para miembros superiores tras el accidente cerebrovascular: una revisión sistemática (Functional electrostimulation for upper limbs after stroke: a systematic review)

Abstract

Introducción: el accidente cerebrovascular o ictus es un trastorno circulatorio cerebral cuya incidencia en España es de 186,9 casos/100.000 habitantes cada año. El ictus provoca un déficit neurológico focal de inicio brusco que puede provocar una hemiparesia con alteraciones motoras, cognitivas y sensitivas, entre otras. Dentro de las técnicas de fisioterapia empleadas, se encuentra la electroestimulación funcional (FES). Objetivo: analizar la evidencia científica sobre los efectos de la electroestimulación funcional en los miembros superiores tras el ictus. Método: se realizó una búsqueda bibliográfica en las bases de datos PubMed, Medline y Cinahl empleando los términos del Medical Subject Headings «Stroke», «Electric Stimulation» y «Upper Extremity» y la palabra clave «Electrical Stimulation, Functional». Resultados: tras aplicar los criterios de inclusión y de exclusión se obtienen 14 estudios que aplican la FES en el miembro superior. La mayoría de los estudios centran su atención en la mejora de la fuerza, del rango de movimiento, de la espasticidad y del tono muscular, del grado de discapacidad, del desarrollo de las actividades de la vida diaria, del dolor y de la escala Fugl Meyer Assessment for Upper Limbs (FMA-UL). Conclusión: la FES parece conseguir beneficios frente a la rehabilitación convencional especialmente en los resultados de la escala FMA-UL. Con relación al resto de variables, aunque parecen observarse algunos beneficios, se necesitan más investigaciones con mayor calidad metodológica y con criterios comunes de medición, tanto en una fase temprana como en una crónica tras el ictus para poder establecer una tendencia de respuesta. Palabras clave: Electroestimulación funcional; Miembros superiores; Accidente cerebrovascular; Modalidades de fisioterapia; Pacientes. Abstract. Introduction: a cerebrovascular accident or stroke is a cerebral circulatory disorder whose incidence in Spain is 186.9 cases/100,000 inhabitants each year. Stroke causes a sudden-onset focal neurological deficit that can cause hemiparesis with motor, cognitive and sensory alterations, among others. Functional electrostimulation (FES) is one of the physiotherapy techniques used. Objective: to analyse the scientific evidence on the effects of functional electrostimulation in the upper limbs after stroke. Methods: a bibliographic search was carried out in the PubMed, Medline and Cinahl databases using the Medical Subject Headings terms «Stroke», «Electric Stimulation» and «Upper Extremity» and the keyword «Electrical Stimulation, Functional». Results: after applying the inclusion and exclusion criteria, 14 studies were obtained that applied the FES in the upper limb. Most studies focus on improving strength, range of motion, spasticity and muscle tone, the degree of disability, the development of activities of daily living, pain and the Fugl Meyer Assessment for Upper Limbs scale (FMA-UL). Conclusion: FES seems to achieve benefits compared to conventional rehabilitation, especially in the results of the FMA-UL scale. Regarding the rest of the variables, although some benefits seem to be observed, more research is needed with higher methodological quality and with common measurement criteria, both in an early phase and in a chronic phase after the stroke to establish a response trend. Keywords: Functional electrostimulation; Upper limbs; Stroke; Physical Therapy Modalities; Patients.

Availability and Usage of Electrophysical Agents by Portuguese Physiotherapists: an online Survey

“…Electrophysical agents (EPAs) are a therapeutic resource widely used by Physiotherapists (PTs), as an adjunct to other intervention modalities in a number of health conditions and populations (Chipchase et al, 2009;Gandolfi et al, 2017;Niño et al, 2022;Springer et al, 2015;Watson, 2000). The International Society for Electrophysical Agents in Physical Therapy refers that EPAs can be used for evaluation, treatment and prevention of deficits in functions and structures, limitation in activity and participation restriction of people and populations (WCPT, 2018).…”

“…The International Society for Electrophysical Agents in Physical Therapy refers that EPAs can be used for evaluation, treatment and prevention of deficits in functions and structures, limitation in activity and participation restriction of people and populations (WCPT, 2018). The correct use of EPAs can maximize the results of physiotherapy intervention (Chipchase, 2012;Niño et al, 2022;Sánchez-Gómez et al, 2022) while, inappropriate use compromises the treatment results (Abe et al, 2016), can harm the client (Houghton et al, 2010) and ultimately damages the profession's image.…”

The effectiveness of robotic rehabilitation for the functional recovery of the upper limb in post-stroke patients: a systematic review

“…In the last few years, technology-supported training is emerging to help therapists, patients, and the health system. Particularly, robot-assisted therapy (RT) is a novel and expanding approach in poststroke rehabilitation, which utilizes robotic devices to facilitate the recovery of motor function and task-oriented training (Chien et al, 2020;Hernández Niño et al, 2022;Villafane et al, 2016;Villafane et al, 2017).…”