University of Birmingham 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-猫眼课题宝

伯明翰大学中风后上肢功能性电刺激对改善日常生活活动和运动功能的有效性：系统评价和荟萃分析

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Denise Curtis;S. Fallows;Michael M. Morris;Carolyn. R. McMakin

背景：中风可导致上肢功能严重受损，影响日常生活活动能力(ADL)。功能性电刺激(FES)包括对运动神经元的电刺激，从而使肌肉群收缩并创造或扩大关于关节的时刻。虽然在卒中后康复中建立了上肢FES，但对上肢FES的有效性尚不清楚。本研究旨在评价卒中后上肢功能锻炼对日常生活活动能力和运动功能的影响。方法：对来自MEDLINE、SouInfo、EMBASE、CENTAL、ISRCTN、ICTRP和ClinicalTrials.gov的随机对照试验进行系统综述。纳入研究的引文检查和系统评价。资格标准：入选者&GT；出血性/缺血性卒中18岁，干预组接受上肢FES加标准护理，对照组接受标准护理。结果是ADL(一级)、功能运动能力(二级)和其他运动结果(三级)。使用等级(建议评估、发展和评价的等级)标准进行质量评估。结果：共纳入20篇研究。在6项研究(标准化平均差值0.64；95%可信区间[−0.02，1.3]；FES组(N)=67)中，客观日常生活能力测量没有发现明显的好处；所有日常生活能力测量的组合是不可能的。对中风后平均2个月内开始使用FES的三项研究的分析表明，FES对ADL有显著的益处(SMD 1.24；CI[0.46，2.03]；n=32)。在3项在中风后1年以上开始进行功能性电刺激的研究中，没有发现显著的日常生活能力改善(SMD−0.10；CI[−0.59，0.38]，n=35)。使用等级进行质量评估发现，由于异质性，低质量证据在所有分析中都很低

Background: Stroke can lead to significant impairment of upper limb function which affects performance of activities of daily living (ADL). Functional electrical stimulation (FES) involves electrical stimulation of motor neurons such that muscle groups contract and create or augment a moment about a joint. Whilst lower limb FES was established in post-stroke rehabilitation, there is a lack of clarity on the effectiveness of upper limb FES. This systematic review aims to evaluate the effectiveness of post-stroke upper limb FES on ADL and motor outcomes. Methods: Systematic review of randomised controlled trials from MEDLINE, PsychINFO, EMBASE, CENTRAL, ISRCTN, ICTRP and ClinicalTrials.gov. Citation checking of included studies and systematic reviews. Eligibility criteria: participants > 18 years with haemorrhagic/ischaemic stroke, intervention group received upper limb FES plus standard care, control group received standard care. Outcomes were ADL (primary), functional motor ability (secondary) and other motor outcomes (tertiary). Quality assessment using GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria. Results: Twenty studies were included. No significant benefit of FES was found for objective ADL measures reported in six studies (standardised mean difference (SMD) 0.64; 95% Confidence Interval (CI) [ − 0.02, 1.30]; total participants in FES group ( n ) = 67); combination of all ADL measures was not possible. Analysis of three studies where FES was initiated on average within 2 months post-stroke showed a significant benefit of FES on ADL (SMD 1.24; CI [0.46, 2.03]; n = 32). In three studies where FES was initiated more than 1 year after stroke, no significant ADL improvements were seen (SMD − 0.10; CI [ − 0.59, 0.38], n = 35). Quality assessment using GRADE found very low quality evidence in all analyses due to heterogeneity, low

University of Birmingham 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

伯明翰大学中风后上肢功能性电刺激对改善日常生活活动和运动功能的有效性：系统评价和荟萃分析

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