Therapeutic electrical stimulation to improve motor control and functional abilities of the upper extremity after stroke: a systematic review
Therapeutic electrical stimulation to improve motor control and functional abilities of the upper extremity after stroke: a systematic review
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DOI：
10.1191/0269215502cr504oa
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发表时间：
2002-06-01
影响因子：
3
通讯作者：
Lankhorst, GJ
中科院分区：
文献类型：
--
作者：
de Kroon, JR;van der Lee, JH;Lankhorst, GJ
背景：治疗性电刺激(TES)是一种旨在改善中风患者上肢功能障碍的治疗策略。目的：评价现有证据关于TES对改善中风后上肢运动控制和功能能力的作用。方法：通过系统的文献检索，确定TES对运动控制和功能能力的影响的随机对照试验(RCT)。两位评分者对研究的方法学质量进行了系统的评估。检查报道的结果以评估TES的效果，并确定与患者特征、刺激方法和方法学质量的可能关系。在可能的情况下，计算效应大小(Hedge‘s g)。方法学评分从7分到16分(最高19分)。所有研究都评估了对运动控制的影响，其中四项报告了积极的效果。三项研究计算的效应大小从0.55到1.46不等。只有两项研究评估了这对功能能力的影响，其中一项报告了积极的影响。两项研究中的亚组分析表明，受刺激影响较轻的患者对刺激的反应更好。除此之外，未发现疗效与患者特征、刺激方法或方法学质量之间的关系。结论：本综述提示电刺激对运动控制有积极作用。关于这对功能能力的影响还不能得出任何结论。
Background: Therapeutic electrical stimulation (TES) is a therapeutic strategy aimed at improving impairments of the upper extremity in stroke.Objective: Assessment of the available evidence on the effect of TES of the affected upper extremity in improving motor control and functional abilities after stroke.Methods: A systematic literature search was performed to identify randomized controlled trials (RCTs) that have studied the effect of TES on motor control and functional abilities. The methodological quality of the studies was assessed systematically by two raters. The reported outcomes were examined to evaluate the effect of TES and to identify a possible relationship with patient characteristics, method of stimulation and methodological quality. When possible, effect sizes were calculated (Hedges' g).Results: Six RCTs were included. The methodological scores ranged from 7 to 16 (maximum 19). All studies assessed the effect on motor control, and four reported a positive effect. Effect sizes calculated in three studies ranged from 0.55 to 1.46. Only two studies assessed the effect on functional ability, one reported a positive effect. Subgroup analyses in two studies suggest a better response to stimulation in less severely affected patients. Apart from this, no relationship between effect and patient characteristics, method of stimulation or methodological quality could be detected.Conclusions: The present review suggests a positive effect of electrical stimulation on motor control. No conclusions can be drawn with regard to the effect on functional abilities.