Discipline of Physiotherapy, The University of Sydney, Australia; Discipline of Physiotherapy, Universidade Federal de Minas Gerais.
Discipline of Physiotherapy, The University of Sydney, Australia; Discipline of Physiotherapy, Universidade do Estado de Santa Catarina, Brazil.
J Physiother. 2014 Mar;60(1):22-30. doi: 10.1016/j.jphys.2013.12.002. Epub 2014 Apr 24.
Does electrical stimulation increase strength after stroke and are any benefits maintained beyond the intervention period or carried over to activity?
Systematic review with meta-analysis of randomised or controlled trials.
Adults who have had a stroke.
Cyclical electrical stimulation applied in order to increase muscle strength.
Strength measures had to be representative of maximum voluntary contraction and were obtained as continuous measures of force or torque, or ordinal measures such as manual muscle tests. Activity was measured using direct measures of performance that produced continuous or ordinal data, or with scales that produced ordinal data.
Sixteen trials representing 17 relevant comparisons were included in this systematic review. Effect sizes were calculated as standardised mean differences because various muscles were studied and different outcome measures were used. Overall, electrical stimulation increased strength by a standardised mean difference (SMD) of 0.47 (95% CI 0.26 to 0.68) and this effect was maintained beyond the intervention period (SMD 0.33, 95% CI 0.07 to 0.60). Electrical stimulation also improved activity (SMD 0.30, 95% CI 0.05 to 0.56) and this effect was also maintained beyond the intervention period (SMD 0.38, 95% CI 0.09 to 0.66).
Cyclical electrical stimulation increases strength and improves activity after stroke. These benefits were maintained beyond the intervention period with a small-to-moderate effect size. The sustained effect on activity suggests that the benefits were incorporated into daily life. Review registration: PROSPERO (CRD42013003895).
电刺激能否增加中风后的肌力，且这些益处是否能在干预期结束后持续存在，或转移到活动能力上？
系统评价，对随机或对照试验进行荟萃分析。
曾发生中风的成年人。
周期性电刺激，目的是增加肌肉力量。
强度测量必须代表最大自主收缩，且作为力或扭矩的连续测量值，或作为徒手肌力测试等顺序测量值获得。活动能力通过产生连续或顺序数据的直接性能测量，或通过产生顺序数据的量表来测量。
这项系统评价纳入了 16 项试验，共涉及 17 项相关比较。由于研究了不同的肌肉，使用了不同的结局测量值，因此计算了效应量作为标准化均数差。总体而言，电刺激使力量增加了 0.47 的标准化均数差（95%置信区间 0.26 至 0.68），这种效果在干预期结束后仍能维持（标准化均数差 0.33，95%置信区间 0.07 至 0.60）。电刺激还改善了活动能力（标准化均数差 0.30，95%置信区间 0.05 至 0.56），这种效果在干预期结束后也能维持（标准化均数差 0.38，95%置信区间 0.09 至 0.66）。
周期性电刺激可增加中风后的肌力和活动能力。这些益处在干预期结束后仍能维持，且具有较小至中等的效应量。对活动能力的持续影响表明，这些益处已融入日常生活中。
PROSPERO（CRD42013003895）。
