Howlett Owen A, Lannin Natasha A, Ada Louise, McKinstry Carol
Department of Occupational Therapy, La Trobe University, Bundoora, VIC, Australia; Bendigo Health, Bendigo, VIC, Australia.
Department of Occupational Therapy, La Trobe University, Bundoora, VIC, Australia; Occupational Therapy Department, Alfred Health, Prahran, VIC, Australia; The John Walsh Centre of Rehabilitation Research, Sydney Medical School (Northern), University of Sydney, St Leonards, NSW, Australia.
Arch Phys Med Rehabil. 2015 May;96(5):934-43. doi: 10.1016/j.apmr.2015.01.013. Epub 2015 Jan 26.
To investigate the effect of functional electrical stimulation (FES) in improving activity and to investigate whether FES is more effective than training alone.
Cochrane Central Register of Controlled Trials, Ovid Medline, EBSCO Cumulative Index to Nursing and Allied Health Literature, Ovid EMBASE, Physiotherapy Evidence Database (PEDro), and Occupational Therapy Systematic Evaluation of Effectiveness.
Randomized and controlled trials up to June 22, 2014, were included following predetermined search and selection criteria.
Data extraction occurred by 2 people independently using a predetermined data collection form. Methodologic quality was assessed by 2 reviewers using the PEDro methodologic rating scale. Meta-analysis was conducted separately for the 2 research objectives.
Eighteen trials (19 comparisons) were eligible for inclusion in the review. FES had a moderate effect on activity (standardized mean difference [SMD], .40; 95% confidence interval [CI], .09-.72) compared with no or placebo intervention. FES had a moderate effect on activity (SMD, .56; 95% CI, .29-.92) compared with training alone. When subgroup analyses were performed, FES had a large effect on upper-limb activity (SMD, 0.69; 95% CI, 0.33-1.05) and a small effect on walking speed (mean difference, .08m/s; 95% CI, .02-.15) compared with control groups.
FES appears to moderately improve activity compared with both no intervention and training alone. These findings suggest that FES should be used in stroke rehabilitation to improve the ability to perform activities.
探讨功能性电刺激（FES）对改善活动能力的效果，并研究FES是否比单纯训练更有效。
Cochrane对照试验中央注册库、Ovid Medline、EBSCO护理及相关健康文献累积索引、Ovid EMBASE、物理治疗证据数据库（PEDro）以及职业治疗有效性系统评价。
纳入截至2014年6月22日的随机对照试验，遵循预先确定的检索和选择标准。
由2人独立使用预先确定的数据收集表进行数据提取。2名评审员使用PEDro方法学评分量表评估方法学质量。针对2个研究目标分别进行荟萃分析。
18项试验（19项比较）符合纳入综述的条件。与无干预或安慰剂干预相比，FES对活动能力有中等程度的影响（标准化均数差[SMD]，0.40；95%置信区间[CI]，0.09 - 0.72）。与单纯训练相比，FES对活动能力有中等程度的影响（SMD，0.56；95% CI，0.29 - 0.92）。进行亚组分析时，与对照组相比，FES对上肢活动能力有较大影响（SMD，0.69；95% CI，0.33 - 1.05），对步行速度有较小影响（均数差，0.08m/s；95% CI，0.02 - 0.15）。
与无干预和单纯训练相比，FES似乎能适度改善活动能力。这些发现表明，FES应用于中风康复以提高活动执行能力。
