Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), 245, Sarmento Leite Street, 90050-170 Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, UFCSPA, Porto Alegre, RS, Brazil.
Rehabilitation Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), 245, Sarmento Leite Street, 90050-170 Porto Alegre, RS, Brazil; Movement Analysis and Neurological Rehabilitation Laboratory, UFCSPA, Porto Alegre, RS, Brazil; Health Sciences Graduate Program, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Ann Phys Rehabil Med. 2021 Jan;64(1):101388. doi: 10.1016/j.rehab.2020.03.012. Epub 2020 May 24.
Functional electrical stimulation (FES) applied to the paretic peroneal nerve has positive clinical effects on foot drop secondary to stroke.
To evaluate the effectiveness of FES applied to the paretic peroneal nerve on gait speed, active ankle dorsiflexion mobility, balance, and functional mobility.
Electronic databases were searched for articles published from inception to January 2020. We included randomized controlled trials or crossover trials focused on determining the effects of FES combined or not with other therapies in individuals with foot drop after stroke. Characteristics of studies, participants, comparison groups, interventions, and outcomes were extracted. Statistical heterogeneity was assessed with the I statistic.
We included 14 studies providing data for 1115 participants. FES did not enhance gait speed as compared with conventional treatments (i.e., supervised/unsupervised exercises and regular activities at home). FES combined with supervised exercises (i.e., physiotherapy) was better than supervised exercises alone for improving gait speed. We found no effect of FES combined with unsupervised exercises and inconclusive effects when FES was combined with regular activities at home. When FES was compared with conventional treatments, it improved ankle dorsiflexion, balance and functional mobility, albeit with high heterogeneity for these last 2 outcomes.
This meta-analysis revealed low quality of evidence for positive effects of FES on gait speed when combined with physiotherapy. FES can improve ankle dorsiflexion, balance, and functional mobility. However, considering the low quality of evidence and the high heterogeneity, these results must be interpreted carefully.
功能性电刺激（FES）应用于麻痹的腓总神经，对中风后足下垂有积极的临床效果。
评估 FES 应用于麻痹的腓总神经对步态速度、主动踝关节背屈活动度、平衡和功能性移动能力的影响。
电子数据库检索从建库到 2020 年 1 月发表的文章。我们纳入了随机对照试验或交叉试验，重点关注 FES 与其他疗法联合或不联合治疗中风后足下垂患者的效果。提取研究、参与者、对照组、干预措施和结局的特征。采用 I ² 统计量评估统计学异质性。
我们纳入了 14 项研究，共 1115 名参与者提供了数据。与常规治疗（即监督/非监督运动和在家中的常规活动）相比，FES 并未提高步态速度。FES 联合监督运动（即物理治疗）优于单独进行监督运动，可改善步态速度。我们发现 FES 联合非监督运动和 FES 联合在家中常规活动的效果不明显。与常规治疗相比，FES 可改善踝关节背屈、平衡和功能性移动能力，但这两个结局的异质性较高。
本荟萃分析显示，FES 联合物理治疗对步态速度的积极影响的证据质量较低。FES 可改善踝关节背屈、平衡和功能性移动能力。然而，考虑到证据质量低和高度异质性，这些结果必须谨慎解释。
