经皮穴位电刺激对脑卒中后上肢运动功能恢复的影响：一项系统评价与Meta分析
Transcutaneous electrical acupoint stimulation for upper limb motor recovery after stroke: a systematic review and meta-analysis.
作者信息
Wang Xiaoyu, Yin Lianjun, Wang Yikun, Zhang Haining, Zhang Shiying, Wu Jiantong, Fan Shun, Li Zhengfei, Li Huanan, Wang Jingui
机构信息
Department of Tuina, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China.
出版信息
Front Aging Neurosci. 2024 Nov 27;16:1438994. doi: 10.3389/fnagi.2024.1438994. eCollection 2024.
BACKGROUND
Transcutaneous electrical acupoint stimulation (TEAS) is an innovative, non-invasive therapy that stimulates the contraction of paralyzed muscles in the upper limbs, promoting functional recovery. Several studies have demonstrated the efficacy of TEAS in restoring upper limb function. This study aims to evaluate the impact of TEAS on upper limb motor recovery after stroke.
OBJECTIVES
This study aims to evaluate the influence of TEAS on upper limb motor recovery after stroke and improve the quality of life in such patients.
METHODS
Eight databases were systematically searched from inception to 1st October 2024. Two independent reviewers conducted the screening and data extraction of the study. The primary outcome measure was the Fugl Meyer Assessment of the Upper Extremity (FMA-UE), which evaluates upper extremity motor function in stroke patients. Secondary outcomes included the Modified Ashworth Scale (MAS) for assessing spasticity and the Modified Barthel Index (MBI) to evaluate patients' abilities to perform activities of daily living. Data synthesis was conducted using RevMan 5.4 and Stata 14.0. The GRADE method was employed to assess the quality of evidence.
RESULTS
A total of 16 trials involving 1,218 stroke patients were included in this meta-analysis. Meta-analysis showed that the TEAS significantly improved upper limb function (SMD = 1.70, 95CI% = 1.09 to 2.31, < 0.00001, = 93%; low certainty of evidence), reduced spasticity (SMD = -1.18, 95CI% = -1.79 to -0.58, < 0.00001, = 90%; very low certainty of evidence), and enhanced the ability to perform daily activities (SMD = 1.53, 95CI% = 0.85 to 2.20, < 0.00001, = 95%; low certainty of evidence).
CONCLUSION
Our results indicated that TEAS improved motor function and functional activities and reduced muscle tone in the upper limbs after stroke. However, these results should be interpreted with caution due to the limited strength of the evidence. High-quality, larger sample, multi-center studies are needed to validate these preliminary findings.
SYSTEMATIC REVIEW REGISTRATION
This study was registered on PROSPERO with registration number CRD42024592509. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024592509.
背景
经皮穴位电刺激（TEAS）是一种创新的非侵入性疗法，可刺激上肢瘫痪肌肉收缩，促进功能恢复。多项研究已证实TEAS在恢复上肢功能方面的疗效。本研究旨在评估TEAS对中风后上肢运动恢复的影响。
目的
本研究旨在评估TEAS对中风后上肢运动恢复的影响，并改善此类患者的生活质量。
方法
系统检索了8个数据库，检索时间从建库至2024年10月1日。由两名独立 reviewers 进行研究的筛选和数据提取。主要结局指标是上肢Fugl Meyer评估量表（FMA-UE），用于评估中风患者的上肢运动功能。次要结局包括用于评估痉挛的改良Ashworth量表（MAS）和用于评估患者日常生活活动能力的改良Barthel指数（MBI）。使用RevMan 5.4和Stata 14.0进行数据合成。采用GRADE方法评估证据质量。
结果
本荟萃分析共纳入16项试验，涉及1218例中风患者。荟萃分析表明，TEAS显著改善了上肢功能（标准化均数差[SMD]=1.70，95%置信区间[CI]=1.09至2.31，P<0.00001，I²=93%；证据质量低），降低了痉挛程度（SMD=-1.18，95%CI=-1.79至-0.58，P<0.00001，I²=90%；证据质量极低），并增强了日常生活活动能力（SMD=1.53，95%CI=0.85至2.20，P<0.00001，I²=95%；证据质量低）。
结论
我们的结果表明，TEAS可改善中风后上肢的运动功能和功能活动，并降低肌张力。然而，由于证据强度有限，这些结果应谨慎解释。需要高质量、大样本、多中心研究来验证这些初步发现。
系统评价注册
本研究已在PROSPERO注册，注册号为CRD42024592509。https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024592509 。
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