电刺激对前交叉韧带手术后患者下肢功能恢复的影响：一项系统评价和Meta分析

Effect of electrical stimulation on functional recovery of lower limbs in patients after anterior cruciate ligament surgery: a systematic review and meta-analysis.

作者信息

Shan Wenjing, Zheng Tingting, Zhang Jing, Pang Rizhao

机构信息

Department of Rehabilitation Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan, China.

Department of Rehabilitation Medicine, The General Hospital of Western Theater Command, Chengdu, Sichuan, China

出版信息

BMJ Open. 2025 Jul 25;15(7):e089702. doi: 10.1136/bmjopen-2024-089702.

DOI:10.1136/bmjopen-2024-089702

PMID:40713045

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12306215/

Abstract

OBJECTIVES

This study aimed to summarise the existing literature about enhancing muscle strength, lower limb function and self-reported function by electrical stimulation (ES) relative to conventional physical therapy following anterior cruciate ligament reconstruction (ACLR), and to assess the comprehensive treatment effects of ES via meta-analysis.

DESIGN

Systematic review, meta-analysis.

METHODS

This study systematically searched five electronic databases (PubMed, Web of Science, Scopus, Embase and Chinese National Knowledge Infrastructure), covering records from their inception until February 2024, adhering to a predefined search strategy. Two independent reviewers extracted and synthesised the relevant data using RevMan software (V.5.3). Due to identified heterogeneity, a random-effects model was applied for the meta-analysis. The meta-analysis calculated the effect sizes concerning lower limb function outcomes as standardised mean differences (SMD) with 95% CIs. The methodological quality of the included studies was assessed by the Physiotherapy Evidence Database scale.

RESULTS

A total of 15 studies involving 1583 patients (between the ages of 15 and 50 years) were included. Meta-analysis results indicated that the ES group could improve the lower limb comprehensive function compared with the control group (CG) based on four clinical tests: the muscle strength (SMD=0.55, 95% CI 0.14 to 0.95, p=0.008, I=74%), the range of motion (SMD=1.10, 95% CI 0.40 to 1.79, p=0.002, I=89%), the Lysholm scale (SMD=1.05, 95% CI 0.36 to 1.73, p=0.003, I=91%) and the visual analogue scale (SMD=0.87, 95% CI 0.38 to 1.37, p=0.006, I=75%). However, there were no significant differences between the CG and the ES group in terms of leg circumference (SMD=0.61, 95% CI -0.78 to 2.00, p=0.39, I=87%).

CONCLUSIONS

Adjunctive ES has the potential to enhance early-phase ACLR rehabilitation outcomes, particularly by improving muscle strength, lower limb function and self-reported function, despite the use of different ES modalities.

PROSPERO REGISTRATION NUMBER

CRD42024549752.

摘要

目的

本研究旨在总结现有关于与前交叉韧带重建（ACLR）术后传统物理治疗相比，电刺激（ES）增强肌肉力量、下肢功能和自我报告功能的文献，并通过荟萃分析评估ES的综合治疗效果。

设计

系统评价、荟萃分析。

方法

本研究按照预定义的检索策略，系统检索了五个电子数据库（PubMed、Web of Science、Scopus、Embase和中国知网），涵盖从建库至2024年2月的记录。两名独立评审员使用RevMan软件（V.5.3）提取并综合相关数据。由于存在异质性，荟萃分析采用随机效应模型。荟萃分析计算了下肢功能结局的效应量，以标准化均数差（SMD）及95%可信区间表示。纳入研究的方法学质量采用物理治疗证据数据库量表进行评估。

结果

共纳入15项研究，涉及1583例患者（年龄在15至50岁之间）。荟萃分析结果表明，基于四项临床测试，ES组与对照组相比可改善下肢综合功能：肌肉力量（SMD = 0.55，95%可信区间0.14至0.95，p = 0.008，I² = 74%）、活动范围（SMD = 1.10，95%可信区间0.40至1.79，p = 0.002，I² = 89%）、Lysholm量表（SMD = 1.05，95%可信区间0.36至1.73，p = 0.003，I² = 91%）和视觉模拟量表（SMD = 0.87，95%可信区间0.38至1.37，p = 0.006，I² = 75%）。然而，对照组和ES组在腿围方面无显著差异（SMD = 0.61，95%可信区间 -0.78至2.00，p = 0.39，I² = 87%）。