The effects of cycling with and without functional electrical stimulation on lower limb dysfunction in patients post-stroke: A systematic review with meta-analysis

NeuroRehabilitation. 2019;44(3):389-412. doi: 10.3233/NRE-182671.

Abstract

Background: One of the leading causes of disability in the world with enormous economic burden is stroke.

Objective: To quantify the effectiveness of different protocols of cycling with/without functional electrical stimulation on functional mobility after stroke.

Methods: Multiple databases were searched till 2018. Data extraction was performed using a pre-determined data collection form. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation.

Results: A total of 14 trials satisfied eligibility criteria and were included. Cycling had a positive effect on the 6-meter walking test performance (SMD, 0.41; 95% CI, 0.11 -0.71; I2 = 0% ) compared with no or placebo intervention (control). Compared with control, cycling had a positive effect on 10-meter walking speed (SMD, 0.30; 95% CI, 0.05 -0.55; I2 = 0% ), and on balance based on the Berg score (SMD, 0.32; 95% CI, 0.06 -0.57; I2 = 49% ). Cycling with functional electrical stimulation had a positive effect on balance (SMD, 1.48; 95% CI, 0.99 -1.97; I2 = 91% ) compared with cycling alone.

Conclusions: It appears that cycling has a positive effect on walking speed, walking ability and balance. Functional electrical stimulation combined with cycling has positive effects on balance beyond cycling alone.

Keywords: Meta-analysis; cycling; disability; functional electrical stimulation; lower limb; stroke.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Bicycling / physiology*
  • Bicycling / trends
  • Clinical Trials as Topic / methods
  • Combined Modality Therapy / methods
  • Electric Stimulation Therapy / methods*
  • Electric Stimulation Therapy / trends
  • Humans
  • Lower Extremity / physiopathology
  • Range of Motion, Articular / physiology
  • Stroke / diagnosis
  • Stroke / physiopathology*
  • Stroke / therapy*
  • Stroke Rehabilitation / methods*
  • Stroke Rehabilitation / trends
  • Walking / physiology
  • Walking Speed / physiology