Contralaterally Controlled Functional Electrical Stimulation for Improving Motor Function After Acquired Brain Injury: A Systematic Review and Meta-analysis

Shan Xie; Yuqian Zhang; Jing Li; Zhefan Wu; Yulong Bai

doi:10.1016/j.apmr.2024.03.001

Contralaterally Controlled Functional Electrical Stimulation for Improving Motor Function After Acquired Brain Injury: A Systematic Review and Meta-analysis

Arch Phys Med Rehabil. 2024 Mar 13:S0003-9993(24)00882-7. doi: 10.1016/j.apmr.2024.03.001. Online ahead of print.

Authors

Shan Xie¹, Yuqian Zhang², Jing Li¹, Zhefan Wu², Yulong Bai³

Affiliations

¹ Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Jing'an District, Shanghai, China; School of Exercise and Health, Shanghai University of Sport, Shanghai, China.
² Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Jing'an District, Shanghai, China.
³ Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Jing'an District, Shanghai, China. Electronic address: dr_baiyl@fudan.edu.cn.

PMID: 38490452
DOI: 10.1016/j.apmr.2024.03.001

Abstract

Objective: To systematically evaluate the effect of contralaterally controlled functional electrical stimulation (CCFES) on motor function after acquired brain injury (ABI).

Data sources: We searched the PubMed, Embase, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), Web of Science, SinoMed, CNKI, VIP Database for Chinese Technical Periodicals and Wanfang Database, from inception to December 2023.

Study selection: Studies were included if they were randomized controlled trials assessing the effect of CCFES on motor function compared with routine rehabilitation or routine electrical stimulation after ABI. Two independent reviewers screened 894 articles for inclusion.

Data extraction: The extracted data included study information, sample size, study population, interventions, measurement evaluated, and the test interval.

Data synthesis: This study included 24 trials with 28 intervention-control pairs and 1148 participants with stroke. Meta-analysis showed that the CCFES group demonstrated more significant improvement than the control group in the Fugl-Meyer Assessment Scale (FMA) (standardized mean difference [SMD]=0.66, 95% confidence interval [CI]=0.44-0.88, P<.001), active range of motion (AROM) (SMD=0.77, 95% CI=0.54-1.01, P<.001), modified Barthel Index (MBI) (SMD=0.55, 95% CI=0.29-0.81, P<.001), Motricity Index (MI) (SMD=0.60, 95% CI=0.26-0.94, P<.001) surface electromyography (sEMG) (SMD=0.81, 95% CI=0.56-1.06, P<.001), and Functional Ambulation Category (FAC) (SMD=0.53, 95% CI=0.24-0.83, P<.001). The CCFES group showed no significant improvement over the control group in the Action Research Arm Test (ARAT) (SMD=0.24, 95% CI=-0.10-0.58, P=.17).

Conclusions: Our synthesized evidence suggests that CCFES could improve motor function in patients with stroke. More RCTs with other patients with brain injury are required to provide future evidence on the therapy effect of CCFES and make a contribution to the uniform standard of CCFES.

Keywords: Acquired brain injury; Contralaterally controlled functional electrical stimulation; Meta-analysis; Motor function; Randomized controlled trial; Rehabilitation; System evaluation.

Publication types

Review