Abstract
Background.
Clinical trials have demonstrated some benefits of
electromyogram-triggered/controlled neuromuscular electrical stimulation
(EMG-NMES) on motor recovery of upper limb (UL) function in patients
with stroke. However, EMG-NMES use in clinical practice is limited due
to a lack of evidence supporting its effectiveness.
Objective. To
perform a systematic review and meta-analysis to determine the effects
of EMG-NMES on stroke UL recovery based on each of the International
Classification of Functioning, Disability, and Health (ICF) domains.
Methods.
Database searches identified clinical trials comparing the effect of
EMG-NMES versus no treatment or another treatment on stroke upper
extremity motor recovery. A meta-analysis was done for outcomes at each
ICF domain (Body Structure and Function, Activity and Participation) at
posttest (short-term) and follow-up periods. Subgroup analyses were
conducted based on stroke chronicity (acute/subacute, chronic phases).
Sensitivity analysis was done by removing studies rated as poor or fair
quality (PEDro score <6).
Results. Twenty-six studies (782
patients) met the inclusion criteria. Fifty percent of them were
considered to be of high quality. The meta-analysis showed that EMG-NMES
has a robust short-term effect on improving UL motor impairment in the
Body Structure and Function domain. No evidence was found in favor of
EMG-NMES for the Activity and Participation domain. EMG-NMES had a
stronger effect for each ICF domain in chronic (≥3 months) compared to
acute/subacute phases. Conclusion. EMG-NMES is effective in the short term in improving UL impairment in individuals with chronic stroke. (And with no written protocol, nothing will be done with this.)
No comments:
Post a Comment