Objective:
To
investigate the effects of cycling with functional electrical
stimulation on walking, muscle power and tone, balance and activities of
daily living in subacute stroke survivors.
Review methods:
Inclusion
criteria were: subacute stroke survivors (<6 months since stroke),
an experimental group performing any type of cycling training with
electrical stimulation, alone or in addition to usual care, and a
control group performing usual care alone. Two reviewers assessed
eligibility, extracted data and analyzed the risks of bias. Standardized
Mean Difference (SMD) or Mean Difference (MD) with 95% Confidence
Intervals (CI) were estimated using fixed- or random-effects models to
evaluate the training effect.
Results:
Seven
randomized controlled trials recruiting a total of 273 stroke survivors
were included in the meta-analyses. There was a statistically
significant, but not clinically relevant, effect of cycling with
electrical stimulation compared to usual care on walking (six studies,
SMD [95% CI] = 0.40 [0.13, 0.67];
P = 0.004), capability to maintain a sitting position (three studies, MD [95% CI] = 7.92 [1.01, 14.82];
P = 0.02) and work produced by the paretic leg during pedaling (2 studies, MD [95% CI] = 8.13 [1.03, 15.25];
P = 0.02).
No significant between-group differences were found for muscular power,
tone, standing balance, and activities of daily living.
Conclusions:
Cycling
training with functional electrical stimulation cannot be recommended
in terms of being better than usual care in subacute stroke survivors.
Further investigations are required to confirm these results, to
determine the optimal training parameters and to evaluate long-term
effects.
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