Effectiveness of functional electrical stimulation compared to other rehabilitation therapies to improve gait in stroke pa¬tients: A systematic review and meta-analysis of randomized controlled trials

Abstract

Introduction: In patients with Stroke, recovering gait is one of the main rehabilitation goals. Functional Electrical Stimulation (FES) is a modality used for this purpose. Objective: To quantify the effectiveness of FES compared to other rehabilitation therapies in improving gait in patients over 14 years of age with Stroke. Material or Patients and Methods: Systematic review and meta-analysis of randomized clinical trials (RCTs). Articles in English or Spa­nish were selected. The primary outcomes analyzed were walking speed, step length, cadence, aerobic capacity, balance, and spasticity. The risk of bias was assessed using RoB-2. Results: A total of 57 articles were selected, including 1163 patients who received FES. Of these, 30 articles were meta-analyzed. FES showed significant improvement in the 10-meter walking speed test for acute and subacute Stroke, step length in chronic Stroke, and the Berg Balan­ce Scale, regardless of the time since Stroke onset. The Modified Ashworth Scale for Spasticity also showed significant differences, independent of the time since Stroke onset. Conclusion: FES is more effective than other reha­bilitation therapies in improving walking speed in acute and subacute Stroke, step length in chronic Stroke, and balance, regardless of the time since Stroke onset. However, the variability in ages, times since onset, types and severity of Stroke, as well as different types and durations of intervention, suggests caution in interpreting the results.