ResultsBackground Analysis
Results
ClinicalRelevance
Purpose
Methods
FunctionalElectricalStimulationandCyclinginStrokeRehabilitation:ASystematicReview
S.Babiarz,SPT,K.Haynes,SPT,M.Mazich,SPT,H.Zhang,SPT,A.Goode,PT,DPT,PhD,R.Clendaniel,PT,PhD
L
Conclusions
Acknowledgements/References
Strokeisaleadingcauseofseriouslong-termdisabilityandasourceofsignificantfinancialburdenintheUnitedStates.Hemiparesisisoneofthemostcommonlastingimpairmentsfollowingastroke,whichcanresultinseveredeficitsingaitandbalanceandconsequently,negativelyimpactfunctionalcapacityandqualityoflife.Currentstrategiesforstrokerehabilitationincludetreadmilltraining,cycling,andfunctionalelectricalstimulation(FES).However,theeffectsofcombinedcyclingandFESasatreatmentstrategyforstrokerehabilitationremainslargelyunexplored.
ToconductasystematicreviewoncurrentevidencefortheeffectofcyclingwithFESongaitandbalanceinsubacutestrokerehabilitation.
● SystematicReviewperformedfollowingPRISMAguidelines.● ElectronicdatabasesincludedPubmed,CINAHL,Embase,andCochraneFigure1.SearchStrategy
Table1.InclusionandExclusionCriteria
● FES+Cyclingimprovessomeaspectsofgaitandbalanceinsubacutestrokepatientswithhemiparesis.○ WhetherFES+CyclingismoreeffectivethanCyclingwithoutFESisunclear
● GaitvelocityisincreasedpostFES+Cyclingintervention.○ Improvementsarenotsignificantlygreaterthancontrols
● BalancewasimprovedpostFES+CyclinginterventionasdemonstratedbyincreasedscoresonBergBalanceScaleandTrunkControlTest.○ Improvementswerenotsignificantlygreaterthancontrols.
● FollowingFES+Cycling,subjectsimprovedscoresontheMotricityIndex(MI)legsubscale.○ SomestudiesfoundsignificantdifferencesinMIscoresbetweentreatment
groupswhileothersdidnot.● Limitations:
○ Inclusionofonlyfull-textarticlesprintedinEnglish○ Comparisoncomplicatedbytheuseofvariedoutcomemeasures
● Gaitvelocityandbalanceareoftenusedasindicatorsforsafecommunityambulation,apriorityformanystrokesurvivors.
● Recoveryingaitandbalancecanreducefallriskinstrokesurvivors,whichcanpreventsecondaryinjuriesandminimizeadditionalburdenofdisease.
● Lowerextremitycyclinginconjunctionwithelectricalstimulationisaneffectivephysicaltherapyinterventionintherecoveryofgaitandbalancefollowingstroke.
● TheuseofFES+Cyclingmayacceleratetherateofrecoveryforpatientswithhemiparesis,andfunctionalgainsaremaintainedduringfollow-upassessments.
WethankLeilaLedbetter,BS,MLIS,forherassistanceinourliteraturesearch.ReferencesAvailableonRequest.
Criteria1. EligibilityCriteria2. RandomAllocation3. ConcealedAllocation4. Baselinecomparability5. Blindsubjects6. blindtherapists7. blindassessors8. adequatefollow-up9. intention-to-treatanalysis10.between-groupcomparisons11.pointestimatesandvariability
+ Metcriteria GoodQuality- Didnotmeetcriteria FairQuality
0%
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140%
Ambrosini* Bauer** Ferrante
PercentageChangeinMotricityIndexScore
Control,Post-training
FES,Post-training
Control,Follow-up
FES,Follow-up
*Ambrosini2011and2012sharedthesamedataforMotricityIndex
***
***p<0.001++p=0.002
***
++
-50%
0%
50%
100%
150%
200%
250%
300%
350%
400%
450%
Ambrosini*,Speed(m/s)
Ferrante**,50mWalk(m/s)
Janssen,6MWT(m)
Lee,6MWT(m)
PercentageChangeinGaitPerformance
Control,Post-training
FES,Post-training
Control,Follow-up
FES,Follow-up
50mWalk:50meterwalk6MWT:6minutewalktest
+++p<0.001
***
***
***
+++
*Ambrosini 2011 and 2012 shared the same data for Gait Speed** Change in Median values as Mean values were unavailable
0%
20%
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120%
Ambrosini 2011,TCT Ferrante,TCT Janssen,BBS Lee,BBS
PercentageChangeinBalancePerformance
Control,Post-training
FES,Post-training
Control,Follow-up
FES,Follw-up
TCT:TrunkControlTestBBS:BergBalanceScale
**p<0.001
**
*Loreportednosignificantdifferences inSmartBalanceMasteroutcomesbetweenControlandFESgroupsPost-Training;noFollow-Updataavailable
**
