Effectiveness of Functional Electrical Stimulation in Improving Clinical Outcomes in the Upper Arm following Stroke: A Systematic Review and Meta-Analysis

Table 2

Summary of the 10 retrieved articles.

	PEDro, Evidence level	Subjects	Intervention	Outcome measures	Results
Kobayashi et al., 1999 [26]	3, 3	Mean age: S-group: 59.3 ± 13.1; D-group: 69.3 ± 7.4; Control: 53.2 ± 9.2	Conventional treatment: including neuromuscular; facilitation, joint; mobilization, muscle; stretching of the shoulder; +; electrical stimulation; 15 min/session,; 2 session/day,; 5 days/week,; 6 weeks	Subluxation: in mm using x-rays; Pain: VAS during active shoulder  abduction; Motor function: maximal; abduction contraction/; EMG measurement of; supraspinatus and deltoid	Subluxation: decreased in S and D groups compared to control; Pain: was reduced by 50% in a number of subjects; Motor function: increase of abduction force; and EMG activity of; supraspinatus and deltoid
Koyuncu et al., 2010 [27]	5, 2a	Mean age: Study group: 60.7 ± 9.49; Control: 62.0 ± 9.72	Conventional PT; +; electrical stimulation; 20 min/session,; 5 session/day,; 4 weeks	Subluxation: in mm using x-ray; Pain: VAS in active and passive shoulder flexion and abduction	Subluxation: decreased significantly after treatment; Pain: no change after treatment
Kim et al., 2000 [28]	6, 1a	Mean age: Study group: 55.3 ± 7.3; Control: 58.2 ± 8.1	Conventional PT and arm sling; +; electrical stimulation; 30 min/day,; 5 days/week,; 6 weeks	Subluxation: in mm using x-ray	Subluxation: was prevented and reduced after 6 weeks of FES training in early intervention group. No effectiveness for patients in late intervention group
Linn et al., 1999 [29]	5, 2a	Mean age: Study group: 71; Control: 73	Conventional PT and OT; +; electrical stimulation,; 30–60 min/session,; 4 sessions/day,; 4 weeks	Subluxation: in cm using X-ray; Pain: measurement of pain-free range of lateral rotation and Verbal Rating Scale (0–4); Motor function: Motor Assessment Scale (0–6); Arm girth: in cm to measure muscle bulk	Subluxation: decreased after the treatment but was not maintained at the end of follow-up period; Pain: decreased during the treatment, not maintained after follow-up; Motor function: no difference between groups; Arm girth: no difference between groups
Wang et al., 2000, 2002 [30, 31]	4, 2a	Mean age: Study group: 56.1 ± 7.4; Control: 56.4 ± 8.4	Conventional treatment; +; electrical stimulation; 0.5–6 hour/session,; 1–3 sessions/day,; 5 days/week,; 6 weeks	Subluxation: in mm using X-ray; Motor function: Fugl-Meyer Assessment	Subluxation: decreased after FES training in hemiplegic subjects with short post-onset duration, but not changed in subjects with subluxation >1 year; Motor function: increased significantly in patients with short post-onset duration but not in patients with long duration after stroke
Baker and Parker 1986 [32]	4, 2a	Mean age: Study group: 56; Control: 55	Conventional therapy: conventional hemi sling and wheelchair with arm support; +; electrical stimulation; 0.5–7 hour/session,; 1–3 sessions/day,; 5 days/week,; 6 weeks	Subluxation: in mm using X-ray; Pain: subjective self-report	Subluxation: decreased in study group after FES treatment. After 3-month follow-up period, the effect of FES was not maintained; Pain: no reduction in the level of pain was observed
Faghri et al., 1994 [33]	4, 2a	Mean age: Study group: 65 ± 13; Control: 69 ± 12	Conventional therapy; +; electrical stimulation; 1.5–6 hour/session,; 1 session/day,; 7 days/week,; 6 weeks	Subluxation: in cm using x-ray; Pain: pain-free range of passive external rotation; Motor function: Bobath assessment chart/EMG assessment of deltoid muscle	Subluxation: reduced compared to the control group; Pain: pain-free passive range of external rotation in shoulder was increased; Motor function: significantly improved based on Bobath assessment chart. EMG activity of deltoid was significantly increased
Church et al., 2006 [34]	8, 1a	Mean age: Study group: 75.5 [64–81]; Control; 73.5 [65.8–79]	Conventional therapy; +; electrical stimulation; 1 hour/session,; 3 session/day,; 7 days/week,; 4 weeks	Pain: numerical rating scale; Motor function: Action Research Arm Test,; Frenchy Arm Test,; Motricity Index	Pain: no significant difference between the groups; Motor function: no significant difference after 4 weeks of treatment and 3 months after stroke
Nakipoglu et al., 2010 [35]	6, 1a	Mean age: Study group: 59.3 ± 14.86; Control: 62.83 ± 12.25	Conventional therapy; +; electrical stimulation; 1 hour/session,; 1 session/day,; 5 days/week,; 4 weeks	Motor function: Brunsrtrom stages, Ashworth scale	Motor function: no significant difference for any of the outcome measures
Mangold et al., 2009 [36]	6, 1a	Mean age: Study group: 62 ± 16.2; Control: 57.5 ± 16.7	Conventional therapy; +; electrical stimulation; 30 minute/session,; 1 session/day,; 3 days/week,; 4 weeks	Pain: pain item of Chedoke McMaster Stroke Assessment; Motor function: Chedoke-McMaster Stroke Assessment	Pain: no significant difference between the groups; Motor function: no significant difference between the groups

FES: functional electrical stimulation; RCT: randomized control trial; PEDro: physiotherapy evidence database; EMG: electromyography; PT: physiotherapy; OT: occupational therapy; VAS: Visual Analogue Scale.