Is functional electrical stimulation effective in improving walking in adults with lower limb impairment due to an upper motor neuron lesion? An umbrella review.

Autor: Andreopoulou G; Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK., Busselli G; Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.; UOC Neurorehabilitation, AOUI Verona, Verona, Italy., Street T; Clinical Sciences and Engineering, Salisbury NHS Foundation Trust and Bournemouth University, Salisbury, UK., Bulley C; Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK., Safari R; College of Health, Psychology and Social Care, University of Derby, Derby, UK., van der Linden ML; Centre for Health, Activity and Rehabilitation Research, Queen Margaret University, Edinburgh, UK., Burridge J; School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
Jazyk: angličtina
Zdroj: Artificial organs [Artif Organs] 2024 Mar; Vol. 48 (3), pp. 210-231. Date of Electronic Publication: 2023 Jun 01.
DOI: 10.1111/aor.14563
Abstrakt: Purpose: To conduct an umbrella review of systematic reviews on functional electrical stimulation (FES) to improve walking in adults with an upper motor neuron lesion.
Methods: Five electronic databases were searched, focusing on the effect of FES on walking. The methodological quality of reviews was evaluated using AMSTAR2 and certainty of evidence was established through the GRADE approach.
Results: The methodological quality of the 24 eligible reviews (stroke, n = 16; spinal cord injury (SCI), n = 5; multiple sclerosis (MS); n = 2; mixed population, n = 1) ranged from critically low to high. Stroke reviews concluded that FES improved walking speed through an orthotic (immediate) effect and had a therapeutic benefit (i.e., over time) compared to usual care (low certainty evidence). There was low-to-moderate certainty evidence that FES was no better or worse than an Ankle Foot Orthosis regarding walking speed post 6 months. MS reviews concluded that FES had an orthotic but no therapeutic effect on walking. SCI reviews concluded that FES with or without treadmill training improved speed but combined with an orthosis was no better than orthosis alone. FES may improve quality of life and reduce falls in MS and stroke populations.
Conclusion: FES has orthotic and therapeutic benefits. Certainty of evidence was low-to-moderate, mostly due to high risk of bias, low sample sizes, and wide variation in outcome measures. Future trials must be of higher quality, use agreed outcome measures, including measures other than walking speed, and examine the effects of FES for adults with cerebral palsy, traumatic and acquired brain injury, and Parkinson's disease.
(© 2023 The Authors. Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)
Databáze: MEDLINE
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