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Adding electrical stimulation during standard rehabilitation after stroke to improve motor function

SHARIFIFAR S; SHUSTER JJ; BISHOP MD
ANN PHYS REHABIL MED , 2018, vol. 61, n° 5, p. 339-344
Doc n°: 188639
Localisation : Documentation IRR

D.O.I. : http://dx.doi.org/DOI:10.1016/j.rehab.2018.06.005
Descripteurs : AF21 - ACCIDENTS VASCULAIRES CEREBRAUX, KA64 - NEMS

Clinical studies have shown that sensory input improves motor
function when added to active training after neurological injuries in the spinal cord. OBJECTIVE: We aimed to determine the effect on motor function of
extremities of adding an electrical sensory modality without motor recruitment
before or with routine rehabilitation for hemiparesis after stroke by a
comprehensive systematic review and meta-analysis. METHODS: We searched databases
including MEDLINE via PubMed and the Cochrane Central Register of Controlled
Trials from 1978 to the end of November 2017 for reports of randomized controlled
trials or controlled studies of patients with a clinical diagnosis of stroke who
underwent 1) transcutaneous electrical nerve stimulation (TENS) or peripheral
electromyography-triggered sensory stimulation over a peripheral nerve and
associated muscles or 2) acupuncture to areas that produced sensory effects,
without motor recruitment, along with routine rehabilitation. Outcome measures
were motor impairment, activity, and participation outcomes defined by the
International Classification of Functioning, Disability and Health. RESULTS: The
search yielded 11studies with data that could be included in a meta-analysis.
Electrical sensory inputs, when paired with routine therapy, improved peak torque
dorsiflexion (mean difference [MD] 2.44 Nm, 95% confidence interval [CI]
0.26-4.63). On subgroup analysis, the combined therapy yielded a significant
difference in terms of sensory stimulation without motor recruitment only on the
Timed Up and Go test in the chronic phase of stroke (MD 3.51sec, 95% CI
3.05-3.98). The spasticity score was reduced but not significantly (MD-0.83
points, 95% CI -1.77-0.10). CONCLUSION: Electrical sensory input can contribute
to routine rehabilitation to improve early post-stroke lower-extremity impairment
and late motor function, with no change in spasticity. Prolonged periods of
sensory stimulation such as TENS combined with activity can have beneficial
effects on impairment and function after stroke.
CI - Copyright (c) 2018 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS

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