Article

OBJECTIVE: To evaluate (1) the effectiveness of transcutaneous electrical nerve
stimulation (TENS) at improving lower extremity motor recovery in stroke
survivors and (2) the optimal stimulation parameters for TENS. METHODS: A
systematic search was conducted for studies published up to October 2017 using
eight electronic databases (CINAHL, ClinicalTrials.gov, the Cochrane Central
Register of Controlled Trials, EMBASE, MEDLINE, PEDro, PubMed and Web of
Science). Randomized controlled trials that evaluated the effectiveness of the
application of TENS at improving lower extremity motor recovery in stroke
survivors were assessed for inclusion. Outcomes of interest included plantar
flexor spasticity, muscle strength, walking capacity and balance. RESULTS: In
all, 11 studies met the inclusion criteria which involved 439 stroke survivors.
The meta-analysis showed that TENS improved walking capacity, as measured by
either gait speed or the Timed Up and Go Test (Hedges' g = 0.392; 95% confidence
interval (CI) = 0.178 to 0.606) compared to the placebo or no-treatment control
groups. TENS also reduced paretic plantar flexor spasticity, as measured using
the Modified Ashworth Scale and Composite Spasticity Scale (Hedges' g = -0.884;
95% CI = -1.140 to -0.625).
The effect of TENS on walking capacity in studies
involving 60 minutes per sessions was significant (Hedges' g = 0.468; 95% CI =
0.201-0.734) but not in study with shorter sessions (20 or 30 minutes) (Hedges' g
= 0.254; 95% CI = -0.106-0.614). CONCLUSION: The results support the use of
repeated applications of TENS as an adjunct therapy for improving walking
capacity and reducing spasticity in stroke survivors.

Langue : ANGLAIS