The effects of cycling with and without functional electrical stimulation on lower limb dysfunction in patients post-stroke: A systematic review with meta-analysis

• Published in: NeuroRehabilitation Vol. 44; no. 3; pp. 389 - 412
• Main Authors: Shariat, Ardalan, Najafabadi, Mahboubeh Ghayour, Ansari, Noureddin Nakhostin, Cleland, Joshua A., Singh, Maria A. Fiatarone, Memari, Amir-Hossein, Honarpishe, Roshanak, Hakakzadeh, Azadeh, Ghaffari, Maryam Selk, Naghdi, Soofia
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2019; IOS Press BV
• Subjects: Balance; Clinical trials; Electrical stimuli; Evidence-based medicine; Meta-analysis; Stroke; Systematic review; functional electrical stimulation; cycling; stroke; lower limb; disability; Meta-analysis
• ISSN: 1053-8135; 1878-6448
• DOI: 10.3233/NRE-182671

BACKGROUND: One of the leading causes of disability in the world with enormous economic burden is stroke. OBJECTIVE: To quantify the effectiveness of different protocols of cycling with/without functional electrical stimulation on functional mobility after stroke. METHODS: Multiple databases were searched till 2018. Data extraction was performed using a pre-determined data collection form. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation. RESULTS: A total of 14 trials satisfied eligibility criteria and were included. Cycling had a positive effect on the 6-meter walking test performance (SMD, 0.41; 95% CI, 0.11 –0.71; I2 = 0% ) compared with no or placebo intervention (control). Compared with control, cycling had a positive effect on 10-meter walking speed (SMD, 0.30; 95% CI, 0.05 –0.55; I2 = 0% ), and on balance based on the Berg score (SMD, 0.32; 95% CI, 0.06 –0.57; I2 = 49% ). Cycling with functional electrical stimulation had a positive effect on balance (SMD, 1.48; 95% CI, 0.99 –1.97; I2 = 91% ) compared with cycling alone. CONCLUSIONS: It appears that cycling has a positive effect on walking speed, walking ability and balance. Functional electrical stimulation combined with cycling has positive effects on balance beyond cycling alone.