Functional electrostimulation in poststroke rehabilitation: A meta-analysis of the randomized controlled trials

Objective: To assess the efficacy of functional electrical stimulation (FES) in the rehabilitation of hemiparesis in stroke. Design: A meta-analysis combined the reported randomized controlled trials of FES in stroke, using the effect size method of Glass, and the DerSimonian-Laird Random Effects Method for pooling studies. Setting: The included studies were pulished between 1978 and 1992. They were conducted in academic rehabilitation medicine settings. Patients: In all included studies, patients were in poststroke rehabilitation. The mean time after stroke varied from 1.5 to 29.2 months. Intervention: FES applied to a muscle or associated nerve in a hemiparetic extremity was compared to No FES. Main Outcome Measure: Change in paretic muscle force of contraction following FES was compared to change without FES. Results: For the four included studies, the mean effect size was .63 (95% Cl: .29, .98). This result was statistically significant (p < .05). Conclusion: Pooling from randomized trials supports FES as promoting recovery of muscle strength after stroke. This effect is statistically significant. There is a reasonable liklihood of clinical significance as well. (C) 1996 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation