Functional Electrical Stimulation and Cycling in Stroke ... Group 14, Cycling and FES... ·...
Transcript of Functional Electrical Stimulation and Cycling in Stroke ... Group 14, Cycling and FES... ·...
ResultsBackground Analysis
Results
ClinicalRelevance
Purpose
Methods
FunctionalElectricalStimulationandCyclinginStrokeRehabilitation:ASystematicReview
S.Babiarz,SPT,K.Haynes,SPT,M.Mazich,SPT,H.Zhang,SPT,A.Goode,PT,DPT,PhD,R.Clendaniel,PT,PhD
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Conclusions
Acknowledgements/References
Strokeisaleadingcauseofseriouslong-termdisabilityandasourceofsignificantfinancialburdenintheUnitedStates.Hemiparesisisoneofthemostcommonlastingimpairmentsfollowingastroke,whichcanresultinseveredeficitsingaitandbalanceandconsequently,negativelyimpactfunctionalcapacityandqualityoflife.Currentstrategiesforstrokerehabilitationincludetreadmilltraining,cycling,andfunctionalelectricalstimulation(FES).However,theeffectsofcombinedcyclingandFESasatreatmentstrategyforstrokerehabilitationremainslargelyunexplored.
ToconductasystematicreviewoncurrentevidencefortheeffectofcyclingwithFESongaitandbalanceinsubacutestrokerehabilitation.
● SystematicReviewperformedfollowingPRISMAguidelines.● ElectronicdatabasesincludedPubmed,CINAHL,Embase,andCochraneFigure1.SearchStrategy
Table1.InclusionandExclusionCriteria
● FES+Cyclingimprovessomeaspectsofgaitandbalanceinsubacutestrokepatientswithhemiparesis.○ WhetherFES+CyclingismoreeffectivethanCyclingwithoutFESisunclear
● GaitvelocityisincreasedpostFES+Cyclingintervention.○ Improvementsarenotsignificantlygreaterthancontrols
● BalancewasimprovedpostFES+CyclinginterventionasdemonstratedbyincreasedscoresonBergBalanceScaleandTrunkControlTest.○ Improvementswerenotsignificantlygreaterthancontrols.
● FollowingFES+Cycling,subjectsimprovedscoresontheMotricityIndex(MI)legsubscale.○ SomestudiesfoundsignificantdifferencesinMIscoresbetweentreatment
groupswhileothersdidnot.● Limitations:
○ Inclusionofonlyfull-textarticlesprintedinEnglish○ Comparisoncomplicatedbytheuseofvariedoutcomemeasures
● Gaitvelocityandbalanceareoftenusedasindicatorsforsafecommunityambulation,apriorityformanystrokesurvivors.
● Recoveryingaitandbalancecanreducefallriskinstrokesurvivors,whichcanpreventsecondaryinjuriesandminimizeadditionalburdenofdisease.
● Lowerextremitycyclinginconjunctionwithelectricalstimulationisaneffectivephysicaltherapyinterventionintherecoveryofgaitandbalancefollowingstroke.
● TheuseofFES+Cyclingmayacceleratetherateofrecoveryforpatientswithhemiparesis,andfunctionalgainsaremaintainedduringfollow-upassessments.
WethankLeilaLedbetter,BS,MLIS,forherassistanceinourliteraturesearch.ReferencesAvailableonRequest.
Criteria1. EligibilityCriteria2. RandomAllocation3. ConcealedAllocation4. Baselinecomparability5. Blindsubjects6. blindtherapists7. blindassessors8. adequatefollow-up9. intention-to-treatanalysis10.between-groupcomparisons11.pointestimatesandvariability
+ Metcriteria GoodQuality- Didnotmeetcriteria FairQuality
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PercentageChangeinMotricityIndexScore
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*Ambrosini2011and2012sharedthesamedataforMotricityIndex
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PercentageChangeinGaitPerformance
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FES,Post-training
Control,Follow-up
FES,Follow-up
50mWalk:50meterwalk6MWT:6minutewalktest
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*Ambrosini 2011 and 2012 shared the same data for Gait Speed** Change in Median values as Mean values were unavailable
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PercentageChangeinBalancePerformance
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FES,Post-training
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TCT:TrunkControlTestBBS:BergBalanceScale
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*Loreportednosignificantdifferences inSmartBalanceMasteroutcomesbetweenControlandFESgroupsPost-Training;noFollow-Updataavailable
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