The Adjunct of Electric Neurostimulation to Rehabilitation Approaches in Upper Limb Stroke Rehabilitation: A Systematic Review With Network Meta-Analysis of Randomized Controlled Trials.
Neuromodulation
; 25(8): 1197-1214, 2022 Dec.
Article
en En
| MEDLINE
| ID: mdl-35216873
ABSTRACT
OBJECTIVE:
This review analyzed the current evidence and the potential for the application of electric neurostimulation such as transcranial direct current stimulation (tDCS) and vagus nerve stimulation (VNS) in upper limb stroke rehabilitation. MATERIALS ANDMETHODS:
We performed a systematic review of randomized controlled trials (RCTs) using network meta-analysis (NMA), searching the following data bases PubMed, Web of Science, Cochrane, and Google Scholar, using specific keywords, from January 2010 to April 2021, and assessing the effects of "tDCS" or "VNS" combined with other therapies on upper limb motor function and activities of daily living (ADL) after stroke.RESULTS:
We included 38 RCTs with 1261 participants. Pairwise NMA showed transcutaneous VNS (tVNS) and anodal tDCS were effective in improving upper limb motor function (tVNS mean difference [MD] 5.50; 95% CI [0.67-11.67]; p < 0.05; anodal tDCS MD 5.23; 95% CI [2.45-8.01]; p < 0.05). tVNS and tDCS (anodal and cathodal) were also effective in improving ADL performance after stroke (tVNS standard MD [SMD] 0.96; 95% CI [0.15-2.06]; p < 0.05; anodal tDCS SMD 3.78; 95% CI [0.0-7.56]; p < 0.05; cathodal tDCS SMD 5.38; 95% CI [0.22-10.54]; p < 0.05). Surface under the cumulative ranking curve analysis revealed that tVNS is the best ranked treatment in improving upper limb motor function and performance in ADL after stroke. There was no difference in safety between VNS and its control interventions, measured by reported adverse events (VNS risk ratio = 1.02 [95% CI = 0.48-2.17; I2 = 0; p = 0.96]).CONCLUSION:
Moderate- to high-quality evidence suggests that tVNS and anodal tDCS were effective in improving upper limb motor function in both acute/subacute and chronic stroke. In addition to tVNS and anodal tDCS, cathodal tDCS is also effective in improving ADL performance after stroke.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Accidente Cerebrovascular
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Estimulación Transcraneal de Corriente Directa
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Rehabilitación de Accidente Cerebrovascular
Tipo de estudio:
Clinical_trials
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Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Neuromodulation
Año:
2022
Tipo del documento:
Article
País de afiliación:
Turquía