title: Functional electrical stimulation improves activity after stroke: a systematic review with meta-analysis.
abstract: OBJECTIVE
  To investigate the effect of functional electrical stimulation (FES) in improving activity and to investigate whether FES is more effective than training alone.
  
  
  METHODS
  Cochrane Central Register of Controlled Trials, Ovid Medline, EBSCO Cumulative Index to Nursing and Allied Health Literature, Ovid EMBASE, Physiotherapy Evidence Database (PEDro), and Occupational Therapy Systematic Evaluation of Effectiveness.
  
  
  METHODS
  Randomized and controlled trials up to June 22, 2014, were included following predetermined search and selection criteria.
  
  
  METHODS
  Data extraction occurred by 2 people independently using a predetermined data collection form. Methodologic quality was assessed by 2 reviewers using the PEDro methodologic rating scale. Meta-analysis was conducted separately for the 2 research objectives.
  
  
  RESULTS
  Eighteen trials (19 comparisons) were eligible for inclusion in the review. FES had a moderate effect on activity (standardized mean difference [SMD], .40; 95% confidence interval [CI], .09-.72) compared with no or placebo intervention. FES had a moderate effect on activity (SMD, .56; 95% CI, .29-.92) compared with training alone. When subgroup analyses were performed, FES had a large effect on upper-limb activity (SMD, 0.69; 95% CI, 0.33-1.05) and a small effect on walking speed (mean difference, .08m/s; 95% CI, .02-.15) compared with control groups.
  
  
  CONCLUSIONS
  FES appears to moderately improve activity compared with both no intervention and training alone. These findings suggest that FES should be used in stroke rehabilitation to improve the ability to perform activities.
authors: Department of Occupational Therapy, La Trobe University, Bundoora, VIC, Australia; Bendigo Health, Bendigo, VIC, Australia. Electronic address: ohowlett@bendigohealth.org.au.
authors: Owen A
authors: OA
authors: Howlett
authors: Department of Occupational Therapy, La Trobe University, Bundoora, VIC, Australia; Occupational Therapy Department, Alfred Health, Prahran, VIC, Australia; The John Walsh Centre of Rehabilitation Research, Sydney Medical School (Northern), University of Sydney, St Leonards, NSW, Australia.
authors: Natasha A
authors: NA
authors: Lannin
authors: Department of Physiotherapy, University of Sydney, Lidcombe, NSW; and La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia.
authors: Louise
authors: L
authors: Ada
authors: Department of Occupational Therapy, La Trobe University, Bundoora, VIC, Australia.
authors: Carol
authors: C
authors: McKinstry
mesh_terms: D002986:Clinical Trials as Topic; D004599:Electric Stimulation Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D009788:Occupational Therapy / Q000379:methods*; D000071939:Stroke Rehabilitation
keywords: Meta-analysis [publication type]; Occupational therapy; Rehabilitation; Review [publication type]