Abstract Background and aims Electrical stimulation is commonly used for motor rehabilitation after stroke, but its benefits and harms were uncertain. The aim of our systematic review was to evaluate whether electrical stimulation improves strength and activity, compared with sham, no intervention, or alternative approaches. We also examined effects on participation, quality of life, and adverse events. Methods We searched CENTRAL, MEDLINE, Embase, four additional databases, two trial registries, and reference lists. Randomized controlled trials involving adults with stroke receiving cyclic electrical stimulation or functional electrical stimulation were included. Certainty of evidence was assessed using GRADE. Results 83 randomized controlled trials and 6 randomized cross-over trials (n = 2905 participants) were included; 34 trials investigated cyclic electrical stimulation (n = 1176 participants), and 55 trials investigated functional electrical stimulation (n = 1729 participants). Cyclic electrical stimulation showed a moderate effect on strength (SMD 0.47, 95% CI 0.32 to 0.61) and activity (SMD 0.50, 95% CI 0.34 to 0.65). Functional electrical stimulation showed a small effect on activity (SMD 0.22, 95% CI 0.11 to 0.34). Adverse events were rare and minor. Conclusions Cyclic electrical stimulation can increase strength and improve activity after stroke. Functional electrical stimulation provides small additional benefit for activity once voluntary movement returns. Evidence for participation and quality of life remains limited. Conflict of interest Katharine Scrivener: nothing to disclose; Louise Ada: nothing to disclose; Joanne Glinsky: nothing to disclose; Simone Dorsch: nothing to disclose; Serena Jamieson: nothing to disclose; Sarah Brighton-Hall: nothing to disclose; Laura McCredie: nothing to disclose; Ashleigh Hanekom: nothing to disclose; Natasha A. Lannin: nothing to disclose.
Scrivener et al. (Fri,) studied this question.