既往研究显示，神经电刺激(NMES)可用于减少卒中患者痉挛状态并改善活动程度。但在临床试验的结果尚有争议性。因此，巴西学者们针对上述相关问题进行了一项系统回顾和随机对照试验的荟萃分析。结果表明，NMES联合其他干预方法可改善卒中后患者痉挛状态并改善关节活动范围，是一种治疗选择。相关论文7月14日在线发表于《卒中》(Sroke)杂志。

        研究者们检索了多个电子数据库，包括PubMed、EMBASE、Cochrane中央对照试验数据库和物理疗法数据库。由两位审核人员根据预先设定好的入选标准评估研究的合格性(包括上下肢电刺激的应用，;并与未接受电刺激治疗的对照组进行对比)，排除那些干预时间<3天的研究。主要转归包括改良阿什沃思量表(Modified Ashworth Scale)评估的痉挛状态，次要转归为角度计测量的活动范围。

        结果在共5066篇文章中，共纳入了包含940例受试者的29项随机临床试验。分析显示，与对照组相比(2.87，13项随机临床试验)，NMES可减少卒中后患者的痉挛状态(−0.30，14项随机临床试验)，并可增加活动范围。

        参考文献：Cinara Stein, MSc,,et al. STROKEAHA.115.009633Published online before print July 14, 2015,doi: 10.1161/STROKEAHA.115.009633

Effects of Electrical Stimulation in Spastic Muscles After Stroke
Systematic Review and Meta-Analysis of Randomized Controlled Trials
1. Cinara Stein, MSc,
2. Carolina Gassen Fritsch, Ft,
3. Caroline Robinson, MSc,
4. Graciele Sbruzzi, DSc and
5. Rodrigo Della Méa Plentz, DSc
-Author Affiliations
1. From the Physical Therapy Department, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil (C.S., C.G.F., C.R., R.D.M.P.); Laboratory of Clinical Investigation, Instituto de Cardiologia do Rio Grande do Sul (IC), Fundação Universidade de Cardiologia (FUC), Porto Alegre, RS, Brazil (C.S.); and Physical Therapy Undergraduation, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil (G.S.).
1. Reprint requests to Rodrigo Della Méa Plentz, PT, ScD, Physical Therapy Department, UFCSPA, Sarmento Leite, 245, CEP: 90050–170, Porto Alegre, RS, Brazil. E-mailroplentz@yahoo.com.br or rodrigop@ufcspa.edu.br
Abstract
Background and Purpose—Neuromuscular electric stimulation (NMES) has been used to reduce spasticity and improve range of motion in patients with stroke. However, contradictory results have been reported by clinical trials. A systematic review of randomized clinical trials was conducted to assess the effect of treatment with NMES with or without association to another therapy on spastic muscles after stroke compared with placebo or another intervention.
Methods—We searched the following electronic databases (from inception to February 2015): Medline (PubMed), EMBASE, Cochrane Central Register of Controlled Trials and Physiotherapy Evidence Database (PEDro). Two independent reviewers assessed the eligibility of studies based on predefined inclusion criteria (application of electric stimulation on the lower or upper extremities, regardless of NMES dosage, and comparison with a control group which was not exposed to electric stimulation), excluding studies with <3 days of intervention. The primary outcome extracted was spasticity, assessed by the Modified Ashworth Scale, and the secondary outcome extracted was range of motion, assessed by Goniometer.
Results—Of the total of 5066 titles, 29 randomized clinical trials were included with 940 subjects. NMES provided reductions in spasticity (−0.30 [95% confidence interval, −0.58 to −0.03], n=14 randomized clinical trials) and increase in range of motion when compared with control group (2.87 [95% confidence interval, 1.18–4.56], n=13 randomized clinical trials) after stroke.
Conclusions—NMES combined with other intervention modalities can be considered as a treatment option that provides improvements in spasticity and range of motion in patients after stroke.