Comparing the effects of functional electrical stimulation with different frequencies and time duration to improve lower extremity muscle strength, gait, balance, posture control, and quality of life among stroke patients: A systematic review

Abstract

Background: Sufficient literature is available regarding Functional Electrical stimulation (FES) for its effects on the function of both the upper limb and lower limb. However, there is still a lack of literature that describes accurate frequency and time duration of FES in improving lower limb functions. Therefore, this review aimed to report the effects of FES regarding its various frequencies, duration, and intensity in improving lower limb muscle strength, gait, posture, and quality of life in patients with stroke.

Methods: We included all those individuals with stroke (Hemiplegia) both acute and chronic irrespective of its type ischemic and hemorrhagic. All patients were well-oriented without cognitive impairments aged between 45 and 80 years old. Randomized controlled trials in which patients were provided FES either four channels or bi-channels on various muscles of the lower limb only were selected. In addition, we only included those RCTs, where FES was applied with specific frequencies and durations on the lower limb only.

Results: The participants in the included studies ranged from 16 to 61 years of age. The majority of the studies were conducted with a population with post-stroke duration of ≥ 6 months. It was evident that functional electrical stimulation with low frequencies is effective in improving various outcomes related to function in the stroke population (P < 0.05).

Conclusion: Functional electrical stimulation with low frequency improves activities of daily living, balance, gait, mobility, postural control, and range of motion, and reduces spasticity and foot drop. For rehabilitation, it would be important to replicate the findings by conducting highly randomized control trials with high quality and a larger number of samples.