Comparative effectiveness of neuromuscular electrical stimulation-based combination interventions for post-stroke lower limb rehabilitation: a systematic review and network meta-analysis.
Kaiqi Zheng, Yuan Yang, Pengcheng Liu and 4 others
PMID 42143314WHAT IT FOUND
Gait training plus electrical stimulation improved balance and leg function more than standard care.
No combination significantly beat others for walking ability, though cycling plus stimulation ranked highest. Rankings are exploratory because most comparisons relied on indirect evidence rather than head-to-head trials.
Key findings
01Core stability training, gait training, and NMES alone each significantly improved balance compared with conventional rehabilitation.
02No intervention showed a statistically significant advantage over any other for walking ability; all credible intervals included zero.
03Augmented reality with gait training and NMES, gait training with NMES, and NMES alone significantly improved lower limb functional mobility versus conventional care.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Most comparisons between active treatments were indirect, relying on their shared comparison to conventional rehabilitation rather than head-to-head trials. Blinding of participants and therapists was not possible in the included studies, introducing potential performance bias. NMES parameters such as frequency, pulse width, and intensity were incompletely reported in many trials, making it unclear if these factors influenced outcomes. The walking ability network had no closed loops, so the consistency of indirect estimates could not be verified. Only English-language publications were included, potentially excluding relevant trials. Many top-ranked interventions in specific domains were supported by only one study, making their rankings unstable.
Declared interests
No specific funding source or author conflicts of interest are reported in the provided text.
The easy way to misread this
Do not interpret the high ranking of cycling plus NMES for walking ability as proof it works better than other combinations. No comparison for walking ability reached statistical significance, and the cycling node was informed by only one trial.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →