Efficacy of functional electrical stimulation for hemiplegic shoulder pain: A systematic review and meta-analysis

Abstract

Background:Hemiplegic shoulder pain is a common issue after stroke and affects many stroke survivors. Emerging studies have shown the positive effects of functional electrical stimulation in the management of hemiplegic shoulder pain. However, a systematic review evaluating its efficacy is lacking.

Objective:To systematically review the effects of functional electrical stimulation for hemiplegic shoulder pain in patients who experienced stroke.

Study design:A systematic review and meta-analysis.

Methods:A systematic review of Embase, PubMed, Web of Science, Scopus, Cumulative Index to Nursing Information and Allied Health Literature (CINAHL), China National Knowledge Infrastructure (CNKI), Wan Fang Database, and China Science and Technology Journal Database (VIP) from the establishment of the databases to July 1, 2024, was carried out. Two researchers independently searched, screened, and extracted data from each database according to the search strategy and resolved any disagreements through negotiation.

Results:Of the 560 articles identified, 7 were included in the final synthesis. We analyzed data from 457 stroke survivors, the results showed that the functional electrical stimulation group had a better performance in relieving shoulder pain (standardized mean difference [SMD] = −1.66; 95 % confidence interval [CI]: −2.58 to −0.74; P = 0.0004), but there was no statistical significance in Fugl-Meyer assessment scores (SMD = 0.32; 95 % CI: −1.00 to 1.63; P = 0.64).

Conclusion:Functional electrical stimulation may be an effective management method to relieve pain for hemiplegic shoulder pain patients. However, these results should be interpreted with caution because of the limited number of studies and potential bias. More rigorous, reasonably designed randomized controlled trial with large sample sizes and long-term follow-up are needed in the future.

Keywords

Shoulder pain / Stroke / Functional electrical stimulation / Randomized controlled trial / Systematic review / Meta-analysis

Ethics approval

Not applicable.

Funding

This study was supported by the Science and Technology Innovation Plan of the Shanghai Science and Technology Commission (22YF1405400); and Young Talent Project of Shanghai Municipal Health Commission (No.2022YQ055).

CRediT authorship contribution statement

Qiu Xiao: Writing - review & editing, Funding acquisition, Formal analysis, Data curation. Bai Yulong: Writing - review & editing, Visualization, Validation, Supervision. Wang Chunyu: Writing - original draft, Methodology, Investigation, Formal analysis, Data curation, Conceptualization.

Data availability

The datasets of the study are available from the corresponding author on reasonable request.

Declaration of Competing Interest

The authors declared no conflict of interest.

Acknowledgements

We would like to thank the Science and Technology Innovation Plan of the Shanghai Science and Technology Commission and Young Talent Project of Shanghai Municipal Health Commission.

Appendix A. Supplementary material

Supplementary data associated with this article can be found in the online version at doi:10.1016/j.hcr.2025.100025.

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