Yan 2005.
| Methods | Design: Single‐blind randomised controlled trial with 3 groups, 2 of which are relevant to and included in this review. Randomisation: Jensen's computerised method of minimisation to one of three groups. Participants allocated after giving informed consent. Dropouts: n = 4. From experimental group, gastric bleeding, n = 1; could not undergo assessment, n = 1. From control group, another stroke, n = 1; discharged early, n = 1. | |
| Participants | n = 32 Experimental: n = 15 recruited and 13 completed, 7 male and 6 female, 7 right and 6 left hemiplegia. Mean age 68.2 (SD 7.7) years, mean time after stroke 8.7 (SD 5.8) days. Control: n = 17 recruited and 15 completed, 7 male and 6 female, 6 right and 9 left hemiplegia. Mean age 73.3 (SD 8.1) years, mean time after stroke 10.1 (SD 2.8) days. Study criteria: (1) unilateral stroke within carotid artery system according to CT; (2) aged 45 to 85 years; (3) independent in daily activities before stroke; (4) no brain stem or cerebellar lesions; (5) no medical comorbidity; (6) no cognitive impairment (scored 7 or above on abbreviated mental test). | |
| Interventions | Duration: 3 weeks. Experimental: Category = 7. FES provided by 2 dual channel stimulators connected with a program timer to form one stimulating unit for FES. Surface electrodes were placed on quadriceps, hamstrings, Tibialis anterior and medial gastrocnemius with participants in side‐lying with paretic lower limb supported in a sling. Intervention was provided for 30 minutes a day, 5 days a week for 3 weeks. Stimulation consisted of 0.3ms pulses given at 30 Hz using the maximum intensity tolerated using an activation sequence that mimicked normal gait. Control: Placebo FES. Stimulation provided from an electrical stimulation device with a disconnected circuit. The treatment frequency and period were identical to experimental FES except that stimulation was provided for 60 minutes per day. Participants were told that they might or might not feel the stimulation. | |
| Outcomes | Baseline measurement: Before treatment. Outcome measurement: End of treatment period i.e. 3 weeks. Included outcomes: (1) peak torque during maximum isometric voluntary contraction of ankle dorsiflexors; (2) co‐contraction ratio of agonist and antagonist [(area of antagonist/area of agonist + angaonist) x 100]; (3) timed up and go test; Other outcomes: (1) percentage of participants able to walk; (2) composite spasticity score. | |
| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Allocation concealment? | Unclear risk | B ‐ Unclear |
Electrostimulation category key is given in Additional Table 01 9HPT: Nine Hole Peg Test ADL: activities of daily living ARAT: Action Research Arm Test CT: computerised tomography CVA: cerebrovascular accident EMG: electromyography ES: electrical stimulation FES: functional electrical stimulation FIM: functional independence measure fMRI: functional magnetic resonance imaging GP: general practitioner MI: myocardial infarction MRC: Medical Research Council PNF: proprioceptive neuromuscular facilitation SD: standard deviation TENS: transcutaneous electrical nerve stimulation vs: versus