Content » Vol 50, Issue 1

Original report

Influence of transcutaneous electrical nerve stimulation on spasticity, balance, and walking speed in stroke patients: A systematic review and meta-analysis

Shuqin Lin, Qi Sun, Haifeng Wang, Guomin Xie
Neurology Department, Ningbo Medical Center Lihuili Eastern Hospital, Ningbo, 200322 Zhejiang, China. E-mail:
DOI: 10.2340/16501977-2266


Objective: To evaluate the influence of transcutaneous electrical nerve stimulation in patients with stroke through a systematic review and meta-analysis.
Methods: PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases were searched systematically. Randomized controlled trials assessing the effect of transcutaneous electrical nerve stimulation vs placebo transcutaneous electrical nerve stimulation on stroke were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was modified Ashworth scale (MAS). Meta-analysis was performed using the random-effect model.
Results: Seven randomized controlled trials were included in the meta-analysis. Compared with placebo transcutaneous electrical nerve stimulation, transcutaneous electrical nerve stimulation supplementation significantly reduced MAS (standard mean difference (SMD) = –0. 71; 95% confidence interval (95% CI) = –1. 11 to –0. 30; p = 0. 0006), improved static balance with open eyes (SMD = –1. 26; 95% CI = –1. 83 to –0. 69; p<0. 0001) and closed eyes (SMD = –1. 74; 95% CI = –2. 36 to –1. 12; p < 0. 00001), and increased walking speed (SMD = 0. 44; 95% CI = 0. 05 to 0. 84; p = 0. 03), but did not improve results on the Timed Up and Go Test (SMD = –0. 60; 95% CI=–1. 22 to 0. 03; p = 0. 06).
Conclusion: Transcutaneous electrical nerve stimulation is associated with significantly reduced spasticity, increased static balance and walking speed, but has no influence on dynamic balance.

Lay Abstract

Stroke patients frequently suffer from spasticity resulting in decreased balance, significantly reduced life quality and tifficulties to perform activities of daily living. This meta-analysis showed that transcutaneous electrical nerve stimulation (TENS) could significantly reduce spasticity and increase static balance and walking speed, but had no influence on dynamic balance.

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