Oral Presentation Australian and New Zealand Stroke Organisation Conference 2026

ELECTRICAL STIMULATION IMPROVES STRENGTH AND ACTIVITY AFTER STROKE: FINDINGS FROM A COCHRANE SYSTEMATIC REVIEW (138305)

Katharine Scrivener 1 2 3 , Louise Ada 4 , Joanne Glinsky 4 , Simone Dorsch 5 , Laura McCredie 1 2 , Sarah Brighton-Hall 3 , Ashleigh Hanekom 6 , Serena Jamieson 7 , Natasha Lannin 1 2
  1. Department of Neurosciences, Monash University, Melbourne
  2. Alfred Health, Melbourne
  3. Department of Health Sciences, Macquarie University, Sydney
  4. Sydney School of Health Sciences, University of Sydney, Sydney
  5. Australian Catholic University, Sydney, NSW, Australia
  6. Independent Researcher, Sydney, Australia
  7. Herefordshire and Worcestershire Health and Care NHS Trust, Worcester, UK

Background/Aims

Electrical stimulation is commonly used for motor rehabilitation after stroke, but its benefits and harms were uncertain. The aim of our systematic review was to evaluate whether electrical stimulation improves strength and activity, compared with sham, no intervention, or alternative approaches. We also examined effects on participation, quality of life, and adverse events.

 

Methods

We searched CENTRAL, MEDLINE, Embase, four additional databases, two trial registries, and reference lists. Randomised controlled trials involving adults with stroke receiving cyclic electrical stimulation or functional electrical stimulation were included. Certainty of evidence was assessed using GRADE.

 

Results

83 randomised controlled trials and 6 randomised cross-over trials (n= 2905 participants) were included; 34 trials investigated cyclic electrical stimulation (n=1176 participants), and 55 trials investigated functional electrical stimulation (n=1729 participants). Cyclic electrical stimulation showed a moderate effect on strength (SMD 0.47, 95% CI 0.32 to 0.61; high-certainty evidence) and activity (SMD 0.50, 95% CI 0.34 to 0.65; moderate-certainty evidence). Functional electrical stimulation showed a likely moderate effect on activity (SMD 0.42, 95% CI 0.16 to 0.68; moderate-certainty evidence) but only a small effect when compared to practice of the same activity (SMD 0.22, 95% CI 0.11 to 0.34; high-certainty evidence). Adverse events were rare and minor.

 

Conclusion

Cyclic electrical stimulation can increase strength and improve activity after stroke. Functional electrical stimulation provides small additional benefit for activity once voluntary movement returns. Evidence for participation and quality of life remains limited.