Efficacy of neuromuscular electrical stimulation for hemiplegic shoulder pain: A systematic review and meta-analysis of randomized controlled trials.
Wenjun Zhao, Song Yang, Ran Zhang et al.
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In 30 seconds
This systematic review and meta-analysis assessed randomized controlled trials of neuromuscular electrical stimulation (NMES) for hemiplegic shoulder pain. Five studies involving 290 patients were included. NMES was associated with reduced shoulder pain (SMD = -0.49; 95% CI: -0.86 to -0.11), improved upper-limb motor function, and greater shoulder forward-flexion and external-rotation range of motion. No significant effects were found for shoulder abduction or activities of daily living. Most positive findings, except shoulder flexion, were influenced by a single study with low methodological quality; the authors advise cautious interpretation.
Key findings
- NMES reduced shoulder pain (SMD = -0.49; 95% CI: -0.86 to -0.11), with subgroup analyses indicating the analgesic effect persisted long term.
- Upper-limb motor function improved (WMD = 4.47; 95% CI: 2.85 to 6.09), although this finding was influenced by one low-quality study.
- Shoulder forward flexion increased (WMD = 11.82; 95% CI: 6.13 to 17.50), while external rotation increased (WMD = 5.41; 95% CI: 2.48 to 8.34).
- No significant effects were observed for shoulder abduction or activities of daily living.
Why it matters
Hemiplegic shoulder pain can limit movement and function, and this synthesis suggests NMES may improve pain and selected measures of shoulder mobility. However, the evidence is based on five trials, and several positive results were sensitive to one low-quality study. The findings therefore inform consideration of NMES as a potential option but do not establish broad functional benefit.
What to keep in mind
Only five studies involving 290 patients were included, and most positive findings other than shoulder flexion were influenced by a single study with low methodological quality.