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Insights on the Potential Mechanisms of Action of Functional Electrical Stimulation Therapy in Combination With Task-Specific Training: A Scoping Review
Affiliation:1. Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada;2. Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada;3. KITE - Research Institute, University Health Network, Toronto, ON, Canada;4. Institute of Medical Science, University of Toronto, Toronto, ON, Canada;5. Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada;6. Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada;7. Library & Information Services, Rumsey Cardiac Centre Library, University Health Network, Toronto Rehabilitation Institute, Toronto, ON, Canada;8. Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
Abstract:
ObjectivesThis scoping review was undertaken to synthetize and appraise the literature on the potential mechanisms of action of functional electrical stimulation therapy in combination with task-specific training (FEST + TST) in the rehabilitation following stroke, spinal cord injury, traumatic brain injury, or multiple sclerosis.Materials and MethodsThe literature search was performed using multiple databases (including APA, PsycInfo, Medline, PubMed, EMBASE, CCRCT, and Cochrane Database of Systematic Reviews) from 1946 to June 2020. The literature search used the following terms: (spinal cord injury, paraplegia, tetraplegia, quadriplegia, stroke, multiple sclerosis, traumatic brain injury, or acquired brain injury) AND (functional electrical stimulation or FES). The search included clinical and preclinical studies without limits to language.ResultsOf the 8209 titles retrieved from the primary search, 57 publications fulfilled the inclusion and exclusion criteria for this scoping review. While most publications were clinical studies (n = 50), there were only seven preclinical studies using animal models. The results of this review suggest that FEST + TST can result in multiple effects on different elements from the muscle to the cerebral cortex. However, most studies were focused on the muscle changes after FEST + TST.ConclusionsThe results of this scoping review suggest that FEST + TST can result in multiple effects on different elements of the neuromuscular system, while most research studies were focused on the muscle changes after FEST + TST. Despite the efficacy of the FEST + TST in the neurorehabilitation after CNS injury or disease, the results of this review underline an important knowledge gap with regards to the actual mechanism of action of FEST + TST.
Keywords:Functional electrical stimulation therapy  mechanism of action  neuromodulation  neurorehabilitation  spinal cord injury  stroke
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