Abstract：
OBJECTIVE: To examine the evidence regarding functional electrical stimulation cycling\'s (FES-cycling\'s) physiological and clinical effects.
METHODS: The study was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses protocol. PubMed, Embase, Cochrane Review, CINAHL, Scopus, Sport Discus, and Web of Science databases were used.
METHODS: Randomized controlled trials involving FES-cycling were included. Studies that did not involve FES-cycling in the intervention group or without the control group were excluded. Two reviewers screened titles and abstracts and then conducted a blinded full-text evaluation. A third reviewer resolved the discrepancies.
METHODS: Meta-analysis was performed using inverse variance for continuous data, with effects measured using the mean difference and random effects analysis models. A 95% confidence interval was adopted. The significance level was set at P<.05, and trends were declared at P=.05 to ≤.10. The I2 method was used for heterogeneity analysis. The minimal clinically important difference was calculated. Methodological quality was assessed using the risk of bias tool for randomized trials. The Grading of Recommendations Assessment, Development, and Evaluation method was used for the quality of the evidence analysis.
RESULTS: A total of 52 studies were included. Metabolic, cardiocirculatory, ventilatory, and peripheral muscle oxygen extraction variables presented statistical (P<.05) and clinically important differences favoring FES-cycling, with moderate-to-high certainty of evidence. It also presented statistical (P<.05) and clinically important improvements in cardiorespiratory fitness, leg and total body lean mass, power, physical fitness in intensive care (moderate-to-high certainty of evidence), and torque (low certainty of evidence). It presented a trend (P=.05 to ≤.10) of improvement in muscle volume, spasticity, and mobility (low-to-moderate certainty of evidence). It showed no difference (P>.10) in 6-minute walking distance, muscle cross-sectional area, bone density, and length of intensive care unit stay (low-to-moderate certainty of evidence).
CONCLUSIONS: FES-cycling exercise is a more intense stimulus modality than other comparative therapeutic modalities and presented clinically important improvement in several clinical outcomes.
METHODS: The study was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses protocol. PubMed, Embase, Cochrane Review, CINAHL, Scopus, Sport Discus, and Web of Science databases were used.
METHODS: Randomized controlled trials involving FES-cycling were included. Studies that did not involve FES-cycling in the intervention group or without the control group were excluded. Two reviewers screened titles and abstracts and then conducted a blinded full-text evaluation. A third reviewer resolved the discrepancies.
METHODS: Meta-analysis was performed using inverse variance for continuous data, with effects measured using the mean difference and random effects analysis models. A 95% confidence interval was adopted. The significance level was set at P<.05, and trends were declared at P=.05 to ≤.10. The I2 method was used for heterogeneity analysis. The minimal clinically important difference was calculated. Methodological quality was assessed using the risk of bias tool for randomized trials. The Grading of Recommendations Assessment, Development, and Evaluation method was used for the quality of the evidence analysis.
RESULTS: A total of 52 studies were included. Metabolic, cardiocirculatory, ventilatory, and peripheral muscle oxygen extraction variables presented statistical (P<.05) and clinically important differences favoring FES-cycling, with moderate-to-high certainty of evidence. It also presented statistical (P<.05) and clinically important improvements in cardiorespiratory fitness, leg and total body lean mass, power, physical fitness in intensive care (moderate-to-high certainty of evidence), and torque (low certainty of evidence). It presented a trend (P=.05 to ≤.10) of improvement in muscle volume, spasticity, and mobility (low-to-moderate certainty of evidence). It showed no difference (P>.10) in 6-minute walking distance, muscle cross-sectional area, bone density, and length of intensive care unit stay (low-to-moderate certainty of evidence).
CONCLUSIONS: FES-cycling exercise is a more intense stimulus modality than other comparative therapeutic modalities and presented clinically important improvement in several clinical outcomes.
摘要：
目的：研究有关FES循环的生理和临床影响的证据。
方法：本研究按照PRISMA进行。PubMed,EMBASE,Cochrane评论,CINAHL,Scopus,运动铁饼，并使用了WebofScience数据库。
方法：纳入涉及FES循环的随机对照试验。在干预组或无对照组中不涉及FES循环的研究被排除。两名审稿人筛选了标题和摘要，然后进行了盲目的全文评估。第三位审阅者解决了差异。
方法：对连续数据采用逆方差法进行Meta分析，效果采用均值差和随机效应分析模型。采用95%的置信区间。显著性水平设置为p<.05，趋势声明为p=.05至≤.10。采用I2方法进行异质性分析。计算最小的临床重要差异。通过随机试验的偏倚风险工具评估方法学质量。采用GRADE法进行证据质量分析。
结果：共纳入52项研究。代谢，心循环,换气,和外周肌氧提取变量呈现统计学(p<.05)和临床上重要的差异，有利于FES循环，具有中等到高度确定性的证据。它还提供了心肺健康的统计学（p<0.05）和临床上重要的改善，腿部和全身瘦体重，电源,重症监护病房的身体素质（证据的中度到高度确定性），和扭矩（证据的低确定性）。它呈现了肌肉体积改善的趋势(p=.05至≤.10)，痉挛,和流动性(证据的低至中等确定性)。它显示六分钟步行距离没有差异（p>.10），肌肉横截面积,骨密度,和ICU住院时间（证据的低至中度确定性）。
结论：FES循环锻炼是一种比其他比较治疗方式更强烈的刺激方式，并且在一些临床结果中表现出临床上重要的改善。
方法：本研究按照PRISMA进行。PubMed,EMBASE,Cochrane评论,CINAHL,Scopus,运动铁饼，并使用了WebofScience数据库。
方法：纳入涉及FES循环的随机对照试验。在干预组或无对照组中不涉及FES循环的研究被排除。两名审稿人筛选了标题和摘要，然后进行了盲目的全文评估。第三位审阅者解决了差异。
方法：对连续数据采用逆方差法进行Meta分析，效果采用均值差和随机效应分析模型。采用95%的置信区间。显著性水平设置为p<.05，趋势声明为p=.05至≤.10。采用I2方法进行异质性分析。计算最小的临床重要差异。通过随机试验的偏倚风险工具评估方法学质量。采用GRADE法进行证据质量分析。
结果：共纳入52项研究。代谢，心循环,换气,和外周肌氧提取变量呈现统计学(p<.05)和临床上重要的差异，有利于FES循环，具有中等到高度确定性的证据。它还提供了心肺健康的统计学（p<0.05）和临床上重要的改善，腿部和全身瘦体重，电源,重症监护病房的身体素质（证据的中度到高度确定性），和扭矩（证据的低确定性）。它呈现了肌肉体积改善的趋势(p=.05至≤.10)，痉挛,和流动性(证据的低至中等确定性)。它显示六分钟步行距离没有差异（p>.10），肌肉横截面积,骨密度,和ICU住院时间（证据的低至中度确定性）。
结论：FES循环锻炼是一种比其他比较治疗方式更强烈的刺激方式，并且在一些临床结果中表现出临床上重要的改善。
