Non-Invasive Electrotherapy for Motor Recovery and Spasticity after Stroke: a Systematic Review

This project presents a systematic review aimed at evaluating the effectiveness of non-invasive electrotherapy modalities in the rehabilitation of motor sequelae and spasticity following stroke. Stroke remains one of the leading causes of long-term disability worldwide, frequently resulting in motor impairments and spasticity that significantly affect functional independence and quality of life. In recent years, several non-invasive electrotherapy techniques have been proposed as complementary interventions to conventional rehabilitation in order to enhance neuroplasticity and improve motor recovery. The objective of this review is to analyze and synthesize current evidence regarding the use of different non-invasive electrotherapy modalities, including neuromuscular electrical stimulation (NMES), transcutaneous electrical nerve stimulation (TENS), functional electrical stimulation (FES), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), transcutaneous spinal direct current stimulation (tsDCS), and afferent electrical stimulation (AES), in patients with stroke. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. A comprehensive literature search was conducted in PubMed, Web of Science, and Scopus for studies published up to 14 November 2023. Eligible studies included randomized controlled trials involving adult stroke patients undergoing non-invasive electrotherapy interventions aimed at improving motor function or reducing spasticity. Methodological quality was assessed using the PEDro scale, levels of evidence were classified according to the Oxford Centre for Evidence-Based Medicine criteria, and risk of bias was evaluated using the Cochrane Risk of Bias tool (RoB 2). The expected outcome of this review is to provide a comprehensive synthesis of current evidence, identify methodological gaps in the literature, and contribute to the development of evidence-based recommendations for the clinical application of electrotherapy in stroke rehabilitation.