SYSTEMATIC REVIEW article

Front. Neurol.

Sec. Experimental Therapeutics

Volume 16 - 2025 | doi: 10.3389/fneur.2025.1574338

The Effectiveness of Low-Frequency Electrical Stimulation in Treating Hemiplegic Shoulder Pain: A Systematic Review and Meta-Analysis

Provisionally accepted
Tao QinTao Qin1Tiantian HuTiantian Hu1Yuzhuo DanYuzhuo Dan1Cheng QiuCheng Qiu1Mei ChenMei Chen2Fanjing KongFanjing Kong3Sha HuangSha Huang3Zhenwei ZhaiZhenwei Zhai4Ying XuYing Xu1Tao SunTao Sun3,5*
  • 1Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
  • 2Department of Rehabilitation Medicine, General Hospital of Western Theater Command, Chengdu, China
  • 3School of Intelligent Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
  • 4The Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
  • 5State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China

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Objective: To clarify the effectiveness of Low-frequency electrical stimulation (LFES) in treating Hemiplegic shoulder pain (HSP), identify the therapeutic effects of different treatment parameters, and provide evidence-based recommendations. Method: We searched PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, and China Science and Technology Journal Database up to October 2023. Randomized controlled trials (RCTs) comparing LFES with comparable single rehabilitation interventions, placebo/sham treatments, or conventional rehabilitation were included. The included outcomes were pain intensity and motor function in the upper extremities.Result: A total of eight studies (341 participants) were included. LFES showed significant therapeutic effects on shoulder pain scores (SMD = -0.68; 95% CI: [-1.18, -0.18], Z = 2.69, p = 0.006, I² = 76%).However, the improvement in upper limb motor function (MD = 8.50; 95% CI: [5.12, 11.88], Z = 4.93, p < 0.001, I² = 16%) was influenced by a single study with lower methodological quality. Subgroup analyses examined factors such as control group type, stimulation type, duration, frequency, pulse width, and stimulation area. The variations in therapeutic effects of LFES across different treatment parameters, different hemiplegic sides, and different stimulation areas were further explored by subgroup analysis.The meta-analysis results indicate that LFES has significant positive effects on alleviating HSP, but its effect on improving motor function requires cautious interpretation due to potential bias.

Keywords: Hemiplegic shoulder pain, Low-frequency electrical stimulation, Stroke, Systematic review, Meta-analysis CI: confidence interval, CNKI: China National Knowledge Infrastructure, CNS: central nervous system, CRPS: complex regional pain syndrome, EMBASE: Excerpta Medica Database, ES: electrical stimulation, FES: functional electrical stimulation, FMA-UE: Fugl-Meyer assessment for upper extremities

Received: 15 Feb 2025; Accepted: 16 May 2025.

Copyright: © 2025 Qin, Hu, Dan, Qiu, Chen, Kong, Huang, Zhai, Xu and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Tao Sun, State Key Laboratory of Southwestern Chinese Medicine Resources, Chengdu University of Traditional Chinese Medicine, Chengdu, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material