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The efficacy and prescription of neuromuscular electrical stimulation (NMES) in adult cancer survivors: a systematic review and meta-analysis

Supportive Care in Cancer volume 26, pages 3985–4000 (2018)Cite this article

Abstract

Purpose

This study aims to (1) summarise and critically evaluate the effects of neuromuscular electrical stimulation (NMES) on indices of health and quality of life (QoL) in adult cancer survivors, (2) assess the safety of NMES as a rehabilitation method in this population, and (3) identify commonly used NMES treatment parameters and describe treatment progression.

Methods

A systematic search of four electronic databases targeted studies evaluating the effects of NMES on physical function, aerobic fitness, muscle strength, body composition, and health-related quality of life (HR-QoL) in adult cancer survivors, published through March 2018. Two reviewers independently reviewed and appraised the risk of bias of each study.

Results

Nine studies were included. Meta-analyses found that the overall pooled effect favoured NMES for improving muscle strength, but the standardised mean difference was not significant (0.36; 95% CI − 0.25, 0.96). Further meta-analyses indicated that NMES significantly improved HR-QoL (0.36; 95% CI 0.10, 0.62), with notable gains identified under the subcategories QoL Function (0.87; 95% CI 0.32, 1.42). Current NMES prescription is not standardised and NMES is prescribed to target secondary complications of treatment. Risk of bias was high for most studies.

Conclusions

NMES use in adult cancer survivors is an emerging field and current literature is limited by studies of poor quality and a lack of adequately powered RCTs. Existing evidence suggests that NMES is safe and may be more effective than usual care for improving HR-QoL. Prescription and progression should be tailored for the individual based on functional deficits.

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Funding

D O’Connor is supported by a grant from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement no. 722012.

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Affiliations

  1. The Insight Centre for Data Analytics, O’Brien Centre for Science, University College Dublin Belfield Campus, Dublin, Ireland

    Dominic O’Connor & Brian Caulfield

  2. UCD School of Public Health, Physiotherapy and Sports Science, Health Sciences Centre, University College Dublin, Dublin, Ireland

    Dominic O’Connor & Olive Lennon

Authors
  1. Dominic O’Connor
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  2. Brian Caulfield
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  3. Olive Lennon
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Corresponding author

Correspondence to Dominic O’Connor.

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The authors declare that they have no conflict of interest.

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O’Connor, D., Caulfield, B. & Lennon, O. The efficacy and prescription of neuromuscular electrical stimulation (NMES) in adult cancer survivors: a systematic review and meta-analysis. Support Care Cancer 26, 3985–4000 (2018). https://doi.org/10.1007/s00520-018-4342-7

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  • DOI: https://doi.org/10.1007/s00520-018-4342-7

Keywords

  • Neuromuscular electrical stimulation
  • Adult cancer survivors
  • Rehabilitation
  • Oncology
  • Physical function