Improving Gait and Daily Function in Stroke Survivors: A Systematic Review on the Effects of Transcutaneous Electrical Nerve Stimulation (TENS)

Introduction
Stroke or cerebrovascular accident is a leading cause of mortality worldwide. One of its most common sequelae is hemiplegia, a paralysis of one side of the body that affects motor and sensory functions, limiting individual performance in activities of daily living and decreasing quality of life. Transcutaneous electrical nerve stimulation (TENS) has emerged as a therapeutic alternative for the treatment of motor dysfunction in patients with hemiplegia, showing positive effects on spasticity, peripheral circulation, and the treatment of painful musculoskeletal disorders. Aim: This study was conducted to analyze the effects of TENS on activities of daily living and gait in patients with stroke sequelae.

Material and methods
A systematic review was carried out using a search strategy applied to MEDLINE, ScienceDirect, LILACS, WEB OF SCIENCE, and Cochrane Central Register of Controlled Trials databases. Experimental, quasi-experimental, cohort, case-control, and cross-sectional studies were included. Studies involving children and adolescents or populations with diagnoses other than stroke, studies using other types of electrical stimulation current, narrative reviews, and case studies were excluded.

Results
TENS produced significant improvements in gait speed and gait endurance, and decreased spasticity in the participants undergoing this intervention. Notably, these improvements were more pronounced in the groups that received TENS combined with exercise.

Conclusions
The use of TENS as a therapeutic strategy is associated with improved performance in activities of daily living and gait-related parameters. However, further studies are needed to consider individual cases and specific application contexts.