Efficacy and safety of electrical stimulation for functional impairment and pain in patients with rheumatoid arthritis: a protocol for systematic review and network meta-analysis of RCTs.

Abstract

Several studies have indicated that transcutaneous electrical nerve stimulation, functional electrical stimulation, neuromuscular electrical stimulation and electroacupuncture exhibit certain therapeutic effects in the treatment of rheumatoid arthritis (RA). However, definitive proof of the effectiveness of different types of electrical stimulation in relieving the different symptomatic manifestations of RA is required. This study aims to analyse the efficacy (health assessment questionnaire, visual analogue scale, etc), safety (adverse reactions) of electrical stimulation for functional impairment (morning stiffness and decreased muscle strength) and pain (joint tenderness and swelling) of RA, and to explore their comparative advantages and potential benefits for patients. We will conduct a systematic and comprehensive search of eight databases, and the search will proceed from the beginning to 5 September 2024. Two reviewers will independently screen the retrieved literature to determine the final included studies. Two reviewers will independently assess the risk of bias for all included eligible studies using the Cochrane Risk of Bias tool (V.2.0). Data synthesis will be performed using a random-effects model for network meta-analysis to compare the efficacy and safety of different electrical stimulations. The surface under the cumulative ranking curve will be used to demonstrate the probability of the benefits and harms of interventions. Funnel plots will be used to detect potential publication bias and small sample study effects. The strength of the evidence will be assessed through the Grading of Recommendations, Assessment, Development and Evaluation framework. Our study data comes from public databases, and the entire study does not directly involve patients and the public, so ethical approval is not required. The final study results will be peer-reviewed and published in a journal. CRD42024586835.