Electrical stimulation (ES) is one of the intervention techniques that is available for the management of patients with rheumatoid arthritis (RA). Specifically, ES is used to improve muscle performance, maintaining or enhancing the muscle strength and endurance that is required for the various functional activities of daily living (ADL). The effects of ES on muscle performance are produced by the recruitment of motor units that are not activated voluntarily during a task due to various factors that include muscle disuse atrophy and articular pain.
A review of randomized (RCT) and controlled clinical trials (CCT), case-control and cohort studies of the use of ES in RA only identified two RCTs, only one of which met the criteria for retention. The results of this one RCT, involving 15 patients with RA affecting the hand, showed significant results that favoured the use of patterned ES derived from a fatigued motor unit from the first dorsal interosseous in a normal hand for all outcome measures: grip strength, pinch strength, and muscle function and endurance. Electrical stimulation whether delivered at a fixed frequency of 10 Hz or at patterned frequency, had significant benefit when compared to a no treatment control group on two outcome measures: pinch strength and muscle endurance. These conclusions however are limited by poor reporting of the characteristics of application of the ES and the poor methodological quality of the trial. The reviewers therefore conclude that there is no clear evidence for the inclusion of ES in the management of RA at this time.