OBJECTIVE: To investigate (i) the effect of functional electrical stimulation (FES) in improving activity and (ii) whether FES is more effective than training alone? Review protocol available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42012003054. DATA SOURCES: Cochrane Central Register of Controlled Trials, Ovid Medline, EBSCO CINAHL, Ovid Embase, Physiotherapy Evidence Database and Occupational Therapy Systematic Evaluation of Effectiveness database. STUDY SELECTION: Randomized and controlled trials up to 22nd June 2014 were included following pre-determined search and selection criteria. DATA EXTRACTION: Data extraction occurred by two people independently using a pre-determined data collection form. Methodological quality was assessed by 2 reviewers using the PEDro methodological rating scale. Meta-analysis was conducted separately for the two research questions. DATA SYNTHESIS: Eighteen trials (19 comparisons) were eligible for inclusion in the review. FES had a moderate effect on activity (SMD 0.40, 95% CI 0.09 to 0.72) compared with no or placebo intervention. FES had a moderate effect on activity (SMD 0.56, 95% CI 0.29 to 0.92) compared with training alone. When subgroup analyses were performed, FES had a large effect on upper limb activity (SMD 0.69, 95% CI 0.33 to 1.05) and a small effect on walking speed (MD 0.08 m/s, 95% CI 0.02 to 0.15) compared with any control. CONCLUSIONS: FES appears to moderately improve activity compared with both no intervention and training alone. These findings suggest that FES should be used in stroke rehabilitation to improve the ability to perform activities.

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