• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.12 no.1
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• pp.1-12
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• 2017

Objective : The purpose of this study is to review the randomized clinical trials of Chuna manual therapy for cervicogenic headache and provide a evidence for the efficacy of Chuna manual therapy. Methods : We searched randomized clinical trials that performed Chuna manual therapy for cervical headache up to Feb. 2017 in 6 databases. Randomized clinical trials were selected according to the inclusion criteria and the data were extracted and analyzed. The risk of bias was assessed using the Cochrane Risk of Bias Criteria. Results : 16 RCTs met the inclusion criteria. The meta-analysis of 13 RCTs showed favorable results for the use of chuna manual therapy compared to drug, physical treatment. Conclusions : In 16 RCTs, we found that Chuna manual therapy was effective in cervicogenic headache. However, all RCTs are exposed to a number of bias risks. Therefore, well designed clinical trial would be needed to raise the evidence level of Chuna manual therapy.

• Journal of the Korean Society of Physical Medicine
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• v.18 no.4
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• pp.109-119
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• 2023

PURPOSE: The definition and scope of biofeedback are broad and lack a clear framework. Therefore, efforts are needed to clearly understand the exact range and definition of biofeedback based on the research and development conducted to date. Thus, the purpose of this study was to arrive at the definition and scope of biofeedback through a literature review and analysis of its application methods. METHODS: This study is a systematic literature review conducted to understand the various types and effects of biofeedback. International databases such as Google Scholar and PubMed were used. Domestic databases utilized for keyword searches included the Research Information Sharing Service (RISS) and the National Digital Science Library (NDSL). Quality assessment of the selected studies in the selection process was done using the Cochrane risk of bias, and the research was analyzed according to the population, intervention, control, and outcomes (PICO) format. RESULTS: Studies conducted between 2019 and 2021 were selected, with 4 papers falling under physiological classifications and 7 under biomechanical classifications. The quality assessment results showed that random sequence generation, allocation concealment, performance bias, and reporting bias were unclear. Detection bias was moderate, and attrition bias and other biases were low. Out of the 11 papers, 9 dealt with physical function outcomes, 5 with daily life activities, and 3 with mental functions. CONCLUSION: Physiological biofeedback tended to influence psychological factors more than physical functions, while biomechanical biofeedback tended to have a positive impact on physical functions.

• Journal of Acupuncture Research
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• v.27 no.3
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• pp.59-64
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• 2010

목적 : 이 연구의 목적은 중풍 환자의 변비에 대한 증상완화요법으로서의 경락 마사지에 대해 그 임상적인 근거를 평가하기 위함이다. 방법 : 본 연구에서는 언어적인 제한 없이 12가지의 데이터베이스에서 개시부터 2010년 4월까지의 문헌을 검색했다. 변비가 있는 중풍 환자를 경락 마사지로 치료한 모든 형태의 임상 연구를 대상으로 하여, 플라시보 대조군 연구나 약물요법 또는 무처치 대조군 연구의 경우를 본 연구에 포함하였으며, 증례 보고나 사례군 연구는 제외하였다. 모든 임상 연구의 방법론적인 질은 Cochrane의 risk of bias analysis를 이용하여 평가하였다. 결과 : 전체적으로 세 편의 비무작위 배정 대조군 연구와 한 편의 비대조군 관찰 연구가 포함되었다. 모든 연구들은 높은 수준의 risk of bias를 보였다. 세 편의 비무작위 배정 대조군 연구들은 경락 마사지의 효과를 무처치군과 비교하였는데, 중풍 환자의 변비에 대해 경락 마사지의 긍정적인 효과를 나타내었으며, 한편의 비대조군 관찰 연구 역시 긍정적인 결과를 보였다. 하지만 모든 연구들은 bias에 노출되어 있었다. 결론 : 경락 마사지가 중풍 환자의 변비에 대해 효과적인 치료법이라는 것을 보여주기에는 현재의 근거가 부족하며, 모든 연구들은 높은 수준의 risk of bias를 가지고 있기 때문에 더욱더 엄격한 연구가 요구된다.

• Restorative Dentistry and Endodontics
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• v.45 no.2
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• pp.25.1-25.12
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• 2020

Objectives: This systematic review evaluated the influence of autoclave sterilization procedures on the cyclic fatigue resistance of heat-treated nickel-titanium (NiTi) instruments. Materials and Methods: A systematic search without restrictions was conducted in the following electronic databases: PubMed, Scopus, Web of Science, ScienceDirect, Cochrane, and Open Grey. The hand search was also performed in the main endodontic journals. The eligible studies were submitted to the methodological assessment and data extraction. Results: From 203 abstracts, a total of 10 articles matched the eligible criteria. After reading the full articles, 2 were excluded because of the absence of the heat-treated instruments in the experimental design and 3 due to the lack of a control group using heat-treated instruments without autoclave sterilization. From the 5 included studies, 1 presented a low risk of bias, 3 presented moderate and 1 high risk. It was observed heterogeneous findings in the included studies, with autoclave sterilization cycles increasing, decreasing or not affecting the cyclic fatigue life of heat-treated NiTi instruments. However, the retrieved studies evaluating the cyclic fatigue resistance of endodontic instruments presented different protocols and assessing outcomes, this variability makes the findings less comparable within and also between groups and preclude the establishment of an unbiased scientific evidence base. Conclusions: Considering the little scientific evidence and considerable risk of bias, it is still possible to conclude that autoclave sterilization procedures appear to influence the cyclic fatigue resistance of heat-treated NiTi instruments.

• Journal of Acupuncture Research
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• v.38 no.1
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• pp.20-31
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• 2021

The objective was to evaluate the effectiveness and safety of acupuncture for patients with rotator cuff diseases. There were 12 electronic databases and 3 trial registries searched up to November 30th, 2019. All randomized trials were eligible, regardless of language, date of publication, or settings. The primary outcomes were pain, shoulder function, and proportion of improved participants assessed within 12 weeks of randomization of the trial. The Cochrane risk of bias for the studies was assessed. Effects sizes were presented as a risk ratio, mean difference, or standardized mean difference with a 95% confidence intervals. Grading of Recommendations Assessment, Development and Evaluation approach was adopted to rate certainty of evidence. Of the 3,686 records screened, 28 randomized trials (2,216 participants) were included in this review. The types of acupuncture included manual acupuncture, dry needling, electroacupuncture, acupotomy, warm needle acupuncture, and fire needle acupuncture. All of the studies had an unclear or high risk of bias related to more than 1 domain. Significant benefits of acupuncture in terms of pain and shoulder function were observed in all comparisons, however, the proportion of improved participants was not described in 2 comparisons. There was substantial heterogeneity among meta-analyzed trials. No serious harm was observed. For primary outcomes, the overall certainty of evidence was very low. There was very low certainty of evidence for the benefits of acupuncture for patients with rotator cuff diseases. The safety of acupuncture remains unclear due to the incompleteness of reporting. Future well-designed randomized trials with transparent reporting are required.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.1
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• pp.1-10
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• 2022

Background: Inferior alveolar nerve block (IANB) is known to have a lower success rate for anesthesia in patients with irreversible pulpitis. This calls for supplementary techniques to effectively anesthetize such patients. This systematic review aimed to evaluate the published literature for determining the success rate of anesthesia induction using post-IANB intraligamentary (IL) injection in the mandibular teeth of patients with symptomatic irreversible pulpitis. The review question was, "What is the success rate of IL injection in the mandibular teeth of patients with irreversible pulpitis as a supplementary technique for endodontic treatment?" Methods: A thorough search of electronic databases and manual searches were performed. The protocol of the review was framed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and was registered in the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) with a proper criterion for inclusion and exclusion of studies. The included studies were analyzed using the Cochrane Collaboration "Risk of Bias" tool. A meta-analysis that included a comparison of primary nerve block and supplemental IL injection was performed. The success rate was evaluated using the combined risk ratio (RR) with a random risk model. A funnel plot was created to measure publication bias. Results: After all analyses, four studies were included. In the forest plot representation, RRs were 3.56 (95% CI: 2.86, 4.44), which were in favor of the supplemental IL injections. Statistical heterogeneity was found to be 0%. These values suggest that supplemental IL injections provide better success rates for anesthesia. Conclusion: According to the pooled qualitative and quantitative analyses, supplemental IL injections increased anesthetic efficacy.

• Journal of Pharmacopuncture
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• v.25 no.4
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• pp.301-316
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• 2022

Objectives: This study aimed to evaluate the efficacy and safety of heat stimuli (e.g., fire needling, warm needling) in acupuncture for acute gout. Methods: Four international online databases (PubMed, Cochrane, Embase, and Chinese National Knowledge Infrastructure) were searched to identify randomized, controlled trials (RCTs) that used fire needling and warm needling for acute gout. The methodological quality of the RCTs was evaluated using the Cochrane risk-of-bias (RoB) tool. Thirteen RCTs (840 patients) were included and analyzed. Three evaluation tools (total effective rate, uric acid level, and pain score) were mainly used. Comparisons were made between Western medicine (WM) and i) fire needling or warm needling treatment alone, ii) fire needling and bloodletting combination treatment, iii) combination of fire needling, bloodletting, and herbal medicine, iv) warm needling (concurrently). Heat stimuli in acupuncture alone or in combination treatment were more effective in terms of the total efficacy rates, uric acid levels, and pain scores than WM alone. Results: In all the evaluation tools, the treatment effects in the fire needling alone or warm needling alone treatment group and the fire needling and bloodletting combination intervention group were significantly better than those in the WM control group. The warm needling and WM combination intervention groups also experienced significantly better treatment effects in terms of total efficacy rates and uric acid levels. Only the pain scores in the fire needling, bloodletting, and herbal medicine combination groups demonstrated significant improvement. Only four studies mentioned adverse reactions: one reported loss of appetite; three studies reported none. According to the Cochrane RoB tool, most studies showed either high or uncertain RoB. Conclusion: Heat stimuli during acupuncture could be effective for acute gout. However, as the included studies were regionally biased, more high-quality studies are needed to confirm the level of evidence.

• Restorative Dentistry and Endodontics
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• v.45 no.4
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• pp.48.1-48.11
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• 2020

Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO₂) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO₂ values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I² statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO₂ values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

• Korean Journal of Acupuncture
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• v.36 no.1
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• pp.1-18
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• 2019

Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF). Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods. Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD -1.05 point on a 0 to 10 point scale, 95% CI -1.45 to -0.65, $I^2=74%$). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF. Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.

• The Journal of Internal Korean Medicine
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• v.41 no.6
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• pp.1100-1118
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• 2020

Objectives: The purpose of this study was to assess the effects of acupuncture as a treatment for allergic rhinitis (AR). We used a meta-analysis and systematic review to analyze the results of randomized controlled trials (RCTs) that applied acupuncture to AR patients. Methods: The key question assessed the effects of acupuncture on patients with AR, and we included only RCTs. We searched the KoreaMed, NDSL, KMBASE, Koreantk, OASIS, PubMed, EMBASE, and Cochrane databases, with no language restriction. We assessed risk of bias with the Cochrane Risk of Bias tool. The random effects model was used to adjust for the heterogeneity of the included studies, and the effect sizes between two groups were reported as mean differences (MD) and risk ratios (RR). Results: Twelve RCTs were analyzed, with a total of 1788 participants; 824 participants were in the treatment group (i.e., acupuncture) and 964 were in the control group (sham acupuncture, western medicine, or waitlist). The meta-analysis results of 7 RCTs comparing the therapeutic efficacy of acupuncture with that of sham acupuncture showed a statistically significant difference (p<0.05) in the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and the Change of Total Nasal Symptom Score (TNSS). The meta-analysis of 4 RCTs comparing the therapeutic efficacy of acupuncture with western medicine showed statistically significant differences (p<0.05) in the RQLQ but not in the changes in effective rate (p>0.05). Conclusions: Acupuncture can be an effective treatment for AR, but more studies are required to enhance the level of evidence and to confirm safety.