Objectives: The purpose of this overview was to summarize the evidence regarding the effectiveness of Cognitive Behavioral Therapy (CBT) for sleep disorders through systematic reviews (SRs) and meta-analyses (MAs). Methods: An overview of systematic review was conducted according to the study protocol (reviewregistry1320). A comprehensive literature search was performed using three databases (Pubmed, Cochrane Central Register of Controlled Trials, and Web of Science) and three Korean databases (KoreaMed, KMbase, and ScienceON). Final studies were selected by three authors according to inclusion and exclusion criteria, and data needed for analysis were extracted by a pre-planned extraction framework. Methodological quality of systematic review was assessed using the 'Assessment of multiple systematic reviews 2 (AMSTAR2)'. Results: Fourteen SRs and MAs were included, of which eleven SRs were performed MAs. Twelve studies studied insomnia among sleep disorders, and the rest are nightmares and sleep disturbances with PTSD. Ten studies reported the effect of CBT on sleep disorders measured by insomnia severity index (ISI) and sleep onset latency (SOL), and all reported a significant improvement effect. Eight studies reported the effect of CBT on sleep disorders measured by wake time after sleep onset (WASO), and seven studies reported a significant improvement effect. The methodological quality of the studies evaluated with AMSTAR 2 was mainly low or very low because of omission of protocol registration and excluded study list. Conclusions: Practical guidelines and studies show that CBT is effective for sleep disorders, but access to CBT needs to be improved.
Background: The application of Kinesio tape (KT) has become an alternative treatment for the reduction of edema owing to its distinct characteristics that mimic skin behavior. Although many studies have found that KT application has a positive effect on edema related to breast cancer and rehabilitation following mandibular third molar surgery, there is little evidence to support the use of KT for musculoskeletal injuries. Objects: The purpose of this study was to review the literature related to KT application for reducing edema caused by musculoskeletal disorders. Methods: A literature search (July 2022) was performed on PubMed for articles published between January 2012 and June 2022. The following keywords were used: "Kinesio taping," "Kinesio tape," "swelling," and "edema," with different combinations and derivations. Only articles available in English were included in this study. Results: Among 68 identified studies, seven met our search strategy and criteria and were included in the literature review. Five of these studies investigated musculoskeletal disorders of the knee joint; two of them reported that KT application had a positive effect on edema measured using perimetry following total knee replacement and anterior cruciate ligament reconstruction. However, the KT application did not improve swelling in patients with acute lateral ankle sprains. Pediatric patients with acute proximal phalangeal joint sprain experienced a more significant improvement in the reduction of swelling than the group using a splint. Conclusion: This literature review found discrepant evidence to support using KT for edema control in musculoskeletal disorders. Further research is needed to determine the effectiveness of KT for controlling edema following musculoskeletal injuries.
Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.
Objectives This study aimed to investigate the clinical trial trends of Chuna manual therapy (CMT) on gynecologic disease and suggest the effectiveness and safety evidence for further study. Methods We searched nine electronic databases (CENTRAL, CiNii, CNKI, EMBASE, KMbase, KISS, MEDLINE PubMed, NDSL, and OASIS) using the search terms "Chuna" and "Tuina" and identified relevant literature that investigated the CMT as an intervention for gynecologic disease. All relevant papers were extracted and selected to be analyzed. Results Among the 1456 studies that were searched and screened, 18 randomized controlled trials (RCTs) satisfied the designated criteria. A meta-analysis showed that CMT had a curative effect on patients with primary dysmenorrhea, postpartum hypogalactia, breast hyperplasia, postpartum urinary retention, and pelvic pain. Conclusions Based on this study, CMT should be comprehensively considered for gynecologic disease. The treatment response was significantly enhanced after treatment; however, there were some limitations in the study. More well-designed RCTs are needed to ensure that all gynecologic patients have a safe and effective therapy.
Background: Occipital neuralgia (ON) is an established risk factor for headaches in the posterior cervical region. Several conservative treatments by nerve decompression and pain relief are available for ON, but these treatments have limitations. Acupuncture treatment, which is known to demonstrate analgesic effects, involves various stimulation methods, and several studies have reported their clinical benefit. No recent systematic review (SR) has compared each acupuncture type for ON treatment. Thus, this SR aims to investigate the clinical effectiveness of each acupuncture type for treating ON. Methods: We will identify relevant studies using electronic databases, including EMBASE, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Korean Studies Information Service System (KISS), Korean Medical Database, KoreaMed, and National Digital Science Library (NDSL) from the inception until August 2023. The primary outcome will include the numerical change of pain symptoms (visual analog scale and numerical rating scale) and effective rate. Safety and secondary outcomes will include adverse events and quality of life. We will compare the conservative treatment with the acupuncture treatment using network meta-analysis. The Cochrane Collaboration "risk of bias" tools will be used to assess the quality of included trials. The Grades of Recommendation, Assessment, Development, and Evaluation will be used to examine the evidence level. Conclusion: This study will provide clinical evidence of several acupuncture types for ON and help clinicians decide on the best.
Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.
Purpose : This study systematically assessed 9 emotion-function programs for schizophrenic individuals that have been implemented over the past 10 years in Korea and abroad, with the objective of providing clinical grounds and data for further programs. Methods : This study identified 2,558 studies from among those registered in the RISS, KISS, EMbase, PubMed and Scopus databases from 2013 to September 2023, using 'schizophrenia' AND 'emotion' AND ('program' OR 'therapy') as keywords. Of the 2,558 studies retrieved from electronic databases, 602 duplicate papers were excluded. After this process, 1,915 papers that did not meet the study's inclusion and exclusion criteria were excluded based on their titles and abstracts. Following a review of the texts of the remaining 41 papers, nine papers were finally selected, excluding 32 papers according to the selection and exclusion criteria. Results : Programs for the emotional function of patients with schizophrenia have continued to be researched. The results of an evaluation on the quality of the selected literature confirmed that a majority of the reviewed items were "uncertain", confirming that there was a risk of bias. The interventions for emotions included art, cognitive-behavioral, and physical programs, of which art programs were frequently applied. Most of the interventions were implemented in hospitals. The dependent variables for evaluating emotions included emotional expression, depression, anxiety, and positive emotions, and among them, emotional expression was used most frequently. Accordingly, the Berkeley expressivity questionnaire was commonly used as an evaluation tool. Conclusion : This study is significant for intending to analyze domestic and overseas programs for the emotions of patients with schizophrenia, thereby proposing the direction for planning and applying interventions in clinical settings. In follow-up studies, it will be necessary to develop a protocol that confirms interventions according to the settings and patient characteristics of programs and expands the scope of literature reviews.
Background: The association between exposure to extremely low frequency-magnetic fields (ELF-MF) and childhood leukemia has been controversial. There is a need to clarify this relationship by summarizing key conclusions from systematic review articles. Objectives: The major aim of this study is to summarize key conclusions from systematic review articles on the association between exposure to ELF-MF and childhood leukemia based on childhood exposure to ELF-MF, proximity from childhood household to high voltage cables, and parental occupational exposure to ELF-MF. Methods: This study was conducted through a brief literature review focusing on systematic, meta-analysis, and pooled analysis methods. We conducted a literature search in PubMed using the key words "ELF-MF" and "childhood leukemia" singly or combined. Results: In 2002, the World Health Organization (WHO)'s International Agency for Research on Cancer (IARC) reviewed two manuscripts to conduct pooled analysis and concluded that there is a significant association between exposure to >0.3 μT or 0.4 μT and childhood leukemia. We found a total of four manuscripts for systematic or pool analysis that have been published since the IARC's conclusion. They consistently concluded that there was a significant association between exposure to >0.4 μT and childhood leukemia compared to ELF-MF exposure to below 0.1 μT. The proximity of children's households to high voltage cable lines and occupational exposure by their parents to ELF-MF during certain periods prior to or during pregnancy were inconsistently associated with childhood leukemia. The study found that many EU countries have implemented precautionary policies to prevent potential childhood leukemia due to exposure to ELF-MF. Conclusions: This study recommends implementing a precautionary policy that includes legal exposure limits for ELF-MF to minimize exposure to ELF-MF.
The human reproductive system can be affected by occupational exposure to many physical and chemical risk factors. This study was carried out to review the studies conducted on the issue of the pathophysiological effects of occupational physical and chemical risk factors on the reproductive system of females and males. In this systematic review, the databases such as "Google Scholar," "Pub-Med," "Scopus," and "Web of Science" were used. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020), the studies included in our study were published between 2000 and 2021. In order to extract the required data, all sections of the articles were reviewed. Out of 57 articles we reviewed, 34 articles were related to field studies and 23 articles to clinical studies. Among them, 43 studies dealt with the pathophysiological effects of chemical agents, six studies dealt with the pathophysiological effects of physical factors, and 8 studies dealt with the pathophysiological effects of physicochemical factors on the human reproductive system. Physical (noise, heat, and radiofrequency radiation) and chemical (such as carbamate and organophosphate pesticides, benzene, toluene, xylene, formaldehyde, NO2, CS2, manganese, lead, nickel, and n-hexane) risk factors had pathophysiological effects on the human reproductive system. The presence of these risk factors in the workplace caused damage to the human reproductive system. The rate of these negative pathophysiological effects can be reduced by performing appropriate managerial, technical, and engineering measures in work environments.
Background: Stroke is one of the causes affecting gait and balance. Taping is considered an effective method for improving balance and gait in stroke patients. Numerous studies have confirmed the functional effects of taping in stroke patients. However, there is still no consensus regarding the use of taping to improve gait and balance. Objects: The purpose of this review was to investigate the effects of taping on the balance and gait of patients with stroke through meta-analysis of studies. Methods: PubMed, Medline, Embase, Web of Science, Cochrane Review, RISS, DBPia, and Science on were used to collect articles on Kinesio and non-elastic taping. The key terms were "Stroke", "Hemiplegia", "Taping", "Tape", "Balance", and "Gait" with cut-off of October, 2022. Taping group was compared with control groups with sham, placebo, and no taping. The outcome measures included the Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and gait speed (cm/s). Eighteen studies (524 patients) were selected for the meta-analysis. Results: Overall, taping improved balance and gait in stroke patients, and Kinesio and non-elastic taping had similar effect sizes. Taping improved the BBS and TUG, and was most effective on gait speed. Contrary to the expectation that a longer duration of taping would be more affective, taping was most effective when the total taping duration was shorter than 500 minutes. In addition, the effect size of taping was greater when it was simultaneously attached to multiple locations. Conclusion: This meta-analysis supports the use of taping to improve gait and balance in stroke patients, and provides guidelines for the location, duration, and type of tape to increase taping efficiency.
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