• Journal of Korean Physical Therapy Science
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• v.27 no.2
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• pp.36-47
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• 2020

Background: This study purposed to provide meaningful information for the accumulation of knowledge on coordinative locomotor training in patients with stroke. Design: Meta-analysis. Methods: This study collected articles which the coordinative locomotor training in patients with stroke. For systematic meta-analysis, 6 articles were finally selected after searching based on the PICOSD criteria. This meta-analysis was conducted according to PRISMA guidelines. Randomized controlled trials were included and the risk of bias was evaluated for each study. Pooled standardized mean differences were calculated using a random effects model. To extract the effect size of each study, the R 3.5.3 software was used. Results: The meta-analysis showed that a total effects size was 1.23 indicating that coordinative locomotor training for patients with stroke had a maximum effect size. Conclusion: A meta-analysis is warranted for further research to determine the effects of coordinative locomotor training in patients with stroke on muscle strength, walking and range of motion.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.2
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• pp.1-16
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• 2018

Purpose : This meta-analysis was aimed at guiding future research in stroke treatment and to provide real-world data relating to the effects of aquatic exercise therapy on balance in patients with chronic stroke. Methods : We performed a meta-analysis comprising 22 studies involving aquatic exercise therapy performed between 2006 and 2017. A meta-analysis software program was used to calculate the mean effect size, effect size by intervention, and effect size by outcome. We also performed a meta-regression analysis and an analysis of publishing bias. Results : The mean effect size was 0.563. The effect size by outcome was observed to be the largest for the functional reach test, followed by the Berg balance scale, balance equipment, the Timed Up and Go test and one leg standing. Meta-regression analysis showed that effect size increased with an increase in the duration, number, length of exercise session. Conclusion : Aquatic exercise therapy appears to show a moderate effect on balance in patients with chronic stroke. A meta-analysis is warranted for further research to determine the effects of aquatic exercise on walking, muscle strength, and range of motion.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.2
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• pp.169-185
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• 2020

Purpose : This study aimed to conduct a comprehensive meta-analysis to evaluate the effect size for pulmonary function and gait capacity of treadmill exercise in stroke patients. In addition, we aimed to examine the current status of treadmill interventions and compare the effect sizes of treadmill training to provide evidence-based practice for future development and application. Methods : The meta-analysis study was conducted using research articles that applied treadmill exercise to stroke patients and were published between January 2005 and February 2020. For a systematic meta-analysis, we conducted a search using the PICOS framework and selected 25 domestic stroke- and treadmill-related studies. The Comprehensive Meta-Analysis program was used to calculate the effect sizes for lung function and gait capacity (6-minute walk test and 10 m walk test). As Cohen's d has a tendency to overestimate the effect size, we used Hedge's g to increase the accuracy in computing the effect size. Results : Based on the results of the meta-analysis, the total effect size of treadmill exercise was 0.535, which was statistically significant, with a medium effect size (p<0.05). The effects of treadmill exercise in stroke patients were divided into dependent variables, namely pulmonary function (0.372) and gait capacity (0.584). In addition, for gait capacity, the effect sizes were evaluated for both the 6-minute walk test (0.756) and the 10 m walk test (0.514). Conclusion : This study provides objective evidence of the effectiveness of treadmill-based gait training programs. We hope that the results of this study will help support the development and implementation of treadmill-based gait training in stroke patients. Treadmill training is expected to improve not only pulmonary function, but also the gait capacity of stroke patients. Long-term investigations on the effects of treadmill training in stroke patients are necessary.

• Physical Therapy Rehabilitation Science
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• v.8 no.2
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• pp.112-123
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• 2019

Objective: Based on the results of previous studies, it is necessary to analyze gait and discuss and present the effects of aquatic exercise for chronic stroke. The purpose of this study was to present objective data on the effect of aquatic exercise on the gait of persons with stroke by performing a meta-analysis. Design: A systematic review and meta-analysis. Methods: We performed a meta-analysis of 23 studies that investigated the effects of aquatic exercise performed between 2006 and 2017. The studies were searched on the basis of the participants, intervention, comparison, outcomes standard. The quality of the research method was assessed using a tool that can assess the risks posed by each study design. A meta-analysis software program was used to calculate the mean effect size, effect size by intervention, and effect size by outcome. We also performed a meta-regression analysis and an analysis of publication bias. Results: The mean effect size of the patients' gait was 0.65 (p<0.05). The largest effect size by outcome was observed at the 6-m walk test, followed by the 6-minutes walk test, 10-m walk test, and the walking equipment test (p<0.05). The meta-regression analysis showed that the effect size increased with increased duration, number, and length of sessions. Conclusions: Aquatic exercise appears to show a moderate effect on the gait of chronic stroke survivors. Meta-analyses on the effects of aquatic exercise in other patient populations are needed. This study suggests standard criteria establishments for the effect of aquatic exercise on the walking ability of persons with chronic stroke.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2164-2172
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• 2020

Background: Stroke patients have multiple disorders, but most have problems with balance and gait. Post-stroke rehabilitation exercise has been shown to be very important for functional recovery. Objectives: To systematically review and meta-analyze the effects of sling exercise (SE) on patients with stroke in studies published in Korea. Design: Meta-analysis. Methods: Five databases, namely, RISS, KISS, NDSL, DBpia and Earticle, were used to collect articles on vibration. Keywords such as "Stroke," "Hemiplegia," "Sling," and "Sling Exercise" were used in the search for published articles. Interventions and comparisons were SE and other exercise (OE). Outcome measures were berg balance scale (BBS) and timed up and go (TUG). Consequently, eight studies were selected in the second screening using meta-analyses. Results: Based on the results of the meta-analysis, SE was effective for BBS in the comparison of SE and OE [2.71, 95% CI (1.42, 4.01)]. It was effective for TUG in the comparison of SE and OE [-1.89, 95% CI (-3.01, -0.77)]. Conclusion: Based on eight limited studies, SE improved BBS and TUG over OE, suggesting improved stroke balance and gait. Therefore, more studies and large-scale sample randomized controlled trials are needed to confirm clinical application.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.4
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• pp.119-130
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• 2019

Purpose : The purpose of this study was to investigate the meta-analysis on the effects of action observation training on stroke patients' walking. Methods : Domestic databases (DBpia, KISS, NDSL, and RISS) were searched for studies that conducted randomized controlled trials (RCTs) associated with action observation training in adults after stroke. The search outcomes were items associated with the walking function. The 18 studies that were included in the study were analyzed using R meta-analysis. A random-effect model was used for the analysis of the effect size because of the significant heterogeneity among the studies. Sub-group and meta-regression analysis were also used. Egger's regression test was conducted to analyze the publishing bias. Cumulative meta-analysis and sensitivity analysis were also done to analyze a data error. Results : The mean effect size was 2.77. The sub-group analysis showed a statistical difference in the number of training sessions per week. No statistically significant difference was found in the meta-regression analysis. Publishing bias was found in the data, but the results of the trim-and-fill method showed that such bias did not affect the obtained data. Also, the cumulative meta-analysis and sensitivity analysis showed no data errors. Conclusion : The meta-analysis of the studies that conducted randomized clinical trials revealed that action observation training effectively improved walking of the chronic stroke patients.

• YAKHAK HOEJI
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• v.53 no.5
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• pp.265-273
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• 2009

The aims of this study are to conduct meta-analysis for obtaining pooled estimates of the utility weight for stroke and to explore the study design characteristics that determine the utility weight for stroke. Medline (Pubmed), CEA Registry (Tufts Medical Center), and KERIS (Korea Education & Research Information Service) were searched to find out the literature that reported quality of life with stroke. Patient characteristics, utility weights and standard errors were extracted and stratified by severity, study method, respondent and country. All estimates were measured on a 0 to 1 scale with 0 representing the death and 1 representing the perfect health. The pooled estimates of the utility weight were 0.627 for total stroke, 0.756 for mild stroke, 0.631 for moderate stroke, and 0.389 for severe stroke (p=0.0001). Non-patients showed significantly lower utility weights than patients for severe (p=0.0122) stroke.

• International Journal of Internet, Broadcasting and Communication
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• v.16 no.1
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• pp.92-98
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• 2024

This meta-analysis systematically reviewed studies on mirror therapy focused on arm and hand function in stroke patients, aiming to comprehensively assess the efficacy of mirror therapy interventions and furnish empirical support for its potential application and future development in the context of stroke rehabilitation. A rigorous search for articles published in international journals up to the year 2022 was conducted. Various assessment tools were employed to calculate effect sizes, evaluating the impact of mirror therapy on arm and hand function in stroke patients. Utilizing a random-effects model, mean effect sizes were determined, yielding a total effect size of 0.545. The effect sizes for the Brunnstrom Recovery Stage (BRS), Box and Block Test (BBT), Modified Barthel Index (MBI), Fugl-Meyer Assessment (FMA), and grip strength test were 0.957, 0.596, 0.490, 0.488, and 0.417, respectively. In summary, we suggest that mirror therapy engenders positive changes in functional recovery among stroke patients, establishing a foundation for its tailored clinical application based on individual subject characteristics.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.115-122
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• 2023

Objective: A previous study reported that cardiovascular training (CT) decreased interleukin-6 (IL-6), a pro-inflammatory cytokine with bidirectional effects. However, because of conflicting results of increasing and decreasing IL-6 levels in stroke patients, it is essential to clarify the effects of CT on IL-6 levels in this population. Therefore, this review aimed to investigate the effects of CT on IL-6 levels in stroke patients through a meta-analysis of randomized controlled trials (RCTs), synthesizing and analyzing the effects qualitatively and quantitatively. Design: A systematic review and meta-analysis of randomized controlled trials. Methods: In this review, conducted in April 2023, electronic databases (Web of Science, CINAHL, Embase, MEDLINE, Google Scholar) were searched to ascertain the effects of CT on IL-6 levels in stroke patients. For qualitative evaluation, ReVMan, provided by the Cochrane Group, was used, and for quantitative evaluation, a random-effects model and SMD (Standardized Mean Difference) were used. Results: Three RCTs measured IL-6 in 117 patients with stroke. The experimental group to which CT was applied showed no significant change compared to the control group.The result of analysis using the random effect model is SMD=-0.23; 95% confidence interval, -0.66 to 0.20. Conclusions: CT does not affect IL-6 levels in stroke patients. These results suggest that CT can be applied regardless of its positive or negative effect on IL-6 levels in stroke patients.

• Research in Community and Public Health Nursing
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• v.29 no.4
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• pp.510-519
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• 2018

Purpose: The purpose of this meta-analysis isto identify social psychological factors related to quality of life and estimate the effect sizes of the factors among patients with strokes. Methods: Thirteen studies with a total of 1,814 patients published from the earliest records to January 8, 2017 were selected through a systematic process of searching the literature, and evaluated against influencing factors of quality of life and their effect sizes. Pooled effect sizes were calculated using the random effect model. Meta-analysis was conducted by R software. Results: The following influencing factors had a strong association with quality of life with stroke: depression (r=-.50; 95% CI: -0.63~-0.46), activities of daily living (r=.46; 95% CI: 0.35~0.56), and social support (r=.40; 95% CI: 0.24~0.53). Conclusion: The findings confirm that depression, activities of daily living and social support are associated with quality of life among patients with stroke survivors. We recommend that any intervention program to improve the quality of life with stroke patients consider addressing these modifiable influencing factors.