• The Journal of Korean Medicine
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• v.45 no.1
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• pp.45-64
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• 2024

Objectives: This study is purposed to investigate the effect and safety of laser therapy for stroke patients by systematic review and meta-analysis of the randomized controlled trials (RCTs). Methods: RCTs on the treatment of laser therapy for stroke patients were selected among the literature published from January 2000 to June 2022 in twelve domestic and foreign databases. The quality of the literature was evaluated using the Cochrane's Risk of Bias tool and RevMan 5.4 was used for the synthesis of results. Results: Total 2,598 patients with stroke were finally selected from 18 RCTs. Meta-analysis showed that laser therapy was effective in significantly improving activities of daily living (MBI), motor function (effective rate), upper motor function (FMA-UE), shoulder pain related factors (CGRP, ET-1, BK). Overall, the risk of bias was uncertain or low in the quality assessment of the literature. Conclusions: Although it is unclear that laser therapy is more effective than sham laser, laser therapy might be more effective in improving symptoms than conventional rehabilitation alone. Furthermore, no serious adverse events were founded in laser therapy studies. However, the quality of the selected literature was generally low. Therefore, further studies with high methodological quality on laser therapy for stroke patients would be required in the future.

• Physical Therapy Korea
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• v.30 no.2
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• pp.92-101
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• 2023

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.

• The Journal of Korean Physical Therapy
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• v.33 no.1
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• pp.21-27
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• 2021

Purpose: The objective of this study was to investigate the effects of Kinesio taping (KT) for balance and gait in patients with stroke through meta-analysis of studies conducted in Korea. Methods: RISS, Science on, and DBPia were the three databases used to collect articles on KT. Keywords such as "Stroke," "Kinesio taping," "Elasticity taping," and "Taping" were used to search for published articles. We systematically searched from the inception of each database to November 2020. Interventions and comparisons were KT and without KT. Outcome measures were the timed up and go (TUG) and 10-meter walking tests (10MWT). Consequently, six studies were selected for the second screening using meta-analyses. Results: Based on the results of the meta-analysis, comparison between patients with and without KT showed that KT was effective for TUG (ES: 2.51, 95% CI: 2.12 to 2.90); however, it was not effective for 10MWT (ES: 0.79, 95% CI: -0.04 to 1.62). Conclusion: The current evidence suggests that KT is more effective than without KT interventions for balance function in post-stroke patients. However, more well-conducted randomized controlled trials are required in the future.

• The Journal of Korean Medicine
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• v.42 no.4
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• pp.75-101
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• 2021

Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

• Journal of the Korea Convergence Society
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• v.11 no.8
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• pp.63-70
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• 2020

This study was designed to test the convergence effectiveness of virtual reality programs for patients with stroke by using meta-analysis. Based on the PICOS criteria, we searched domestic literature and selected the final 9 studies in relation to 'stroke' and 'virtual reality programs'. Evaluation of the risk of bias in individual studies was conducted using evaluation tools according to the design of each study. The effect size of the meta-analysis was calculated using CMA program. The mediating effect analysis was conducted by sub-group analysis and meta-regression analysis. The overall effect size of the virtual reality program on the activities of daily living ability was Hedges's g=0.302(95% CI: 0.064~0.540), Therefore, virtual reality programs can increase the activities of daily living in stroke patients and have a positive impact on the medical industry that the convergence of virtual reality industry and healthcare industry.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.471-477
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• 2022

Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

• Journal of Korean Academy of Nursing
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• v.42 no.4
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• pp.537-548
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• 2012

Purpose: The purpose of this study was to use meta-analysis to evaluate the variables related to depression in patients who have had a stroke. Methods: The materials of this study were based on 16 variables obtained from 26 recent studies over a span of 10 years which were selected from doctoral dissertations, master's thesis and published articles. Results: Related variables were categorized into sixteen variables and six variable groups which included general characteristics of the patients, disease characteristics, psychological state, physical function, basic needs, and social variables. Also, the classification of six defensive and three risk variables group was based on the negative or positive effect of depression. The quality of life (ES=-.79) and acceptance of disability (ES=-.64) were highly correlated with depression in terms of defensive variables. For risk variables, anxiety (ES=.66), stress (ES=.53) showed high correlation effect size among the risk variables. Conclusion: These findings showed that defensive and risk variables were related to depression among stroke patients. Psychological interventions and improvement in physical functions should be effective in decreasing depression among stroke patients.

• Journal of Society of Preventive Korean Medicine
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• v.12 no.3
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• pp.59-65
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• 2008

Objective : This study was conducted to integrate the results of studies which show the relationship between risk factors(smoking, drinking, intaking coffee, exercise, BMI, family history, hypertension, DM, hyperlipidemia, heart disease, TIA) and the incidence of stroke in Korean adults. Methods : We surveyed 17 stroke-related articles, published between 1995 and 2007, and conduct meta-analysis. And we estimated common odds ratio(OR). Results : The overall OR of risk factors associated CVD were as follow : Smoking had a 2.488 OR, no regular exercise had a 1.942 OR, $BMI{\geq}25$ had a 1.848 OR, hypertension had a 6.053 OR, DM had a 2.931 OR, heart disease had a 5.455 OR, and TIA had a 5.238 OR. Conclusion : The result of this study suggest that smoking, no regular exercise, $BMI{\geq}25$, hypertension, DM, heart disease, and TIA are important risk factor of stroke.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.2
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• pp.15-28
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• 2019

Objectives : This study aimed to systematically and comprehensively review controlled clinical trials on the effectiveness and safety of Chuna Manual Therapy for stroke. Methods : By October 7, 2019, three core databases and three domestic databases were searched. Seven major academic journals on the related field were also hand-searched. Methodological quality of the included studies was evaluated using the Cochrane risk of bias tool. Meta-analysis was conducted and the quality of its evidence was assessed using the GRADE methodology. Results : Five articles met the eligibility criteria. The results of most of included studies were in favor of Chuna Manual Therapy. No study described any adverse events during or after the clinical trials. Meta-analysis of three eligible studies showed that the pre- and post-treatment scores on the Modified Barthel Index (mean difference 8.00, 95% confidence interval 0.26 to 15.74) and Berg Balance Scale (mean difference 3.57, 95% confidence interval 0.64 to 6.51) of the Chuna-treated group were significantly different, but only marginally higher than those of the non-treatment group. Thus, the level of evidence gathered from these studies was assessed to be low. Conclusions : Based on current available evidence, any confirmative conclusions cannot be made on the effectiveness and safety of Chuna Manual Therapy for stroke because of the small sample size, low methodological quality, presence of statistical heterogeneity, and missing safety information. More rigorously designed large-scale multi-center studies are needed to establish more specific and credible evidence to support or oppose the use of Chuna Manual Therapy for stroke.

• Physical Therapy Korea
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• v.19 no.2
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• pp.48-58
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• 2012

The objective of this study was to evaluate the effects of mirror therapy on motor function recovery following a stroke through a systemic review and meta-analysis. In total, nine of the 48 studies were identified from search engines between 1997 and 2011, as well as from a review of the reference lists of each identified study. The quality of each study was assessed using Jadad scale, and the effect size was calculated as a Cohen's effect size using MetaAnalyst (Beta 3.13). The overall effect size of the mirror therapy was 2.005 (95% confidence interval=1.041~2.970) in a random-effects model. This finding suggests that mirror therapy is beneficial for improving motor function following a stroke. The results from the subgroup analysis according to categorical variables were as follows: First, the effect size was larger for an onset time of less than 1 year (1.166) than for a duration of 1 year or more (.668). Second, the effect size of unpublished dissertations (1.610) was larger than published articles (1.221). Third, motor recovery of upper extremities (1.609) had a greater effect than motor recovery of lower extremities (.903). The major limitation of this study is the relatively small study population. Therefore, further individual studies of mirror therapy should be conducted in order to generalize the effects. In addition, mirror therapy supervised by a physical therapist should be recognized as a potential approach to manage motor function following a stroke and recommended to patients to improve their motor function.