• Title/Summary/Keyword: Randomized Clinical Trials

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Effect of Kegel Exercise to Prevent Urinary and Fecal Incontinence in Antenatal and Postnatal Women: Systematic Review (임신 및 출산 여성의 요실금 및 대변실금 예방을 위한 케겔운동의 효과: 체계적 문헌 고찰)

  • Park, Seong-Hi;Kang, Chang-Bum;Jang, Seon Young;Kim, Bo Yeon
    • Journal of Korean Academy of Nursing
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    • v.43 no.3
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    • pp.420-430
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    • 2013
  • Purpose: The aim of this study was to review the literature to determine whether intensive pelvic floor muscle training during pregnancy and after delivery could prevent urinary and fecal incontinence. Methods: Randomized controlled trials (RCT) of low-risk obstetric populations who had done Kegel exercise during pregnancy and after delivery met the inclusion criteria. Articles published between 1966 and 2012 from periodicals indexed in Ovid Medline, Embase, Scopus, KoreaMed, NDSL and other databases were selected, using the following keywords: 'Kegel, pelvic floor exercise'. The Cochrane's Risk of Bias was applied to assess the internal validity of the RCT. Fourteen selected studies were analyzed by meta-analysis using RevMan 5.1. Results: Fourteen RCTs with high methodological quality, involving 6,454 women were included. They indicated that Kegel exercise significantly reduced the development of urinary and fecal incontinence from pregnancy to postpartum. Also, there was low clinical heterogeneity. Conclusion: There is some evidence that for antenatal and postnatal women, Kegel exercise can prevent urinary and fecal incontinence. Therefore, a priority task is to develop standardized Kegel exercise programs for Korean pregnant and postpartum women and make efficient use of these programs.

Virtual Reality-based Training Program Using Computer-human Interface for Recovery of Upper Extremity Use in Stroke Patients (뇌졸중 환자에서 상지 회복을 위해 컴퓨터-인간 연동을 이용한 가상현실 기반 훈련 프로그램)

  • Lee, Kyoung-Hee;Hwang, Ki-Chul
    • Journal of Digital Convergence
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    • v.14 no.1
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    • pp.285-290
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    • 2016
  • To identify virtual reality (VR) interventions used for upper extremity rehabilitation in stroke patients. The Medline database was searched up to February 11, 2015. Randomized controlled and clinical trials that included a VR intervention for upper extremity rehabilitation in stroke patients were included. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of the included studies. In total, 8 studies were included. PEDro scores varied from 5 to 8/10. All studies showed significant improvement in outcomes in favor of the VR group. This review suggests that VR applications used for upper extremity rehabilitation in stroke patients predominantly mediate learning through providing task-oriented and graduated learning with variable and unpredictable practice.

Effects of Korean Red Ginseng on Dry Mouth: A Randomized, Double-Blind, Placebo-Controlled Trial

  • Park, Jae-Woo;Lee, Beom-Joon;Bu, Young-Min;Yeo, In-Kwon;Kim, Jin-Sung;Ryu, Bong-Ha
    • Journal of Ginseng Research
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    • v.34 no.3
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    • pp.183-191
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    • 2010
  • Dry mouth is easily neglected if not associated with oral diseases. Consequently, xerostomatic patients often use unconventional therapies. In traditional Korean medicine, Korean red ginseng (KRG) has long been used to relieve dry mouth. However, no clinical trials have investigated whether KRG actually has an effect on dry mouth. This study was performed to evaluate the efficacy of KRG for dry mouth. We enrolled 100 volunteers with no obvious oral or salivary gland diseases and divided them into KRG and placebo groups. Each group was divided into six subgroups according to age and gender. The subjects received 6 g/day of KRG or placebo for 8 weeks. The dry mouth visual analog scale (VAS), salivary flow rate, and a dry mouth-related symptom questionnaire were evaluated at baseline and at 4 and 8 weeks. KRG treatment did not show any significant differences for any of the variables. However, KRG improved the dry mouth VAS at 4 weeks and dry mouthrelated symptoms at 8 weeks in women, but not in men. Subgroup analyses revealed that KRG markedly improved the dry mouth VAS in women of menopausal age (40 to 59 years) at 4 and 8 weeks. KRG may have beneficial effects for dry mouth in women, especially those of menopausal age, but not in men. Further investigation in post- and perimenopausal women is required to elaborate on these findings.

The Effects of Sciatic Nerve Mobilization on Hamstring Flexibility, Lower Limb Strength and Gait Performance in Patients With Chronic Stroke

  • Shin, Yun-hyeok;Chon, Seung-chul
    • Physical Therapy Korea
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    • v.22 no.4
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    • pp.8-16
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    • 2015
  • The purpose of this study was to evaluate the effects of mobilization of the sciatic nerve on hamstring flexibility, lower limb strength, and gait performance in patients with chronic stroke. This study was a randomized clinical trial with a crossover design. Sixteen subjects were recruited for this study. The subjects were randomly divided into two intervention groups and underwent either of the following two interventions: sciatic nerve mobilization or static stretching of the hamstring. We assessed hamstring flexibility, lower limb strength, and gait performance using a digital inclinometer, a hand-held dynamometer, and the 10-meter walk test, respectively. Subjects had a 24-hour rest period between each session in order to minimize carryover effects. Measurements for each test were assessed prior to and immediately after the intervention sessions. Using a two-way analysis of variance test with repeated measures, data from the two trials were analyzed by comparing the differences between both techniques. The level of statistical significance was set at .05. Sciatic nerve mobilization resulted in significantly better knee extensor strength (p=.023, from $15.32{\pm}5.98$ to $18.16{\pm}6.95kg$) and knee flexor strength (p=.011, from $7.80{\pm}4.80$ to $8.15{\pm}4.24kg$) in the experimental group than in the control group. However, no significant effects of static stretching of the hamstring were observed on hamstring flexibility from the ankle plantar flexion (p=.966) and ankle neutral positions (p=.210) and on gait performance (p=.396). This study indicated that the sciatic nerve mobilization technique may be more effective in muscle activation of the knee extensor muscle and knee flexor muscle than hamstring static stretching technique in patients with chronic stroke.

Current Pharmacogenetic Approach for Oxaliplatin-induced Peripheral Neuropathy among Patients with Colorectal Cancer: A Systematic Review (대장암 환자의 옥살리플라틴(oxaliplatin) 유도 말초신경병증에 대한 약물유전학적 접근: 체계적 문헌고찰)

  • Ahn, Soojung;Choi, Soyoung;Jung, Hye Jeong;Chu, Sang Hui
    • Journal of Korean Biological Nursing Science
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    • v.20 no.2
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    • pp.55-66
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    • 2018
  • Purpose: Peripheral neuropathy is common among colorectal cancer (CRC) patients who undergo oxaliplatin-based (OXL) chemotherapy. A pharmacogenetic approach can be used to identify patients at high-risk of developing severe neuropathy. This type of approach can also help clinicians determine the best treatment option and prevent severe neurotoxicity. The purpose of this study is to investigate the evidence of pharmacogenetic markers for OXL-induced peripheral neuropathy (OXIPN) in patients with CRC. Methods: A systematic literature search was conducted using the following databases up to December 2017: Pubmed, EMBASE, and CINAHL. We reviewed the genetic risk factors for OXIPN in observational studies and randomized controlled clinical trials (RCTs). All processes were performed independently by two reviewers. Results: Sixteen studies published in English between 2006 and 2017 were included in this review. A genome-wide association approach was used in one study and various candidate genes were tested, based on their functions (e.g., DNA damage or repair, ion channels, anti-oxidants, and nerve growth etc.). The genes associated with incidence or severity of OXIPN were ABCG2, GSTP1, XRCC1, TAC1, and ERCC1. Conclusion: This study highlighted the need and the importance of conducting pharmacogenetic studies to generate evidence of personalized OXIPN symptoms management. Additional studies are warranted to accelerate the tailored interventions used for OXIPN in patients with CRC (NRF-2014R1A1A3054386).

A Systematic Review Focused on Health Behavior and Physiological Indicators of Diabetic Patients in Interventional Studies Based on Health Belief Model (건강신념모델 기반 중재연구가 당뇨환자의 건강행위와 생리적지표에 미치는 효과를 중심으로 한 체계적 문헌고찰)

  • Noh, Eun-Young;Cho, Yoonjeong;Lee, Yewon;Yun, Sunyoung
    • Journal of Korean Biological Nursing Science
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    • v.22 no.1
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    • pp.1-10
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    • 2020
  • Purpose: Diabetes Mellitus (DM) is a leading cause of death with a prevalence rate of 12.4% in South Korea. Self-management is crucial for patients with DM, because many studies have reported that self-management intervention based on the Health Belief Model (HBM) is effective. The purpose of this study was to investigate the current state of HBM based intervention studies and the components and effects of the theories used in the study for diabetes patients. Methods: A systematic review was conducted using the Pubmed, Cochrane Library and Embase databases from January 2009 to May 2019. We reviewed characteristics of intervention based on the HBM in randomized controlled clinical trials (RCTs), quasi-experimental study intervention. Results: Eight studies published in English between 2009 and 2019 were included in this review. The key components of the health behavior promotion program applied to the DM patients were perceived susceptibility, perceived severity, perceived benefits, perceived barriers and self-efficacy. The intervention based on these components has reported to significantly increase the health behavior change, likelihood of taking health action and improve physiological indicators (HbA1c, and fasting blood sugar etc.). Conclusion: This study highlighted the importance of intervention programs based on the HBM for DM patients.

Acupuncture Treatment for Ankylosing Spondylitis Using China National Knowledge Infrastructure: A Literature Review (강직성 척추염의 침 치료에 대한 최근 연구동향 분석: China National Knowledge Infrastructure 검색을 중심으로)

  • Yu, Jae-eun;Kwon, Yong-Su;Kim, Hyo-Jun;Park, Joon;Kim, Gook-Beom;Lee, Hee-Won;Bae, Jun-Hyo
    • Journal of Korean Medicine Rehabilitation
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    • v.30 no.4
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    • pp.79-88
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    • 2020
  • Objectives This study was performed to research the trends of Chinese acupuncture treatment for ankylosing spondylitis (AS). Methods We searched clinical studies about Chinese acupuncture treatment for AS through China National Knowledge Infrastructure. We analyzed the characteristics of selected studies according to research design, sample size, publication year, treatment methods, evaluation criteria and adverse events. Results 16 studies published from 2015 to 2020 were selected. They consisted of 11 randomized controlled trials and 5 case reports. In these studies, several types of acupuncture treatments were performed and especially there were many treatments that applied thermal stimulation of needles. The most commonly used evaluation criteria was effective rate. Conclusions This study showed that acupuncture treatment could be effective for AS. It suggested that various studies should be conducted to provide reliable evidence about acupuncture treatment for AS in Korea.

Effect of smear layer deproteinization on bonding of self-etch adhesives to dentin: a systematic review and meta-analysis

  • Alshaikh, Khaldoan H.;Hamama, Hamdi H.H.;Mahmoud, Salah H.
    • Restorative Dentistry and Endodontics
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    • v.43 no.2
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    • pp.14.1-14.16
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    • 2018
  • Objectives: The aim of this systematic review was to critically analyze previously published studies of the effects of dentin surface pretreatment with deproteinizing agents on the bonding of self-etch (SE) adhesives to dentin. Additionally, a meta-analysis was conducted to quantify the effects of the above-mentioned surface pretreatment methods on the bonding of SE adhesives to dentin. Materials and Methods: An electronic search was performed using the following databases: Scopus, PubMed and ScienceDirect. The online search was performed using the following keywords: 'dentin' or 'hypochlorous acid' or 'sodium hypochlorite' and 'self-etch adhesive.' The following categories were excluded during the assessment process: non-English articles, randomized clinical trials, case reports, animal studies, and review articles. The reviewed studies were subjected to meta-analysis to quantify the effect of the application time and concentration of sodium hypochlorite (NaOCl) and hypochlorous acid (HOCl) deproteinizing agents on bonding to dentin. Results: Only 9 laboratory studies fit the inclusion criteria of this systematic review. The results of the meta-analysis revealed that the pooled average microtensile bond strength values to dentin pre-treated with deproteinizing agents (15.71 MPa) was significantly lower than those of the non-treated control group (20.94 MPa). Conclusions: In light of the currently available scientific evidence, dentin surface pretreatment with deproteinizing agents does not enhance the bonding of SE adhesives to dentin. The HOCl deproteinizing agent exhibited minimal adverse effects on bonding to dentin in comparison with NaOCl solutions.

Calcium hydroxide intracanal medication effects on pain and flare-up: a systematic review and meta-analysis

  • Ibrahim, Ahmed Mohamed;Zakhary, Siza Yacoub;Amin, Suzan Abdul Wanees
    • Restorative Dentistry and Endodontics
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    • v.45 no.3
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    • pp.26.1-26.18
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    • 2020
  • Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1-14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion: Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

Surgical management of male genital lymphedema: A systematic review

  • Aulia, Indri;Yessica, Eva Chintia
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.3-8
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    • 2020
  • Genital lymphedema (GL) is an uncommon and disabling disease that manifests as enlargement of the genital region resulting from the disturbance of lymphatic drainage. Although conservative treatment such as decompression is typically the first-line approach, surgical intervention has been shown to be effective in certain cases. This study aimed to systematically review studies evaluating available surgical alternatives for the treatment of male GL. A systematic search strategy using keyword and subject headings was applied to PubMed, Scopus, EMBASE, and Cochrane Library in May 2019. Studies investigating various surgical techniques to treat penile and scrotal lymphedema were included. The potential risk of bias of included trials was evaluated using the methodological index for non-randomized studies (MINORS). In total, 13 studies met the inclusion criteria, nine of which were determined to be high-quality. The average MINORS score was 12.45 for studies involving excision and 14 for studies involving lymphovenous anastomosis (LVA). The most common reason for a low score was a failure to describe the inclusion criteria. Recurrence of lymphedema during follow-up was reported in four studies involving excision and in no studies involving LVA. In general, the quality of the included literature was considered to be fair. Although surgical intervention might not always prevent the recurrence of lymphedema, all of the studies reported improved quality of life after the procedure. This study could be used as the basis for evidence-based guidelines to be applied in clinical practice for managing male GL.