Objective: The objective of this study is to investigate the effect of treadmill training with real optic flow scene on functional recovery of balance and balance self-efficacy in stroke patients. Design: Single blind, Randomized controlled trial. Methods: Nine patients following stroke were divided randomly into the treadmill with optic flow group (n=3), treadmill with virtual reality group (n=3), and control group (n=3). Subjects in the treadmill with optic flow group wore a head-mounted display in order to receive a speed modulated real optic flow scene during treadmill training for 30 minutes, while those in the treadmill with virtual reality group and control group received treadmill training with virtual reality and regular therapy for the same amount of time, five times per week for a period of three weeks. Timed up and go test (TUG) and activities-specific balance confidence scale (ABC scale) were evaluated before and after the intervention. Results: TUG in the treadmill training with optic flow group showed significantly greater improvement, compared with the treadmill training with virtual reality group and control group (p<0.05). Significantly greater improvement in the ABC scale was observed in the treadmill training with optic flow group and the tread mill training with virtual reality group, compared with the control group (p<0.05). Conclusions: Findings of this study demonstrate that treadmill training with real optic flow scene can be helpful in improving balance and balance self-efficacy of patients with chronic stroke and may be used as a practical adjunct to routine rehabilitation therapy.
Objectives : To research trends of studies on treatments of lumbar herniated intervertebral disc in Korean medicine. Methods : We searched papers using Korean Traditional Knowledge Portal, OASIS, KISS. We used "low back pain", "radiculopathy", "lumbar herniated intervertebral disc" as keyword. Limitations were as follows; Domestic studies, published from 2000 to 2011, mentioning the treatments of lumbar herniated intervertebral disc in Korean medicine. This study researched and classified the papers according to the fields of the treatment and methods of study. Results : The results were obtained as below ; 1. The number of papers published in 2000 was only three, but steadily increased to 15 in 2010 and the total number of papers was 93. 2. When categorized according to the fields of treatment, 93 researches are classified as acupuncture, moxibustion, Chuna therapy, drug, various physical therapies and collaborative Oriental-Western medicine therapy. 3. When categorized according to the methods of study, 70 researches were the simple case report and non-RCT(non-randomized controlled trial) were 11 and RCT(randomized controlled trials) has been reported in 11 researches. 4. General assessment tools were VAS, ODI before, however these days, Physical examination(ROM, SLRT, etc.), Radiologic tests(MRI, X-ray), DITI etc. are used more in order to evaluate objective therapeutic effects. Conclusions : These results indicate that researches on lumbar herniated intervertebral disc in Korean medicine have been investigated by various method and steadily increasing.
Objectives The purpose of this study is to evaluate efficacy and safety of Mahaenggamsuktang for treating mycoplasma pneumonia in children based on the randomized controlled trials (RCTs). Methods Literatures were searched from OASIS, KISS, NDSL, CNKI, Cochrane, Embase and Pubmed, and the search was conducted on January 29, 2020. Only RCTs published since 2000 were included. Trials comparing Mahaenggamsuktang combined with antibiotics or antibiotics treatment alone for the treatment of mycoplasma pneumonia in children were included. Results 17 trials, including 2,241 participants with mycoplasma pneumonia were included in this review. As a result of the meta-analysis, total effective rate of combination of Mahaggamsuktang and antibiotics was 1.24 times higher than that of the antibiotics alone, which was statistically significant. Symptoms with fever, lung sounds, cough, chest X-ray lesion findings, wheezing were also significantly reduced in the treatment group with Mahaenggamseoktang and antibiotics. Also, Serum CRP level was significantly lower with combination treatment. The incidence of adverse reactions was lower in the treatment group with Mahaenggamseoktang and antibiotics, but it was not statistically significant. Conclusions As a result of meta-analysis, combination treatment of Mahaenggamseoktang and antibiotics seems significantly effective for the treatment of mycoplasma pneumonia in children. In order to have a higher level of evidence for efficacy and safety of Mahaenggamsuktang in treating mycoplasma pneumonia, additional RCTs with good qualities are required.
Objectives The purpose of this study is to research current trends of acupuncture treatment of lumbar herniated intervertebral disc using the PubMed database. Methods We set up the search strategy and investigated clinical trials on acupuncture treatment of lumbar herniated intervertebral disc through PubMed search. This study analyzed previous researched papers published from January 1st, 2000 to April 30th, 2014, and classified them by publication year, journal names, types of literature, treatment methods and evaluation scales. To assess the quality of the reviewed literature, randomized controlled trial (RCT) studies were assessed by Cochrane's risk of bias (ROB) tool and non-RCT studies were assessed by risk of bias for non-randomized studies (RoBANS). Results We found 35 studies on the acupuncture treatment of lumbar herniated intervertebral disc. Papers on this topic have been published, on average, three to four times annually in 9 journals since the mid-2000's. The journal with the largest number of publications was Chinese Acupuncture & Moxibustion, and most of articles were classified as RCT. Acupuncture treatment was performed individually or together with other treatments. The most frequently used pain evaluation index was visual analogue scale (VAS). The index of effective rate was used frequently but there was a lack of objectivity. In regards to the quality of the studies, outcome assessment in RCT showed that random sequence generation, allocation concealment, and the blinding of participants and personnel increase potential of risk of bias. For non-RCT assessment, outcome showed that confounding variable, measurement of intervention were at high risk of bias. Conclusions In order to obtain objective clinical evidence of acupuncture treatment of lumbar herniated intervertebral disc, further clinical studies should be designed to minimize the risk of bias, using STRICTA with larger sample sizes.
Heo, Eunyoung;Kim, Deog Kyeom;Oh, So Hee;Lee, Jung-Kyu;Park, Ju-Hee;Chung, Hee Soon
Tuberculosis and Respiratory Diseases
/
v.80
no.3
/
pp.265-269
/
2017
Background: The first line of anti-tuberculosis (TB) drugs are the most effective standard of drugs for TB. However, the use of these drugs is associated with hepatotoxicity. Silymarin has protective effects against hepatotoxicity of anti-TB drugs in animal models. This study aims to investigate the protective effect of silymarin on hepatotoxicity caused by anti-TB drugs. Methods: This is a prospective, randomized, double-blind and placebo-controlled study. Patients were eligible if they were 20 years of age or order and started the first-line anti-tuberculosis drugs. Eligible patients were randomized for receiving silymarin or a placebo for the first 4 weeks. The primary outcome was the proportion of patients who showed elevated serum liver enzymes more than 3 times the upper normal limit (UNL) or total bilirubin (TBil) > $2{\times}UNL$ within the first 8 weeks of anti-TB treatment. Results: We enrolled a total of 121 patients who silymarin or a placebo to start their anti-TB treatment, for the first 8 weeks. The proportions of elevated serum liver enzymes more than 3 times of UNL at week 2, week 4, and week 8 did not show any significant difference between the silymarin and placebo groups, at 0% versus 3.6% (p>0.999); 4.4% versus 3.6% (p>0.999); and 8.7% versus 10.8% (p=0.630), respectively. However, patients with TBil >$2{\times}UNL$ at week 8 were significantly low in the silymarin group (0% versus 8.7%, p=0.043). Conclusion: Our findings did not show silymarin had any significant preventive effect on the hepatotoxicity of anti-TB drugs.
Kim, So-Jung;Jang, Jin-Young;Kim, Nam-Sik;Kim, Yong-Suk;Nam, Sang-Soo
Journal of Acupuncture Research
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v.28
no.5
/
pp.57-64
/
2011
Objectives : The purpose of this study is to compare the efficacy after acupuncture on local acupoints group and distal acupoints group for chronic neck pain. Design : A randomized, crossover clinical trial. Methods : From 15st, September 2010 to October 30th, 2010. 20 patients with chronic neck pain were randomly assigned to either group A or group B. Group A received acupuncture at local acupoints then after 1 week washout period acupuncture at distal acupoints. Group B received the treatment in reverse order. To evaluating efficiency and satisfaction, visual analog scale(VAS), neck disability index(NDI), cranio-cervical flextion test(C-CFT) and five-point likert scale were measured before and after each treatment. Results : Patients in local acupoints group experienced greater improvement than distal acupoints group in VAS. Both local acupoints group and distal acupoints group showed significant improvement in NDI but not in C-CFT and the NDI score change comparison between the two groups had no significance. Local acupoints group showed more effective than distal acupoints group on five-point likert scale. Conclusions : Local acupoints is more effective than distal acupoints in controlling pain in chronic neck pain.
Objectives : Recent well-designed randomized controlled trials(RCTs) and their meta-analysis have been published on the efficacy of acupuncture in different condition. In most of them, real acupuncture is compared with sham acupuncture including invasive and non-invasive sham methods. But it is not clear how active sham methods are. These results tend to lead the conclusion that acupuncture has no more effective than sham acupuncture. In order to investigate that sham acupuncture is appropriate as a control, we reviewed several acupuncture trials using different sham acupuncture as a control. Methods : We searched Cochrane researches of acupuncture, reviewed and analyzed 25 RCTs in 42 Cochrane reviews. And especially we compared the effect of acupuncture according to the type of sham acupuncture. Results : Invasive sham acupunctures are used in 12 RCTs and non-invasive types are used in the rest. The majority of studies(19 RCTs) fail to show effects beyond a sham acupuncture. Streitberger's sham needle is a validated sham acupuncture of non-invasive type that was used in 8 trials and also no significant group differences are shown except one trial. Conclusions : Acupuncture is a complex intervention. Clinical trials of acupuncture need to be reexamined and redesigned to remove several bias. Especially, sham acupuncture as a control might be investigated for physiological effects as well as validation test including patient-blinding and de qi sensation. Other research need to be investigated and developed for acupuncture trials.
Ghanem, Ali M.;Hachach-Haram, Nadine;Leung, Clement Chi Ming;Myers, Simon Richard
Archives of Plastic Surgery
/
v.40
no.4
/
pp.312-319
/
2013
Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.
Objectives The purpose of this study is to evaluate the efficacy and safety of herbal medication for the treatment of nocturnal enuresis in children by analyzing randomized controlled trials conducted in China. Methods We searched literatures from China National Knowledge Infrastructure published up to 19 January, 2018. Selected literatures were collected and analyzed in order of publication year, and then demographic information, treatment method, duration of illness, duration of treatment, follow-up period, outcome measurement and adverse events. Results A total of 34 studies were selected for the analysis. In most studies, the total efficacy of the treatment group was reported to be higher than that of the control group, and the recurrence rate and complete cure rate were also found to be more effective in the herbal medicine treatment group. The most frequently used medical herb was Alpiniae Fructus (益智仁), and the use of medical herbs belong to tonifying yang (補陽藥), tonifying qi (補氣藥), and astringing essence strengthening collapse medicine (澁精縮尿止帶藥) were relatively high. The adverse events rate for the herbal medicine treatment group were significantly lower than those in the Western medicine treatment group. Conclusions This study showed that a herbal medicine treatment can be effective and safe option for treating pediatric nocturnal enuresis. However, additional well-designed clinical studies need to be performed to establish a basis.
Objectives Plantar fasciitis is one of the most common causes of heel pain. Plantar fasciitis can be managed with acupuncture, but the evidence for its effectiveness is uncertain. The aim of this review was to assess the effectiveness of acupuncture for plantar fasciitis. Methods I searched specific Korean and foreign electronic databases (KCI, RISS, NDSL, OASIS, KTKP, National Assembly Library, KMbase, PubMed, The Cochrane Library and China National Knowledge Infrastructure). The key search terms were 'heel pain', 'plantar fasciitis' and 'acupuncture'. Twenty-seven trials were included; eleven case reports, fourteen randomized controlled trials (RCTs) and two non-randomized controlled trials (NRCTs). Results Twenty-seven studies reported that acupuncture treatment reduced plantar fasciitis pain. However, the evidence provided by the case reports was regarded as weak because the methodological quality was poor, and the placebo effect of acupuncture was not accounted for in the RCTs and NRCTs. Overall, the methodological quality of the RCTs and NRCTs was weak. Conclusions There is some evidence for the effectiveness of acupuncture for plantar fasciitis. However, in order to reinforce the evidence for acupuncture's effectiveness, additional placebo-controlled trials with well-designed methodologies are required.
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