• 제목/요약/키워드: Randomized controlled trials

검색결과 1,181건 처리시간 0.022초

Efficacy of topical interventions for temporomandibular disorders compared to placebo or control therapy: a systematic review with meta-analysis

  • Mena, Mariam;Dalbah, Lana;Levi, Lauren;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제20권6호
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    • pp.337-356
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    • 2020
  • This systematic review focused on the efficacy of topical products in reducing temporomandibular joint disorder (TMD)-associated pain, in comparison to placebo or control interventions. The EMBASE, Web of Science, Cochrane Library, and MEDLINE via PubMed databases were searched for randomized controlled trials (RCTs) using topical interventions in adults diagnosed with TMD. The pain intensity was the primary outcome, and other clinical findings were the secondary outcomes. The risk of bias was evaluated according to the Cochrane's handbook. The search up to February 7, 2020 identified a total of 496 unduplicated references. Nine RCTs with 355 adult patients diagnosed with TMD were included. The meta-analysis did not show a significant reduction in baseline pain intensity in the nonsteroidal anti-inflammatory drug (NSAIDs) group, when compared to the placebo group (P = 0.288). One study demonstrated a statistically significant pain score decrease for Theraflex-TMJ compared to placebo after 10 d of treatment (P = 0.003) and follow-up, 5 d after the last application (P = 0.027). Ping On reduced pain at 4 weeks of application (P < 0.001) but not after 7 d of application (P = 0.136). In one study, cannabidiol (CBD) significantly improved the pain intensity compared to placebo (P < 0.001). However, no differences were found with capsaicin in the two studies (P = 0.465). Evidence was of low quality because the studies were considered as having an unclear or a high risk of bias and a small number of studies were analyzed. The evidence is not sufficient to support the use of topical NSAIDs and capsaicin, and limited evidence was found for Threraflex-TMJ, bee venom, Ping On, and CBD, with only one study reporting for each. Additional studies are recommended to validate these results.

운동-인지 이중과제가 인지장애를 가진 노인의 인지기능에 미치는 영향: 무작위 실험연구에 대한 체계적 고찰 (The Effects of Motor-cognitive Dual Task on Cognitive Function of Elderly with Cognitive Disorders: Systematic Review of Randomized Controlled Trials)

  • 신수정;박경영
    • 융합정보논문지
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    • 제10권12호
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    • pp.216-225
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    • 2020
  • 본 연구는 체계적 고찰을 통해 선정된 연구를 질적 분석하여 인지장애가 있는 노인에게 실시된 이중과제의 적용방법, 결과측정방법, 중재효과를 알아보고자 시행되었다. 본 연구는 2010년 1월부터 2019년 12월까지 등록된 연구를 검색하였다. 전자 데이터베이스 PubMed, ProQuest를 이용하였으며, 검색어는'dual task' OR 'multi modal' AND 'mild cognitive impairment' OR 'dementia' OR 'Alzheimer's disease' AND 'intervention' OR 'rehabilitation를 사용하였다. 최종 선정된 연구는 8편이었다. 이중과제는 단독중재로서 적용되기보다 다른 운동중재와 함께 구성된 복합중재의 부분으로 이용되고 있었다. 이중과제의 인지 및 운동과제는 각각 별개의 내용으로 서로 독립적인 과제가 대부분이었다. 평가는 MMSE, CERAD와 같은 전반적인 인지기능평가와 집행기능평가, 기억력평가 등이 포함되었고 이중과제의 직접적인 향상을 보기위하여 Dual task cost를 이용하기도 하였다. 본 연구는 이중과제의 연구 및 임상적 적용을 위한 기초적인 자료로서 이용될 수 있을 것으로 생각된다.

Preliminary Experience of Neuroform Atlas Stenting as a Rescue Treatment after Failure of Mechanical Thrombectomy Caused by Residual Intracranial Atherosclerotic Stenosis

  • Yi, Ho Jun;Sung, Jae Hoon;Lee, Dong Hoon
    • Journal of Korean Neurosurgical Society
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    • 제64권2호
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    • pp.198-206
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    • 2021
  • Objective : The low-profile Neuroform Atlas stent can be deployed directly without an exchange maneuver by navigating into the Gateway balloon. This retrospective study assessed the safety and efficacy of Neuroform Atlas stenting as a rescue treatment after failure of mechanical thrombetomy (MT) for large artery occlusion. Methods : Between June 2018 and December 2019, a total of 31 patients underwent Neuroform Atlas stenting with prior Gateway balloon angioplasty after failure of conventional MT caused by residual intracranial atherosclerotic stenosis (ICAS). Primary outcomes were successful recanalization and patency of the vessel 24 hours after intervention. Secondary outcomes were vessel patency after 14 days and 3-month modified Rankin Scale. Peri-procedural complications, intracerebral hemorrhage (ICH), and 3-month mortality were reviewed. Results : With a 100% of successful recanalization, median value of stenosis was reduced from 79.0% to 23.5%. Twenty-eight patients (90.3%) showed tolerable vessel patency after 14 days. New infarctions occurred in three patients (9.7%) over a period of 14 days; two patient (6.5%) underwent stent occlusion at 24 hours, and the other patient (3.2%) with delayed stent occlusion had a non-symptomatic dot infarct. There were no peri-procedural complications. Two patients (6.5%) developed an ICH immediately after the procedure with one of them is symptomatic. Conclusion : Neuroform Atlas stenting seems to be an effective and safe rescue treatment modality for failed MT with residual ICAS, by its high successful recanalization rate with tolerable patency, and low peri-procedural complication rate. Further multicenter and randomized controlled trials are needed to confirm our findings.

Low-Level Laser Therapy including Laser Acupuncture for Non-Specific Chronic Low Back Pain: Systematic Review and Meta-Analysis

  • Yeum, Hyewon;Hong, Yejin;Nam, Dongwoo
    • Journal of Acupuncture Research
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    • 제38권1호
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    • pp.8-19
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    • 2021
  • Low-level laser therapy including laser acupuncture (LLLT/LA) has been widely used for non-specific chronic low back pain (NCLBP). However, there is no critically appraised evidence of its potential benefits. This study aimed to evaluate the effectiveness of LLLT/LA for NCLBP. There were 12 databases (MEDLINE, CENTRAL, EMBASE, KoreaMed, KMBASE, KISS, NDSL, KISTI, OASIS, CNKI, CiNII, J-stage) searched for randomized controlled trials using LLLT/LA for NCLBP up until June 2019. The primary outcome was pain intensity and functional status/disability due to NCLBP. A random-effects meta-analysis was conducted on 20 studies involving 1,323 participants. LLLT/LA showed a significant positive effect on pain relief scores compared with sham treatments (SMD -0.51, 95% CI: -0.88 to -0.13; χ2 = 31.12, I2 = 74%). Alone, the therapy showed a significant positive effect on function/disability scores (30 participants, MD -11.90, 95% CI: -17.37 to -6.43). As an add-on treatment, it showed a significant positive effect on pain relief (80 participants, MD -5.10, 95% CI: -9.31 to -0.88; χ2 = 28.99, I2 = 97%) and improved function/disability scores (120 participants, MD 5.44, 95% CI: 2.19 to 8.68; χ2 = 4.07, I2 = 75%). Among 20 studies, 9 studies reported no adverse events and 1 study reported mild adverse events. LLLT/LA may be an alternative or add-on treatment for NCLBP.

소아 해수에 대한 추나요법의 효과: 체계적 문헌 고찰과 메타분석 (Chuna Manual Therapy for Pediatric Cough: A Systematic Review and Meta-analysis)

  • 박혜진;김현태;이상현;황만석;황의형;신병철;허인
    • 척추신경추나의학회지
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    • 제16권1호
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    • pp.25-34
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    • 2021
  • Objectives This review was conducted to evaluate the effectiveness and clinical significance of Chuna manual therapy (CMT) in the treatment of pediatric cough. Methods Ten electronic databases (PubMed, EMBASE, Cochrane, CNKI [CAJ], KMBASE, KISS, KISTI, NDSL, RISS, and Oasis) were searched. Only randomized controlled trials (RCTs) using CMT for pediatric cough treatment were included. The methodological quality of each RCT was evaluated using the Cochrane risk-of-bias tool (v1.0). Results Nine RCTs met the inclusion criteria. The meta-analysis revealed positive effects of CMT in the treatment of pediatric cough. Both CMT alone and CMT combined with Chinese medication or Chinese medicine acupoint application (CMAA) were effective in treating pediatric cough. Conclusions This systematic review shows the reliability, effectiveness, and clinical significance of CMT in the treatment of pediatric cough. However, the evidence is limited due to the defective design of the included RCTs. More well-designed RCTs are required to provide clearer evidence for this claim.

수족냉증의 침 치료법에 대한 고찰 (A Review of Acupuncture Treatment Methods for Cold Hypersensitivity of Hands and Feet)

  • 최수지;최윤석;이연선;노은지;김동일
    • Korean Journal of Acupuncture
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    • 제38권2호
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    • pp.43-61
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    • 2021
  • Objectives : The purpose of this study is to review the acupuncture treatment for cold hypersensitivity of hands and feet. Methods : We searched articles in 7 search engines with keywords related to 'Cold hypersensitivity of hands and feet' and 'Raynaud disease' in March 2021. Clinical studies that used acupuncture for cold hypersensitivity of hands or feet were included. Animal studies and nonclinical data were excluded. Data on acupuncture treatment such as methods, site, duration, frequency, and period were analyzed. Also, network analysis between acupoints was conducted. Results : Of 41 selected articles, there were 32 case reports, 7 randomized controlled trials, and 2 uncontrolled clinical studies. Studies were conducted using manual acupuncture, electroacupuncture, warm needling, pharmacopuncture, fire needling, and auricular acupuncture. Most studies used more than one acupoint (n=40), and there were 111 acupoints selected for acupuncture treatment for cold hypersensitivity of hands and feet. The most commonly used acupoint was LI11 (n=27). In terms of the correlation of acupoints, LI11 had the highest value of degree centrality at 0.6989. The mean treatment time, number of treatments, and duration were 26.8±8.87 minutes, 15.51±15.75 times, and 77.69±132.80 days. Conclusions : The results of this study could be useful in establishing the evidence for performing standardized acupuncture treatment for cold hypersensitivity of hands and feet.

신경가동술의 국내 연구 동향과 임상적 활용: 주제범위 문헌고찰 (Research trends and clinical applications of neural mobilization in Korea: A scoping review)

  • 이은경;김진현;이정한;조은별
    • 척추신경추나의학회지
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    • 제16권1호
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    • pp.53-66
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    • 2021
  • Objectives The purpose of this scoping review is to investigate the trends and gaps in existing research on neural mobilization in Korea and to suggest further directions for study. Methods A scoping review was sequentially conducted according to the five steps outlined by Arksey and O'Malley, and the PRISMA-ScR checklist. We searched five domestic databases (RISS, DBpia, KISS, ScienceON, and KMBASE) and identified relevant literature reported until April 15, 2021. The key search terms used were "Neural mobilization" and "Neurodynamic". Results Of the 1383 studies identified in the search, 50 were finally selected. Of these, 45 studies were in the field of medicine and pharmacy and physical therapy as the most common sub-field. Thirty-eight of the 50 studies (76%) were randomized controlled trials. Neural mobilization was most frequently used in the treatment of stroke (n = 13) and of various neuromusculoskeletal diseases such as cervical radiculopathy (n = 8) and low back pain (n = 5). The main targets of neural mobilization were the median nerve (n = 20) and sciatic nerve (n = 14). The most commonly used technique for neural mobilization was that developed by Butler and Jones in 1991 (n = 10). Conclusions This is the first scoping review of neural mobilization in Korea. We believe that further research on neural mobilization with other types of research design is necessary to investigate the utility of neural mobilization and to establish standard protocols. Our findings indicate that neural mobilization can be considered as an intervention for neuromusculoskeletal diseases in Korean medicine.

주름 개선을 위한 침 연구의 현황분석 (Recent Research Trends of Acupuncture for Wrinkle Treatment)

  • 정현석;김태준;박지연
    • Korean Journal of Acupuncture
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    • 제38권2호
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    • pp.62-74
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    • 2021
  • Objectives : The aim of this study is to analyze the effect of acupuncture and the details of acupuncture treatment methods on skin wrinkles. Methods : Search was conducted in Pubmed, KISS, and NDSL databases for acupuncture studies on skin wrinkles. The detailed therapeutic techniques of acupuncture used for skin wrinkles and the effect of acupuncture on skin wrinkle improvement were analyzed. Then, the study results using the same indicator were compared through meta-analysis in order to compare the effects of acupuncture with the control group. The quality of randomized controlled trials (RCTs) was assessed using the risk of bias (ROB) assessment tool (Ver. 1.0, Cochrane Collaboration). Results : A total of 10 RCTs and 19 case series were included in this study. The most frequently used therapeutic technique for skin wrinkle improvement was Microneedle therapy system (MTS, n=19), and they were mostly used with aesthetic solutions (13 out of 19 studies). Skin wrinkle related indexes were most commonly used to evaluate skin wrinkle improvement (n=14). Panax Ginseng pharmacopuncture showed the most remarkable effect in improving the range of skin wrinkles and the depth of skin wrinkles. MTS+epidermal growth factor improved the levels of skin hydration, skin elasticity, and variation of skin pigment the most. MTS+Endothelial precursor cell improved the number of skin melanin the most. Three RCTs included in the meta-analysis showed moderate ROB on average. Conclusions : Acupuncture treatment was effective in improving skin wrinkles. However, a precise study design using unified indicators and appropriate controls needs to be performed in further studies in order to establish more convincing evidence of the effectiveness of acupuncture for improving skin wrinkles.

다낭신의 중의치료에 대한 임상연구 동향 - CNKI검색을 중심으로 (A Review of Clinical Studies of Chinese Medicine Treatment of Polycystic Kidney Disease Using the CNKI Database)

  • 주아라;박미소;최요섭;추원정;백혜경;박무진
    • 대한한방내과학회지
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    • 제42권3호
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    • pp.225-238
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    • 2021
  • Objective: This research reviews and investigates the trends in recent clinical studies of polycystic kidney disease (PKD) in China. Method: We searched for clinical studies discussing Oriental medicine-based treatments for PKD in the China National Knowledge Infrastructure (CNKI) database. Thirteen clinical articles published from 2001 to 2019 were analyzed. The search focused on the authors, publication year, type of study, purposes of study, method and duration of treatment, evaluation criteria, and results of the selected articles. Results: Of the articles from the database, 9 case series and 4 randomized controlled trials (RCTs) were analyzed. Ten articles used herbal medicine; 4 used herbal medicine for external use. Gamigyejibokryeong-hwan was the most common herbal prescription. The most frequently used herb was Polia Sclerotium (茯苓), and Cnidii Rhizoma (川芎) was employed in all the external uses. All 13 studies confirmed the efficacy of Oriental medicine treatments. Conclusion: 1. Scientifically designed and more varied clinical studies are required to develop treatments for PKD. 2. The current study could be used as basic data in future clinical studies on treatment and further studies of PKD.

Comparison of pregnancy outcomes using a time-lapse monitoring system for embryo incubation versus a conventional incubator in in vitro fertilization: An age-stratification analysis

  • Chera-aree, Pattraporn;Thanaboonyawat, Isarin;Thokha, Benjawan;Laokirkkiat, Pitak
    • Clinical and Experimental Reproductive Medicine
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    • 제48권2호
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    • pp.174-183
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    • 2021
  • Objective: The aim of this study was to compare the pregnancy outcomes of in vitro fertilization with embryo transfer between embryos cultured in a time-lapse monitoring system (TLS) and those cultured in a conventional incubator (CI). Methods: The medical records of 250 fertilized embryos from 141 patients undergoing infertility treatment with assisted reproductive technology at a tertiary hospital from June 2018 to May 2020 were reviewed. The study population was divided into TLS and CI groups at a 1 to 1 ratio (125 embryos per group). The primary outcome was the live birth rate. Results: The TLS group had a significantly higher clinical pregnancy rate (46.4% vs. 27.2%, p=0.002), implantation rate (27.1% vs. 12.0%, p=0.004), and live birth rate (32.0% vs. 18.4%, p=0.013) than the CI group. Furthermore, subgroup analyses of the clinical pregnancy rate and live birth rate in the different age groups favored the TLS group. However, this difference only reached statistical significance in the live birth rate in women aged over 40 years and the clinical pregnancy rate in women aged 35-40 years (p=0.048 and p=0.031, respectively). The miscarriage rate, cleavage rate, and blastocyst rate were comparable. Conclusion: TLS application improved the live birth rate, implantation rate, and clinical pregnancy rate, particularly in the advanced age group in this study, while the other reproductive outcomes were comparable. Large randomized controlled trials are needed to further explore the ramifications of these findings, especially in different age groups.