• Title/Summary/Keyword: Randomized controlled trials

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Effects of Back Muscle Stretching on the Flexibility of Spinal Column of Normal Adults (정상성인에 있어 배부근 스트레칭 운동이 척주 유연성에 미치는 영향)

  • Gong, Won-Tae;Lee, Sang-Yong
    • Journal of the Korean Society of Physical Medicine
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    • v.1 no.1
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    • pp.23-36
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    • 2006
  • Purpose : The purpose of this study was to evaluate the effects of back muscle stretching on the flexibility of spinal column. Methods : The subjects were consisted of healthy adults (18 of females, 22 males ; mean aged 21.83) from 18 to 29. All subjects randomly assigned to the control group, back muscle stretching group. back muscle stretching group received back muscles stretching for 20 minutes per day and 3 times a week during 3 week period. Spine motion analyzer (Spinal Mouse) was used to measure the flexibility of spinal column. All measurement of each subjects were measured at pre-experiment, after 10 days, and after 21 days. Results : The results of this study were summarized below 1. The sacral tilt angle of the hip joint of control group, back muscle stretching group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the sacral tilt angle significantly increased at the back muscle stretching group rather than the control group. 2. The thoracic vertebral tilt angle of the control group, back muscle stretching group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 3. The lumbar vertebral tilt angle of the control group, back muscle stretching group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 4. The spinal tilt angle of control group, back muscle stretching group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the spinal tilt angle significantly increased at the back muscle stretching group rather than the control group(p>0.5). 5. The length of the spinal column of control group, back muscle stretching group was no significantly differences at pre-experiment and after 10 days (p>0.5), but differency of each group occurred at after 21 days(p<0.5). the length of the spinal column significantly increased at the back muscle stretching group rather than the control group(p<0.5). Conclusion : These data suggests that 3-week back muscle stretching improved the flexibility of sacrum, spinal column, and also improved spinal column lengthening. Additional randomized controlled trials to more fully investigate treatment effects and factors that may mediate these effects are needed.

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The Effects of Back Muscle Stretching and Abdominal Muscle Strengthening Exercises on the Flexibility of Spinal Column of Normal Adults (정상 성인에 있어 배부근 스트레칭 운동과 복부근력강화 운동이 척주 유연성에 미치는 영향)

  • Gong, Won-Tae
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.12 no.1
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    • pp.1-15
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    • 2006
  • Purpose: The purpose of this study was to evaluate the effects of abdominal muscle strengthening exercises and back muscle stretching on the flexibility of spinal column. Methods: The subjects were consisted of healthy adults ( 28 of females, 32 males; mean aged 21.6) from 18 to 29. All subjects randomly assigned to the control group, back muscle stretching group, abdominal muscle strengthening exercises group. back muscle stretching group received back muscles stretching for 20 minutes, abdominal muscle strengthening exercises group received abdominal muscle strengthening exercises for 30 minutes per day and 3 times a week during 3 week period. Spine motion analyzer (Spinal Mouse) was used to measure the flexibility of spinal column. All measurement of each subjects were measured at pre-experiment, after 10 days, and after 21 days. Results: The results of this study were summarized below 1. The sacral tilt angle of the hip joint of control group, back muscle stretching group, abdominal strengthening exercises group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the sacral tilt angle significantly increased at the back muscle stretching group, abdominal muscle strengthening exercises group, rather than the control group. 2. The thoracic vertebral tilt angle of the control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 3. The lumbar vertebral tilt angle of the control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment, after 10 days, after 21 days(p>0.5). 4. The spinal tilt angle of control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment and after 10 days(p>0.5), but differency of each group occurred at after 21 days(p<0.5). the spinal tilt angle significantly increased at the back muscle stretching group, abdominal muscle strengthening exercises group, rather than the control group(p<0.5). 5. The length of the spinal column of control group, back muscle stretching group, abdominal muscle strengthening exercises group was no significantly differences at pre-experiment and after 10 days (p>0.5), but differency of each group occurred at after 21 days(p<0.5). the length of the spinal column significantly increased at the back muscle stretching group, abdominal muscle strengthening exercises group, rather than the control group(p<0.5). Conclusion: these data suggests that 3-week abdominal muscle strengthening exercises and back muscle stretching improved the flexibility of sacrum, spinal column, and also improved spinal column lengthening. Additional randomized controlled trials to more fully investigate treatment effects and factors that may mediate these effects are needed.

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Clinical Practice Guideline on Acupuncture for Post-stroke Spasticity (뇌졸중후 경직에 대한 침치료 임상진료지침)

  • Kim, Je-Shin;Shin, Seung-Won;Lee, Eui-Ju;Shin, Byung-Cheul;Lee, Myeong-Soo;Lim, Sung-Min;Nam, Dong-Woo;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.36 no.1
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    • pp.1-8
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    • 2015
  • Objectives: This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with post-stroke spasticity. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on post-stroke spasticity, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: One systematic review and 7 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of electroacupuncture treatment for post-stroke spasticity. However, it did not show any sufficient evidence to treat the patients with post-stroke spasticity with the sole acupuncture. The moderate evidence was presented that over 3 times of the electroacupuncture treatments with 1-100 Hz frequency should be performed every week on the acupoints, such as LI11, LI10, TE5, LI4, ST36, GB34, ST40, or LR3, for 20-30 minutes. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for post-stroke spasticity.

The Efficacy of Acupuncture for Postoperative Pain in Patients with Solid Tumor : A Systematic Review and Meta Analysis (고형암 환자의 수술 후 통증에 대한 침 치료 효과 : 체계적 문헌고찰 및 메타분석)

  • Yoon, Sung Soo;Ryu, Han Sung;Oh, Hye Kyung;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.22 no.2
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    • pp.1-11
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    • 2017
  • Objectives: Postoperative pain is one of postoperative complications in patients with solid tumor. This systematic review and meta-analysis were aimed to evaluate the efficacy of acupuncture for postoperative pain in solid tumor. Methods: We searched for randomized controlled trials (RCTs) using acupuncture for postoperative pain in adult patients with solid tumor up to September 2016. Acupuncture was defined as manual acupuncture, electroacupuncture and pharmacopuncture. The following databases were searched: PubMed, EMBASE, Cochrane Library, CNKI, CiNii, KoreaMed, Kmbase, KISS, NDSL, KISTI. The results of the studies were meta-analyzed and the risk of bias was assessed. Results: Five studies were included in this review. When acupuncture was compared with usual care, Prince-Henry pain scale score was significantly lower in acupuncture group (MD=-0.44, 95% CI: -0.62 to -0.26, P<0.001, $I^2=87%$) and 10 points pain score (including Numeric Rating Scale and Visual Analog Scale) was lower in acupuncture group but not significantly (MD=-1.00, 95% CI: -2.00 to -0.00, p=0.05). When acupuncture was compared with sham acupuncture, 10 points pain score was significantly lower in acupuncture group (MD=-0.39, 95% CI: -0.65 to -0.14, p=0.002, $I^2=0%$). Any serious adverse events were not reported. Conclusion: This review shows that acupuncture may be considered for postoperative pain in patients with solid tumor without serious adverse events. However, only a few studies were included in this study, further investigation is needed in this area.

Meta-Analysis for Effect of Dietary Isoflavones on Breast Density and Hot Flush Suppression (이소플라본의 유방암 항암효능에 대한 메타분석)

  • Kwon, So-Jeen;Song, Bang-Ho
    • Microbiology and Biotechnology Letters
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    • v.39 no.3
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    • pp.224-237
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    • 2011
  • For establishing the efficacy against breast cancer occurrence, women's mammographic breast density and hot flush remission related to pre and post-menopausal symptoms were selected as biomarkers. Meta analysis applied the final selection of 40 papers from Medline to assess the efficacy of isoflavone-rich soy or supplements versus placebo under randomized controlled trials. Interestingly, the exposure to the purified isoflavones was more effective than the exposure to the crude extract of soy isoflavones for hot flush suppression. The length and the amount of dosage dependency is the most appropriately suggested to be one year long with 50~100 mg/day of isoflavone-rich soy or supplements. Funnel plots was used to interpret the results, overall effect of isoflavones on breast density in post-menopausal women was revealed to be less effect [effect size: 0.062, 95% confidence interval (CI): 0.005 to 0.12], than that of pre-menopausal women (effect size: 0.101, CI: -0.003 to 0.205). The reason why breast density was found higher among the pre-menopausal than the post-menopausal women is that the phytoestrogens of dietary isoflavones were antagonized against estrogen by the basis of estrogen receptor binding affinity. Overall, the Meta analysis reported that isoflavone had limited influence on breast density by suppressing the expansion by only 2%, while it was more effective to suppressing the hot flush, showing a dramatic decrease of 23%.

Effect of luteal phase support with vaginal progesterone on pregnancy outcomes in natural frozen embryo transfer cycles: A meta-analysis

  • Seol, Aeran;Shim, Yoo Jin;Kim, Sung Woo;Kim, Seul Ki;Lee, Jung Ryeol;Jee, Byung Chul;Suh, Chang Suk;Kim, Seok Hyun
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.2
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    • pp.147-152
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    • 2020
  • Objective: The purpose of this study was to determine the effect of vaginal progesterone for luteal phase support (LPS) on the clinical pregnancy rate (CPR) in natural frozen embryo transfer (FET) cycles via a meta-analysis. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) and retrospective studies that met our selection criteria. Four online databases (PubMed, Embase, Medline, and the Cochrane Library) were searched between January 2017 and May 2017. Studies were selected according to predefined inclusion criteria and meta-analyzed using R software version 2.14.2. The main outcome measure was CPR. Results: A total of 18 studies were reviewed and assessed for eligibility. One RCT (n = 435) and three retrospective studies (n = 3,033) met the selection criteria. In a meta-analysis of the selected studies, we found no significant difference in the CPR (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.60-1.55) between the vaginal progesterone and control groups. An analysis of the two retrospective cohort studies that reported the live birth rate (LBR) following FET showed a significantly higher LBR in the vaginal progesterone group (OR, 1.72; 95% CI, 1.21-2.46). A subgroup meta-analysis of FET conducted 5 days after injection of human chorionic gonadotropin showed no significant differences between the two groups with regard to the CPR (OR, 1.18; 95% CI, 0.90-1.55) or miscarriage rate (OR, 0.73; 95% CI, 0.36-1.47). Conclusion: The results of this meta-analysis of the currently available literature suggest that LPS with vaginal progesterone in natural FET cycles does not improve the CPR.

Research Trends of Fermented Medicinal Herbs - Based on Their Clinical Efficacy and Safety Assessment (발효한약의 최근 연구 동향 - 안전성과 유효성 기반)

  • Choi, Yun-Kyung;Sul, Jae-Uk;Park, Seoul-Ki;Yu, Sun-Nyoung;Kim, Sang-Hun;Rhee, Moon-Soo;Ahn, Soon-Cheol;Shin, Mi-Sook
    • Journal of Life Science
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    • v.22 no.12
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    • pp.1729-1739
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    • 2012
  • The aim of this study was to evaluate the clinical efficacy and safety of fermented medicinal herbs. A search of the China National Knowledge Infrastructure (CNKI), PubMed databases and Korean Journal of Oriental Medicine in 2000-2011 located 11 randomized controlled trials (RCTs) that investigated the clinical efficacy of fermented medicinal herbs. Domestic RCTs reported clinical efficacy on improvement of immune responses and clinical safety on usage of fermented medicinal herbs in subjects suffering from cerebral hemodynamics. Countries other than Chinareported studies on the cause of esophageal cancer and on local inflammatory reactions. In China, studies were reported on the effectiveness of fermented medicinal herbs on scapulohumeral periarthritis of the stasis type, chronic superficial gastritis, dysuria induced by benign prostatic hyperplasia of deficiency of kidney yang, diabetic nephropathy, essential hypertension, and benign prostate hyperplasia. These results indicate that fermented medicinal herbs have obvious clinical effects in some diseases and no adverse reactions. Therefore, we need to initiate more fermentation research with useful bacteria, fungi, and mushrooms to produce fermented medicinal herbs. Both governments and research authorities should focus on research involving fermentation of medicinal herbs.

Seven-Day Continuous Abstinence Rate from Smoking at 1, 2, or 3 Years after the Use of Varenicline

  • Kim, Jin Se;Jang, Ju Young;Park, Eun Hye;Lee, Joo Young;Gu, Kang Mo;Jung, Jae Woo;Choi, Jae Chol;Shin, Jong Wook;Park, In Won;Choi, Byoung Whui;Kim, Jae Yeol
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.92-98
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    • 2015
  • Background: Varenicline, a selective partial agonist/antagonist of the ${\alpha}4{\beta}2$ nicotinic receptor, has proven effectiveness for smoking cessation by several randomized, controlled trials. Because few studies have evaluated the long-term efficacy of varenicline, we tried to evaluate the smoking status of varenicline users up to 3 years after the initial prescription of the drug. Methods: We interviewed varenicline users who were prescribed the drug from June 2007 to May 2010 by telephone, from June 2010 to May 2011. Results: One-hundred and thirty-three of 250 varenicline users (53.2%) were available for the survey. Seven-day continuous abstinence from smoking was adhered to by 17 of 39 respondents (43.6%) at 1 year, and 11 of 36 (30.6%) and 19 of 58 (32.8%) at 2 and 3 years since the first use of varenicline, respectively. Compared to current smokers, successful quitters were older (55.0 years vs. 49.9 years, p=0.01), had better compliance to the 12-week course (27.7 vs. 9.3%, p=0.01), and had taken varenicline longer (10.1 vs. 5.9 weeks, p=0.01). Fifty-four of 71 current smokers (76.1%) were willing to stop smoking in the near future. The preferred ways to cease smoking were will-power (48.1%), varenicline (25.9%), nicotine replacement therapy (11.1%), and others (14.9%). Conclusion: Smokers should be encouraged to stick to the proven way for recommended period of time for successful cessation of smoking.

Palliative Management of Gastric Cancer with Outlet Obstruction: Stent versus Bypass (위배출구 폐색을 동반한 위암환자의 치료)

  • Kim, Hyung-Ho
    • Journal of Gastric Cancer
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    • v.9 no.1
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    • pp.6-9
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    • 2009
  • Gastric cancer with gastric outlet obstruction has a high incidence of direct invasion into neighboring organs, with a low resection rate and a poor prognosis. Traditionally, open gastrojejunostomy has been the standard palliative treatment in these patients. Recently, endoscopic self-expanding metal stents have been used increasingly for the palliative treatment of malignant gastric outlet obstruction, but the choice of modality to treat the obstruction caused by gastric cancer is still controversial. Many studies have shown that endoscopic stenting is less invasive and offers not only a shorter time to oral intake and length of hospital stay, but also less frequent complications compared to open gastrojejunostomy. However, recurrent obstruction by tumor overgrowth and ingrowth occur more frequently and re-intervention for recurrent obstructive symptoms are more frequently performed after stent placement than after gastrojejunostomy. Thus, stent placement may be associated with more favorable results in patients with a relatively short life expectancy, while gastrojejunostomy is preferable in patients with a more prolonged prognosis. Also, open surgery affords a greater chance for curative surgery. However, most underlying diseases analyzed in previous studies were pancreaticobiliary malignancies, and there have been few prospective studies specific for patients with gastric cancer. Additional randomized controlled trials with larger sample sizes are expected to decide the treatment modality for unresectable gastric cancer with gastric outlet obstruction.

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The Effect of Dachaihu Decoction for Hyperlipidemic Acute Pancreatitis: A Systematic Review and Meta-Analysis (고지혈성 급성 췌장염에 대한 대시호탕의 효과 : 체계적 문헌고찰과 메타분석)

  • Kim, Yoon-jung;Jung, Yu-jin;Park, Dong-il
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.306-325
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    • 2020
  • Objectives: The aim of this study is to investigate the effect of a Dachaihu decoction for hyperlipidemic acute pancreatitis (HLAP) by systematic review and meta-analysis of Chinese clinical studies. Methods: China National Knowledge Infrastructure (CNKI) was utilized as the major search engine. The date of the literature search was March 7, 2020. Randomized controlled trials (RCTs) about using a Dachaihu decoction for HLAP were included in this study. Meta-analysis was performed by synthesizing outcome data, including total effective rate, abdomen pain relief time, first bowel movement time, blood amylase recovery time, and triglyceride (TG) levels (mmol/L). The selected literature was assessed using Cochrane's risk of bias (RoB). Results: Twelve of 44 RCTs met the inclusion criteria. Most studies were evaluated with RoB as having unclear risk. The total effective rate of herbal medicine treatment based on the Dachaihu decoction was significantly higher than that of symptomatic supportive treatment in 10 articles (risk ratio=1.15, 95% CI: 1.08 to 1.21, p<0.00001, I2=0%). Herbal medicine treatment based on a Dachaihu decoction was significantly more effective than symptomatic supportive treatment in terms of reducing abdomen pain relief time (in all articles; mean difference=-1.70, 95% CI: -1.91 to -1.41, p<0.00001, I2=45%), first bowel movement time (in 7 articles; mean difference=-1.46, 95% CI: -1.86 to -1.05, p<0.00001, I2=73%), blood amylase recovery time (in 8 articles; mean difference=-1.48, 95% CI: -2.04 to -0.92, p<0.00001, I2=90%), and TG levels (in 8 articles; mean difference=-1.59, 95% CI: -2.28to -0.91, p<0.00001, I2=90%). Only one article reported side effects of treatment among the intervention group and control group, citing pancreatic ulcer and pancreatic pseudocyst formation. Conclusions: This study suggests that herbal medicine treatment based on a Dachaihu decoction could yield higher efficacy for HLAP than symptomatic supportive treatment alone. However, the results might be somewhat biased because of the poor quality and small sample size of the included RCTs. Well-qualified clinical studies are needed to prove the effectiveness of Dachaihu decoction therapy for HLAP.