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The effects of virtual reality training on gait, balance, and upper extremity function in patients with stroke: A meta-analysis

  • Lee, Hyun soo;Kim, You Lim;Lee, Hae ji;Lee, Byounghee
    • Journal of Korean Physical Therapy Science
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    • v.28 no.3
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    • pp.11-29
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    • 2021
  • Background: The purpose of this study is to investigate the effects of virtual reality on gait, balance, and upper extremity functions compared to other independent variables or no variables. Additionally, the possibility of virtual reality for stroke patients was discussed. Design: Meta-analysis. Methods: The search for this study was a search term that combined stroke, virtual reality, and training, and the electronic search was conducted through EMBASE, MEDLINE, and Cochrane Library. As a result of the search, 21 studies satisfying the selection criteria of the target study were confirmed as the final analysis target. This study consisted of 21 randomized experimental studies and 21 randomized controlled trials, and the total number of participants was 642. [Experimental group (n=314), control group (n=328); total 642]. As a result of the study, upper extremity function was assessed using a box and block test, a modified Ashworth scale, and a scale including range of motion. The balance was evaluated by the berg balance scale. Gait was a Timed Up and Go test (TUG), stride length, and gait function. Scales including a walking rate scale were evaluated. The effect size for the intervention of the analytical study was meta-analyzed with the RevMan 5.3.3 program of the Cochrane library. Results: The results of the study showed that the function of walking was statistically significant. Balance showed statistically significant results. The upper extremity function showed no statistically significant results. Conclusion: Through this rehabilitation treatment by applying virtual reality environment to the rehabilitation of stroke patients in the future can be proposed as an effective intervention method for the balance and gait function of stroke patients.

Effects of Herbal Medicines on Osteoporosis in Rheumatoid Arthritis: Study Protocol for a Systematic Review and Meta-Analysis (한약이 류마티스 관절염 환자의 골다공증에 미치는 영향: 체계적 문헌 고찰 및 메타분석을 위한 프로토콜)

  • Kwon, Do Young;Gu, Ji Hyang;Lee, Eun Jung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.77-84
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    • 2022
  • Objectives This study is designed to identify the effectiveness of herbal medicine for osteoporosis in rheumatoid arthritis. Methods We will investigate 10 databases, 4 Korean databases (KoreaMed, KMBASE, Koreanstudies Information Service System [KISS], ScienceOn) and 6 of abroad (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure [CNKI], WanFang, Citation Information by NII [CiNii]) without publication date, language limitation for clinical study of herbal medicine for osteoporosis in rheumatoid arthritis. Type, dose, duration, frequency of herb medicine will be analyzed. Results Randomized controlled trials about herbal medicine or herb extract for osteoporosis in rheumatoid arthritis should be included in the study. Cochrane's risk of bias tools will be used to assess quality of the study. Mean differences or standardized mean differences of 95% confidence intervals will calculated and data synthesis will be conducted using Review Manager (RevMan, ver.5.3; The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Conclusions It is expected to provide basic data for the active use of herb medicine by systematically synthesizing and analyzing the actual situation, effectiveness, and safety of herb medicine for osteoporosis in rheumatoid arthritis.

Effect of Electroacupuncture on Impairment of Motor and Sensory Functions after Spinal Cord Injury: A Systematic Review and Meta-analysis (척수손상으로 인한 운동 및 감각 기능 손상에 대한 전침의 효과: 체계적 문헌 고찰 및 메타 분석)

  • Jung, Su-Eun;Kim, Gyu-Hui;Park, Jung-Hyeon;Lee, Young-Hun;Park, Sang-Eun;Cho, Sung-Woo
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.2
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    • pp.37-54
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    • 2022
  • Objectives This review investigates the effectiveness of electroacupuncture for impairment of motor and sensory functions after spinal cord injury. Methods The databases used for the search were PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), National Digital Science Library (NDSL), Koreanstudies Information Service System (KISS), Research Information Sharing Service (RISS), KMBASE, and Oriental Medicine Advanced Searching Integrated System (OASIS). The literature were searched using a total of 9 domestic and foreign databases. Randomized controlled trials (RCTs) using electroacupuncture as an intervention was selected. The selected studies are analyzed the risk of bias through Cochrane risk-of-bias tool, and meta-analysis was perfomed using RevMan version 5.3 (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Results A total of 14 RCT studies were selected through 9 domestic and foreign databases, and analyzed. As a result of meta-analysis, when electroacupuncture was performed together with rehabilitation treatment or western drug treatment, it was effective in the recovery of motor and sensory functions of spinal cord injury patients. Conclusions This review suggests that electroacupuncture can be applied as an effective treatment for the recovery of motor and sensory functions of spinal cord injuries. However, there are several limitations, including the small number and heterogeneity of the included studies, as well as their poor methodological quality. Therefore, further, higher-quality studies should be required.

Effects of pain neuroscience education on kinesiophobia in patients with chronic pain: a systematic review and meta-analysis

  • Kim, Hyunjoong;Lee, Seungwon
    • Physical Therapy Rehabilitation Science
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    • v.9 no.4
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    • pp.309-317
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    • 2020
  • Objective: One of the treatment strategies for controlling chronic pain and preventing disability is patient education. Pain neuroscience education (PNE) has been proven to be effective in explaining the biological and physiological processes associated with pain experiences to patients. The purpose of this review is to investigate the effectiveness of PNE for kinesiophobia such as avoidance response in patients with chronic pain. Design: A systematic review and meta-analysis. Methods: MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of controlled trials databases were searched through November 2020 and included a randomized controlled trials evaluating kinesiophobia in musculoskeletal patients with chronic pain. In 8 randomized controlled trial studies, 'Cochrane's risk of bias (RoB) tool was used for qualitative analysis, and results of post-intervention were analyzed through RevMan 5.4 for quantitative analysis. Results: For this review, 8 randomized controlled trials of 369 patients with chronic pain were selected for PNE. A systematic review and meta-analysis also included 8 randomized controlled trials. The effect on kinesiophobia was more effective than the control group (-0.86; 95% confidence interval [CI], -1.22 to -0.51; heterogeneity [χ2=21.18, df=7, I2=67%]; overall effect [Z=4.80]). In addition, the effect on pain was more effective than the control group (-0.53; 95% CI, -1.05 to -0.01; heterogeneity [χ2=47.42, df=7, I2=85%]; overall effect [Z=2.01]). Conclusions: The results of this review suggest that PNE and combined PNE have a positive effect on the improvement of pain and kinesiophobia in patients with chronic pain.

Analysis of Clinical Research Trends for Thread Embedding Acupuncture of Cervical Radiculopathy

  • Eun Sil, Heo;Hyun-Jong, Lee;Jung Hee, Lee;Sang Ha, Woo;Yun Kyu, Lee;Seong Hun, Choi;Jae Soo, Kim
    • Journal of Acupuncture Research
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    • v.39 no.4
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    • pp.283-296
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    • 2022
  • In this study, the evidence of thread embedding acupuncture (TEA) in treating cervical radiculopathy in randomized controlled trials was investigated. We searched 16 databases up to August 22, 2022. Of the 2,644 studies retrieved, 22 randomized controlled trials (2,483 participants) were selected. Quality assessments were performed using Cochrane's risk-of-bias tool and RevMan 5.4 software. Outcome measures in the included studies typically showed TEA had a significant therapeutic effect compared with simple acupuncture and other remedies, and TEA was better than sham TEA. Catgut and polydioxanone had no difference in effectiveness, however, catgut was considered to be less safe. TEA was shown to be more therapeutic when inserted deeper into the skin. Ultrasound guided TEA was more effective and safer than conventional TEA, and using a flat blade needle was better than conventional needles for TEA. No serious adverse events were reported from using TEA, and only a few mild side effects were observed. However, the limited number and heterogeneity of the included studies, together with the unclear methodological quality, indicate that higher-quality studies need to be conducted to determine the effectiveness and safety of TEA for cervical radiculopathy.

Effects of Banhahubak-tang on Gastroesophageal Reflux Disease : A Systematic Review and Meta-Analysis (위식도역류질환에 대한 반하후박탕의 효과 : 체계적 문헌고찰과 메타분석)

  • Kang, Sieun;Kim, Kyoungmin;Jin, Myungho
    • Journal of Society of Preventive Korean Medicine
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    • v.26 no.2
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    • pp.11-24
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    • 2022
  • Objectives : This study was designed to investigate the effect of Banhahubak-tang on gastroesophageal reflux disease(GERD) through a systematic review and meta-analysis of randomized controlled trials(RCTs). Methods : RCTs using Banhahubak-tang on GERD was searched in databases such as EMBASE, PubMed, MEDLINE, CENTRAL, CNKI, KISS, RISS, ScienceON, and OASIS. RCTs published up to October 8th, 2021 were included. Meta-analysis was performed by synthesizing outcome data, including Total Effectiveness Rate (TER), Reflux Symptom Index(RSI), Reflux Finding Score(RFS), and Incidence of Adverse Reactions. RevMan 5.4 software was used for data analysis. The Cochrane collaboration bias risk assessment scale was used to evaluate the methodological quality of the included studies. Results : Ten RCTs met the inclusion criteria. The total effective rate was the most commonly used outcome measure. The meta-analysis revealed that the TER in the experimental group was higher than that of the control group(N=2, RR:1.22, 95% CI:1.09 to 1.36, P=0.0004, I2=0%)(N=6, RR:1.22, 95% CI:1.14 to 1.32, P<0.00001, I2=0%)(N=8, RR:1.22, 95% CI: 1.14 to 1.30, P<0.00001, I2=0%). On the other hand, RSI(N=2, MD : -4.29, 95% CI: -4.71 to -3.86, I2=94%), RFS(N=2, MD : -3.28, 95% CI: -3.71 to -2.85, I2=96%), and Incidence of Adverse Reactions(N=5, RR: 0.32, 95% CI: 0.17 to 0.61, I2=0%) in the experimental group were lower than that of the control group. Conclusion : Treatment with Banhahubak-tang was found to be effective on GERD. However the results might be biased because of the poor quality and small sample size of the included RCTs.

Effect and stability of miniscrew-assisted rapid palatal expansion: A systematic review and meta-analysis

  • Huang, Xinyi;Han, Yu;Yang, Shuangyan
    • The korean journal of orthodontics
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    • v.52 no.5
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    • pp.334-344
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    • 2022
  • Objective: This study aimed to systematically analyze the effect and stability of miniscrew-assisted rapid palatal expansion (MARPE) to provide a reference for the clinical treatment of patients with maxillary transverse deficiency (MTD). Methods: We searched PubMed, Science Direct, Web of Science, Embase, Cochrane Library, CNKI, and Wanfang Database for relevant studies published before February 18, 2021 and selected them according to the eligibility criteria. The Cochrane Handbook for Systematic Reviews (version 5.1.0) criteria were used for the quality assessment of randomized controlled trials, while the scoring protocol of the methodological index for non-randomized studies was used for non-randomized controlled trials. Statistical analysis was performed using the RevMan5.3 software. Results: All the included studies showed a relatively high success rate of expansion. The changes in both the intermolar and alveolar widths after MARPE were statistically significant. MARPE exhibited greater skeletal expansion effects than did conventional RPE. The midpalatal suture was opened in parallel after MARPE. A small amount of relapse was observed 1 year after expansion. MARPE caused tooth inclination and a decrease in alveolar height, but it was less significant than in conventional RPE. Conclusions: MARPE may be an effective treatment modality for patients with MTD. It causes great transverse skeletal expansion in late adolescence. In comparison to conventional RPE, MARPE has lower detrimental periodontal effects and has certain clinical advantages.

The Effects of Non-pharmacological Interventions on Sleep among Older Adults in Korean Long-term Care Facilities: A Systematic Review and Meta-analysis

  • Jung, Sun Ok;Kim, Hyeyoung;Choi, Eunju
    • Research in Community and Public Health Nursing
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    • v.33 no.3
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    • pp.340-355
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    • 2022
  • Purpose: This study aimed to examine the effects of non-pharmacological sleep intervention programs in improving sleep quality among older adults in long-term care facilities. Methods: A literature search and selection was performed on nine different databases using the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Overall, 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, the effect size was estimated using the random-effects model in Review Manager (RevMan) desktop version 5.4 of the Cochrane Library. Results: The meta-analysis of overall non-pharmacological interventions obtained a total effect size of 1.0 (standardized mean difference [SMD]=1.0, 95% confidence interval [CI]: 0.64~1.35), which was statistically significant (Z=5.55, p<.001). The most frequently studied non-pharmacological intervention was aroma therapy, with an effect size of 0.61 (SMD=0.61, 95% CI: 0.14~1.08), which was statistically significant (Z=2.55, p=.010). In the subgroup analysis, group-based interventions, interventions for >4 weeks, and untreated control studies were more effective. Conclusion: This study confirms that non-pharmacological interventions are effective in improving sleep quality among older adults in long-term care facilities. However, the sample size was small and the risk of bias in assessing the interventions of individual studies was unclear or high, thereby limiting the generalizability of the results. Further reviews that evaluate randomized control trials, evidence-based interventions that consider older adult participants' physical activity levels, different intervention methods and durations, and different control group intervention types are needed to obtain more conclusive evidence.

The Effect of Combination Therapy of Yukmijihwang-tang and Western Medicine on Primary Glomerulonephritis: Systemic Review and Meta-analysis (일차성 사구체신염의 육미지황탕과 양약 병용요법에 대한 체계적 문헌고찰 및 메타분석)

  • Tae-young Huh;Ye-seul Kim;Kyoung-min Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.1
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    • pp.12-34
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    • 2023
  • Objective: This study was conducted to evaluate the effectiveness of the combination therapy of Yukmijihwang-tang and Western medicine on primary glomerulonephritis. Methods: We conducted a search using keywords, such as Yukmijihwang-tang and Liuwei Dihuang, in eight databases (CNKI, CiNii, Pubmed, Embase, Cochrane, Science On, OASIS, RISS). There was no limit to the publication period of the papers. A meta-analysis was conducted and classified according to the outcome measurements, such as the total effective rate (TER), serum creatinine (SCr), and blood urea nitrogen (BUN). Data analysis was performed using the RevMan 5.4.1 software, and Cochrane's risk of bias (ROB) was used to assess the quality of the papers. Results: A total of 12 randomized control trials were selected. The meta-analysis showed that the treatment group combining Yumijihwang-tang and Western medicine was more efficient than the control group using Western medicine alone (RR: 1.29, CI: 1.20 to 1.39 p=<0.00001). The treatment group also reduced the BUN (MD: -2.40, CI: -2.90 to -1.89, p<0.00001) and Scr (MD: -33.34, CI: -40.85 to -25.82, P<0.00001) more than the control group. Conclusion: This study suggests that the combination therapy of Yukmijihwang-tang with Western medicine is effective in treating primary glomerulonephritis. However, these findings should be interpreted cautiously due to the unknown or high risk of bias in the included trials.

Effectiveness of the Shugan Jieyu Capsule against Psychiatric Symptoms in Epilepsy: a protocol for systematic review and meta-analysis

  • Sejin Kim;Yunna Kim;Seung-Hun Cho
    • Journal of Pharmacopuncture
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    • v.26 no.1
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    • pp.38-43
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    • 2023
  • Objectives: Psychiatric symptoms in epilepsy are very common, and the most common symptoms are depression, insomnia, and anxiety. These symptoms not only lower the quality of life of epilepsy patients, but also elevate the risk of epileptic seizures. There are no specific criteria for the available antiepileptic drugs to ameliorate these symptoms in patients with epilepsy, and there is a lack of evidence to support the efficacy and safety of existing drugs. The Shugan Jieyu capsule (SJC) is a traditional herbal medicine composed of Acanthopanax senticosus and Hypericum perforatum and is reported to be effective in relieving psychiatric symptoms. The purpose of this study was to assess the efficacy of SJC as a treatment for psychiatric symptoms in epilepsy patients. Methods: Electronic databases will be investigated for publications in English, Korean, Japanese, and Chinese. The participants of the study are epilepsy patients with psychiatric symptoms diagnosed using any validated criteria. All types of controls will be compared-placebo, conventional treatments, and no treatment-to groups treated with SJC or modified SJC. We will measure the degree of improvement in psychiatric symptoms and check epileptic symptoms, such as the frequency of seizures. The study selection and data extraction will be performed by two independent reviewers, who will also assess methodological quality using the risk-of-bias tool by Cochrane. We will use Review Manager software (RevMan) to carry out all statistical analyses. Results: This systematic review and meta-analysis will be performed in accordance with the PRISMA-P statement. Conclusion: This systematic review is the first study to assess the efficacy and safety of SJC for the treatment of psychiatric symptoms in epilepsy. We expect that this study will provide clinically applicable evidence for patients with epilepsy when selecting drug treatments.