• Journal of Oriental Neuropsychiatry
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• v.27 no.4
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• pp.261-274
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• 2016

Objectives: To determine the general characteristics of clinical studies about Hwabyung and assess their limitations and alternatives. Methods: Clinical studies that examined the effects of traditional Korean medicine intervention on Hwabyung were included in this study. A systematic search of English, Chinese, Japanese, and Korean databases was performed. The characteristics of included articles were described and those articles were assessed by Risk of Bias (RoB) tool or Risk of Bias for Nonrandomized Studies (RoBANS) tool. Results: Sixteen articles were selected from 1,826 articles. Most clinical studies about Hwabyung were published in Korea. The number of conducted trials was insufficient. The prevailing study design was randomized controlled trial. Traditional Korean medicine intervention used in the trials were acupuncture, herbal medicine, counselling, meditation, emotional freedom technique (EFT), music therapy, art therapy, and multi intervention program. Herbal medicine study used placebo as control while non-pharmacological intervention study mostly used no treatment as control. Most of the trials were supported by the government. Therefore, financial conflict of interest might not exist for results. We judged that some studies had a high risk of bias. In general, most of the studies with a high risk of bias were non-pharmacological intervention studies, and the risk of bias was mainly due to lack of blinding. Conclusions: More clinical studies of Hwabyung are needed. There are some issues about a suitable comparison and effective blinding strategy for non-pharmacological study. Improving methodological quality is required.

• Journal of Korea Entertainment Industry Association
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• v.15 no.8
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• pp.291-303
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• 2021

The purpose of this study is to identify the effects of laughter therapy on depression and sleep wake disorders among the elderly in residential facilities using a systemic review and meta-analysis. Twelve databases were searched. Two researchers independently performed the selection of the studies, data coding and assessment. The risk of bias was assessed using risk of bias (RoB) and risk of bias assessment tool for non-randomized studies (RoBANs). To estimate the effect size, meta-analysis of the studies was performed using R version 4.04. Out of the 1,122 retrieved articles, one randomized controlled trial (RCT) and eleven non-randomized controlled trials (non-RCTs) were selected for analysis. The overall effect size of eleven studies on depression was determined to be -1.04 (95% Cl: -1.53~-0.54, p<.001). There were statistically significant in the effect of below ten sessions and the effect of below 400 minutes'and 400 to 1000 minutes'interventions on depression. The overall effect size of five studies on sleep wake disorders was 0.83 (95% Cl: -0.26~1.93, p=.136), which was not statistically significant. There was statistically significant in the effect of below 300 minutes'interventions on sleep wake disorders. Laughter therapy was an effective non-pharmacological intervention to reduce depression among the elderly in residential facilities. The findings also suggest that guidelines for laughter therapy need to be developed considering the number of sessions and a duration of intervention to reduce depression and sleep wake disorders of the elderly in residential facilities.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4787-4793
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• 2014

Background: Many cancer patients experience poor pain control due to various factors, including misconceptions regarding the use of opioid analgesics. For management of cancer pain, interventions involving education of both patients and physicians have been attempted. Objectives: This review aimed to assess the current evidence of the benefits of education for the management of cancer pain. Methods: We searched the Medline, EMBASE, Cochrane library, and major Korean databases to identify relevant studies. We included most study designs, but excluded case series. The primary outcomes were pain intensity and quality of life (QoL). Two reviewers assessed the risk of bias using the Cochrane's tool for RCT and Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) for non-randomized studies, independently. Results: After extensive searches, 3,324 publications were screened, and 32 studies were selected. The education interventions used in the included studies included a wide variety of education methods, but the most common method was a booklet produced for patients. Regardless of the education method used, the results of the meta-analysis were as follows. The SMDs of the most severe, average, and current pain in the RCTs were significant. The SMD of worst, average, and current pain were -0.34 (-0.55, -0.13), -0.40 (-0.64, -0.15), and -0.79 (-1.35, -0.23). In the non-randomized studies, the effects on average pain were significant, but those on worst and current pain were not. Conclusions: Education intervention reduced the pain of cancer patients. Therefore, patient education could be considered to be an effective method of cancer pain management. However, our data should be interpreted with caution, and studies using standardized protocols are needed to confirm these observations.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.87-97
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• 2021

Purpose : The purpose of this meta-analysis was to evaluate the effects of transcranial direct current stimulation on the lower extremity function of stroke patients. Methods : Domestic data were gathered from studies that conducted clinical trials associated with transcranial direct current stimulation and its impact on lower extremity function of stroke patients. A total of 592 studies published between 2012 and 2020 were identified, with 7 studies satisfying the inclusion data. The studies consisted of patient, intervention, comparison, and outcome (PICO) data. The search outcomes were items associated with muscle activity, balance, muscle strength and walking ability. Cochrane risk of bias (ROB) was used to evaluate the quality of 3 randomized control trials. The quality of 4 non-randomized control trials was evaluated using risk of bias assessment tool for non-randomized studies (RoBANS). Effect sizes in this study were computed as the corrected standard mean difference (SMD). A random-effect model was used to analyze the effect size because of the high heterogeneity among the studies. Egger's regression and 'trim-and-fill' tests were carried out to analyze the publishing bias. Results : The following factors had a large total effect size (Hedges's g=2.10, 95 %CI=1.54~2.66) involving transcranial direct current stimulation on stroke patients: muscle activity (Hedges's g=2.38, 95 %CI=1.08~3.68), balance (Hedges's g4=2.41, 95 %CI=1.33~3.60), walking ability (Hedges's g=1.54, 95 %CI=0.49~2.59), and muscle strength (Hedges's g=2.45, 95 % CI: 0.85~4.05). Egger's regression test showed that the publishing bias had statistically significant differences but 'trim-and-fill' test showed that there was still statistical difference. Conclusion : This study provides evidence for the effectiveness of transcranial direct current stimulation on the lower extremity in terms of muscle activity, balance, walking ability, and muscle strength in stroke patients. However, due to the low quality of studies and high heterogeneity factors, the results of our study should be interpreted cautiously.