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뇌졸중에 대한 도인 운동요법의 효과: 체계적 문헌 고찰 (Daoyin Exercise Therapy for Stroke : A Systematic Review)

  • 이상현;신병철;황의형;허인;박선영;황만석
    • 척추신경추나의학회지
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    • 제14권2호
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    • pp.29-42
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    • 2019
  • Objectives : This study aimed to review the effects of Daoyin exercise on stroke patients in clinical studies. Methods : In this study, we reviewed 11 electronic databases (CAJ, EMBASE, Cochrane Library, Web of Science, Pubmed, RISS, Dbpia, NDSL, KISTI, KISS, KMBASE) on October 27, 2019. We included only randomized controlled trials (RCTs) which evaluated the effect of Daoyin exercise on stroke patients. The methodological quality of the included studies was checked using the Cochrane risk of bias tool. Results : After screening the papers, eleven RCTs fulfilled the inclusion criteria. The results of the meta-analysis showed that Daoyin exercise improves the measurement value on the Fugl-Meyer Assessment, Modified Barthel Index and National Institutes of Health Stroke Scale in stroke patients. Conclusions : We concluded that Daoyin exercise has therapeutic effects in functional recovery and in enhancing the independence of daily living activities for stroke patients. However, the quality of the original articles was low and the number of papers included were few. Thus, to confirm these results, further well-designed RCTs should be conducted.

유착성 관절낭염에 대한 추나요법의 효과: 체계적 문헌고찰과 메타분석 (Chuna Manual Therapy for Adhesive Capsulitis : A Systematic Review and Meta Analysis)

  • 조주찬;허인;박선영;신병철
    • 척추신경추나의학회지
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    • 제14권2호
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    • pp.1-14
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    • 2019
  • Objectives : To evaluate the effectiveness of Chuna Manual Therapy for adhesive capsulitis by a systematic review manner. Methods : Five foreign electronic databases (Pubmed, Ovid-medline, Embase, Cochrane library, Chinese Academic Journals (CAJ)) and two Korean medical electronic databases (Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS)) were searched to find all randomized controlled trials (RCTs) using Chuna Manual Therapy as a treatment for adhesive capsulitis. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : Twenty-one RCTs met our inclusion criteria. The meta-analysis showed positive results on the use of Chuna Manual Therapy combined with acupuncture or exercise therapy in terms of the efficacy rate and pain using the Visual Analogue Scale (VAS), compared to acupuncture or exercise alone [SMD-1.81 (95% CI & -2.54, -1.08), P<0.001, RR 1.19 (95% CI 1.14, 1.23), P<0.001)]. Positive results in terms of efficacy rate were also obtained comparing Chuna Manual Therapy to acupuncture alone [RR 1.10 (95% CI 1.02, 1.18), P=0.01]. Conclusions : Our systematic review found favorable results on the effectiveness of Chuna Manual Therapy for pain and efficacy rate of adhesive capsulitis. However, evidence was limited due to the lack of well-designed RCTs. More qualified clinical trials are needed to obtain stronger evidence.

뇌졸중의 추나요법에 대한 체계적 문헌 고찰 (Chuna Manual Therapy for Stroke: A Systematic Review and Meta-analysis)

  • 김미경;한창호
    • 척추신경추나의학회지
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    • 제14권2호
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    • pp.15-28
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    • 2019
  • Objectives : This study aimed to systematically and comprehensively review controlled clinical trials on the effectiveness and safety of Chuna Manual Therapy for stroke. Methods : By October 7, 2019, three core databases and three domestic databases were searched. Seven major academic journals on the related field were also hand-searched. Methodological quality of the included studies was evaluated using the Cochrane risk of bias tool. Meta-analysis was conducted and the quality of its evidence was assessed using the GRADE methodology. Results : Five articles met the eligibility criteria. The results of most of included studies were in favor of Chuna Manual Therapy. No study described any adverse events during or after the clinical trials. Meta-analysis of three eligible studies showed that the pre- and post-treatment scores on the Modified Barthel Index (mean difference 8.00, 95% confidence interval 0.26 to 15.74) and Berg Balance Scale (mean difference 3.57, 95% confidence interval 0.64 to 6.51) of the Chuna-treated group were significantly different, but only marginally higher than those of the non-treatment group. Thus, the level of evidence gathered from these studies was assessed to be low. Conclusions : Based on current available evidence, any confirmative conclusions cannot be made on the effectiveness and safety of Chuna Manual Therapy for stroke because of the small sample size, low methodological quality, presence of statistical heterogeneity, and missing safety information. More rigorously designed large-scale multi-center studies are needed to establish more specific and credible evidence to support or oppose the use of Chuna Manual Therapy for stroke.

Comparison of Fusion Rate between Demineralized Bone Matrix versus Autograft in Lumbar Fusion : Meta-Analysis

  • Han, Sanghyun;Park, Bumsoo;Lim, Jeong-Wook;Youm, Jin-Young;Choi, Seoung-Won;Kim, Dae Hwan;Ahn, Dong Ki
    • Journal of Korean Neurosurgical Society
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    • 제63권6호
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    • pp.673-680
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    • 2020
  • The demineralized bone matrix (DBM) as the bone graft material to increase the fusion rate was widely used in spinal fusion. The current study aimed to compare the fusion rate of DBM to the fusion rate of autograft in lumbar spine fusion via meta-analysis of published literature. After systematic search, comparative studies were selected according to eligibility criteria. Checklist (risk of bias assessment tool for non-randomized study) was used to evaluate the risk of bias of the included nonrandomized controlled studies. The corresponding 95% confidence interval (95% CI) were calculated. We also used subgroup analysis to analyze the fusion rate of posterolateral lumbar fusion and lumbar interbody fusion. Eight studies were finally included in this meta-analysis. These eight studies included 581 patients. Among them, 337 patients underwent spinal fusion surgery using DBM (DBM group) and 204 patients underwent spinal fusion surgery with mainly autologous bone and without using DBM (control group). There was no significant differences of fusion rate between the two groups in posterolateral fusion analysis (risk ratio [RR], 1.03; 95% CI, 0.90-1.17; p=0.66) and interbody fusion analysis (RR, 1.13; 95% CI, 0.91-1.39; p=0.27). Based on the available evidence, the use of DBM with autograft in posterolateral lumbar spine fusion and lumbar interbody fusion showed a slightly higher fusion rate than that of autograft alone; however, there was no statistically different between two groups.

턱관절장애에 대한 수기요법의 체계적 문헌 고찰과 메타분석 (A Systematic Review and Meta-analysis of Manual Therapy for Temporomandibular Disorder)

  • 김홍국;유덕우;정성목;김성진;백승원;이창희;윤진영
    • 척추신경추나의학회지
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    • 제12권1호
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    • pp.13-27
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    • 2017
  • Objectives: To evaluate and summarize the efficacy and safety of manual therapy in temporomandibular disorder(TMD). Methods: Ten databases (Pubmed, Cochrane, EMBASE, AMED, CINAHL, CNKI, and four Korean databases) were searched up to March 2017. Pain and range of motion(ROM) of temporomandibular joint were used as the primary outcome measure, and effective rates, dysfunction scale and adverse events were used as secondary outcome measures. The Cochrane risk of bias tool was used to evaluate the methodological quality. Results: 10 randomized controlled trials(RCTs) involving 603 participants were included. There were no significant differences between the two groups in comparison with placebo manual therapy group. In comparison with Wait-list and conventional treatment groups, manual therapy significantly alleviated pain and ROM. Five RCTs(50.0%) reported adverse events and there were no adverse cases by manual therapy. Conclusions: We found evidence that manual therapy may alleviate symptoms of patients with TMD. A positive effect was observed in comparison with conventional treatment and Wait-list, but no conclusion for the comparisons with placebo manual therapy. There is no evidence of worsening symptoms or causing adverse events.

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신바로약침과 침치료를 이용한 족저근막염 환자 4례에 대한 임상증례보고 (The Clinical Study of the ShinBaro Pharmacopuncture and acupuncture treatment on Plantar Fasciitis)

  • 최철우;허석원;윤용일;민부기;김민균;윤제필;최진령;오민석
    • 척추신경추나의학회지
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    • 제8권2호
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    • pp.151-157
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    • 2013
  • Objects : This study is a report on treatment effect of the case that treated by using of Shinbaro pharmacopunture and acupuncture to plantar fasciitis patients. Methods : The four patients diagnosed with Plantar fasciitis were treated by using of Shinbaro pharmacopunture and acupuncture, Algometer Pressure and Numeric rating scale(NRS) were used as the evaluation tool of treatment effect. Results : Shinbaro pharmacopunture and acupuncture showed improvement of symptoms for all patient groups and brought about significant change on numerical value of Algometer Pressure and Numeric rating scale(NRS). Conclusions : The result shows that Shinbaro pharmacopunture and acupuncture can be effective treatment to Plantar fasciitis. Merely later, further study is needed.

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성인 변비에 대한 추나요법의 효과 : 체계적 문헌 고찰 (Chuna Manual Therapy for Adult Constipation : A Systematic Review)

  • 김병준;황의형;허인;임경태;조주찬;신병철
    • 척추신경추나의학회지
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    • 제11권2호
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    • pp.23-33
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    • 2016
  • Objectives : This study aimed to determine the evidence of effectiveness and safety of Chuna manual therapy for adult constipation patients. Methods : We searched 10 electronic databases(Ovid-MEDLINE, Pubmed, EMBASE, Cochrane Library, CAJ, Oasis, KISS, NDSL, KMBASE, KISTI) and related 2 journals up to October 2016. We included randomized controlled trials(RCTs) of testing Chuna manual therapy for adults constipation patients. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool. Results : Nine RCTs were eligible in our inclusion criteria. The meta-analysis of 6 studies showed positive results for the use of Chuna manual therapy for constipation. Conclusions : There is favorable evidence of Chuna manual therapy for treating adult constipation with meta-analysis. However, our systematic review has limited evidence to support Chuna manual therapy for constipation because of low quality of original articles and further well-designed RCTs should be encouraged.

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Comparison of Root Images between Post-Myelographic Computed Tomography and Magnetic Resonance Imaging in Patients with Lumbar Radiculopathy

  • Park, Chun-Kun;Lee, Hong-Jae;Ryu, Kyeong-Sik
    • Journal of Korean Neurosurgical Society
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    • 제60권5호
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    • pp.540-549
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    • 2017
  • Objective : To evaluate the diagnostic value of computed tomography-myelography (CTM) compared to that of magnetic resonance imaging (MRI) in patients with lumbar radiculopathy. Methods : The study included 91 patients presenting with radicular leg pain caused by herniated nucleus pulposus or lateral recess stenosis in the lumbar spine. The degree of nerve root compression on MRI and CTM was classified into four grades. The results of each imaging modality as assessed by two different observers were compared. Visual analog scale score for pain and electromyography result were the clinical parameters used to evaluate the relationships between clinical features and nerve root compression grades on both MRI and CTM. These relationships were quantified by calculating the receiver-operating characteristic curves, and the degree of relationship was compared between MRI and CTM. Results : McNemar's test revealed that the two diagnostic modalities did not show diagnostic concurrence (p<0.0001). Electromyography results did not correlate with grades on either MRI or CTM. The visual analog pain scale score results were correlated better with changes of the grades on CTM than those on MRI (p=0.0007). Conclusion : The present study demonstrates that CTM could better define the pathology of degenerative lumbar spine diseases with radiculopathy than MRI. CTM can be considered as a useful confirmative diagnostic tool when the exact cause of radicular pain in a patient with lumbar radiculopathy cannot be identified by using MRI. However, the invasiveness and potential complications of CTM are still considered to be pending questions to settle.

소아 알레르기 비염에 대한 추나요법의 효과 : 체계적 문헌 고찰과 메타분석 (Chuna Manual Therapy for Pediatric Allergic Rhinitis : A Systematic Review and meta-analysis)

  • 박선영;박인화;이상현;황만석;황의형;신병철
    • 척추신경추나의학회지
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    • 제14권1호
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    • pp.25-37
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    • 2019
  • Objectives : This review determines the evidence of effectiveness and safety of Chuna manual therapy (CMT) for pediatric allergic rhinitis. Methods : We searched 12 electronic databases (Pubmed, EMBASE, Cochrane Library, Web of Science, CAJ, J-STAGE, RISS, DBpia, NDSL, KISTI, KISS, and KMBASE) and two related journals up to the end of April, 2019. We only included randomized controlled trials (RCTs) investigating CMT for the treatment of pediatric allergic rhinitis. The methodological quality of the included RCTs was evaluated using the Cochrane risk of bias tool 1.0. Results : Twelve RCTs were eligible in our inclusion criteria. A meta-analysis of five studies demonstrated positive results for the using CMT for the treatment of pediatric allergic rhinitis. When used in conjunction with traditional Chinese medicine, CMT treatment significantly improved total efficacy rate compared with traditional Chinese medicine alone (P<0.02, n=5). Conclusions : Based on a published meta-analysis, there is reliable evidence for the use of CMT in treating pediatric allergic rhinitis. However, it should be noted that the studies included in this systematic review were heterogeneous and were of low quality, warranting further investigation using well-designed RCTs.

소아 말초성 안면마비에 대한 추나요법의 효과 : 체계적 문헌고찰 (Effect of Chuna Manual Therapy for Peripheral Facial Paralysis in Children : A Systematic Review)

  • 김의별;강기완;김민우;고연석
    • 척추신경추나의학회지
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    • 제14권1호
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    • pp.1-11
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    • 2019
  • Objectives : The purpose of this study is to review clinical studies about the effect of chuna manual therapy (CMT) for peripheral facial paralysis in children. Methods : In this review, we searched 11 electronic databases (Pubmed, Cochrane Library, EMBASE, CINAHL, CAJ, Oasis, NDSL, KISS, RISS, KISTI, Dbpia); We concluded our literature search in April 23, 2019. We included only randomized controlled trials (RCTs) of testing CMT for peripheral facial paralysis in children. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. The meta-analysis was performed by synthesizing outcome data of total efficacy rate (TER). Results : After screening papers, a total of 6 RCTs were selected and analyzed. In the 6 RCTs, patients(n=15-60 per study) were randomized into groups for treatment and control. Specifically, the treatment group received CMT, while the control group was concurrently given usual care, such as acupuncture and medicine. The meta-analysis showed that the treatment group receiving CMT alone showed significant improvement in TER, compared to the control group receiving acupuncture therapy alone(P<0.05). And the treatment group receiving CMT combined with usual care showed positive results, in terms of TER, compared to the control group receiving usual care, but was not statistically significant(P>0.05). Conclusions : Our analysis suggests that CMT has therapeutic effects for peripheral facial paralysis in children. However, to confirm this result, further investigation accompanied by high quality studies is required.