• Title/Summary/Keyword: randomized controlled trials (RCTs)

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The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials

  • Kim, Mikyung;Han, Chang-ho
    • The Journal of Korean Medicine
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    • v.42 no.4
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    • pp.75-101
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    • 2021
  • Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

Review of Clinical Studies of Oral Herbal Medicine Treatment for Pediatric Chickenpox using CNKI Database - Focused on Chinese Randomized Controlled Trials after 2000s - (CNKI로 검색한 소아 수두의 한약 내복 치료에 대한 임상연구 동향 - 2000년대 이후 RCT 연구를 중심으로-)

  • Choi, Jung Yoon;Kim, Jang Hyun;Min, Sang Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.34 no.3
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    • pp.18-36
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    • 2020
  • Objectives The purpose of this study is to analyze Chinese randomized controlled trials (RCTs), and to evaluate the effectiveness and safety of the oral herbal medicine treatment for pediatric chickenpox. Methods We searched RCTs after 2000s from the China National Knowledge Infrastructure (CNKI). Afterwards, the year of publication, demographic information, duration of chickenpox, intervention, treatment duration, outcome measure, results and adverse events were investigated and analyzed for this study. Results 21 RCTs out of 219 studies were collected and analyzed. Although each composition of the herbal medicine was different, they have common ingredients such as 清熱解毒, 散結消腫, 疏散風熱, 涼血解毒, 解表散風 in order to make efficacy of 清熱解毒, 散結消腫, 疏散風熱, 涼血解毒, 解表散風. The oral herbal medicine showed better efficacy and safety to improve clinical symptoms such as total efficacy, cure rate, antipyretic time, antipruritic time, scab time, anti-rash time, hospitalization period and herpes recovery time compared to the western medicine treatment. Conclusions These results show that the oral herbal medicine treatment on chickenpox in children may be more effective in reducing of clinical symptoms compared to the western medicine treatment.

A Review of Randomized Controlled Trials of Pes Anserinus Tendinitis/Bursitis Syndrome in the China National Knowledge Infrastructure Database

  • Choi, Hyo Jung;Back, Hye Kyung;Kim, Young-Jun;Oh, Da Yoon;Park, Cheol Woo;Namgoong, Jin
    • Journal of Acupuncture Research
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    • v.38 no.4
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    • pp.284-292
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    • 2021
  • The purpose of this study was to review randomized controlled trials (RCTs) of pes anserinus tendinitis or bursitis (PATB) syndrome in the China National Knowledge Infrastructure database to investigate the efficacy of traditional Chinese medicine treatment for PATB syndrome. There were 20 RCTs published from 2001 to 2021 which were selected for analysis by publication year, number of samples, evaluation criteria, treatment duration, and treatment method. Out of the 142 retrieved RCTs, 20 were relevant to this review, and had performed Chinese medicine treatments including acupuncture (the most common treatment typically using acupoints SP10, ST35, SP9, and LR8), manipulation (typically using acupoints ST35, SP10, and SP9), and external application therapy (typically herbal medicine) in the treatment of PATB syndrome. Chinese medicine treatments were used widely in the treatment of PATB syndrome. We hope in the future, this review may initiate the development of treatments for PATB syndrome using Korean medicine.

Relationship between Postural Balance Training and Fall Risks for Elderly: a Systematic Review of Randomized Controlled Trials

  • Kim, Heesuk;Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • v.10 no.2
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    • pp.185-196
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    • 2021
  • Objective: Falling is one of main accident to facilitate the physical injuries in order adults. The purpose of the systematic review was to determine the effects of postural balance training whether the recovery of falls in elderly with normal physical function or not throughout summing the selected studies quantitatively. Design: A systematic review Methods: MEDLINE and other four databases were searched up to April 20, 2021 and randomized controlled trials (RCTs) evaluating postural balance approaches on fall risks in elderly. The researched studies excluded the double studies, titles and abstract, and finally full-reported study. The selected RCTs studies were extracted characteristics of the studies and summary of results based on PICOS-SD (population, intervention, comparison, outcomes, and setting- study design) model to synthesize the papers qualitatively. Results: The review involved 22 RCT reports with 4,847 community older adults aged 65 years or over. Nineteen of the selected RCT studies reported dual or multimodal exercises show the beneficial effect for older adults compared to one-type treatment or no intervention. All of selected showed low risk in the selection, attrition, and reporting bias. However, detection bias showed low risk at 75% records of the involved RCTs and performance bias was low risk at only three records. Conclusions: The results of the systematic review propose that a standardized therapeutic approach and the intensity are needed for improving risk of falls in older adults.

A Review of Randomized Controlled Trials of Traditional Chinese Medicine Treatment for Coronavirus Disease 2019 Patients (Coronavirus Disease-2019 환자 치료에 대한 중의 RCT 연구 동향)

  • Park, Ju-heon;Yoon, Seong-hoon;Lee, In
    • The Journal of Internal Korean Medicine
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    • v.43 no.1
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    • pp.41-52
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    • 2022
  • Objectives: The purpose of this study is to investigate recent trends in randomized controlled trials (RCTs) on the treatment of Coronavirus disease 2019 (COVID-19) patients with traditional Chinese medicine (TCM) and analyze the results for the activation of COVID-19 Korean medicine research. Methods: We searched for RCTs published from December 2019 to October 2021 in the Chinese National Knowledge Infrastructure Database (CNKI). The investigation focused on the type of study, the purpose of the study, and the treatment methods. Results: A total of 8 RCTs were selected and analyzed from the 447 searched studies. All studies attempted to observe the effects of herbal medicine. Herbal medicine included granules, decoctions, and intravenous injections. The most frequently used herb type was drugs for clearing away heat and detoxification and releasing the exterior syndrome. In most studies, the effectiveness of TCM treatment of COVID-19 was significantly high. Conclusions: Although more quality studies are needed to support these results, TCM treatment for COVID-19 has been effective. Therefore, we hope that Korean medicine studies on infectious diseases will be actively conducted like TCM and contribute to national health.

Electroacupuncture Treatment for Post-Stroke Foot Drop: A Systemic Review of Randomized Controlled Trials

  • Hye Jeong Jo;Go Eun Chae;Hyun Woo Kim;Young Jin Lee;Ahra Koh;Ji Eun Choi;So Jung Kim;Woo Young Kim
    • Journal of Acupuncture Research
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    • v.41 no.2
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    • pp.75-86
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    • 2024
  • A review of randomized controlled trials (RCTs) using electroacupuncture (EA) to treat patients with foot drop was performed to analyze the effectiveness of EA for this condition. Relevant studies (n = 183) from 7 databases (Cochrane Library, Excerpta Medica Database, PubMed, China National Knowledge Infrastructure, Korean Studies Information Service System, Research Information Sharing Service, and Oriental Medicine Advanced Searching Integrated System) were selected based on the inclusion and exclusion criteria, and 12 RCTs met the selection criteria. In all 12 studies, EA showed significantly positive changes. In most indicators, positive changes were observed in the EA group compared with that in the control group. Significant increases were confirmed in muscle strength-related indicators such as the Fugl-Meyer motor scale, surface electromyography, active range of motion, and gait-related indicators such as the Tinetti score, maximum walking speed, and Berg balance scale. No notable adverse events were reported. EA is suggested as an effective treatment for post-stroke foot drop; however, more RCTs are required.

Randomized Clinical Controlled Trials of a Herb Remedies in Korea - Systematic Review (한약을 이용한 한국에서의 무작위 임상시험 개괄적 검토)

  • Oh, Rai-Young;Seol, In-Chan;Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.31 no.4
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    • pp.1-8
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    • 2010
  • Objective: The study aimed to review all randomized controlled clinical trials (RCTs) performed in Korea with herbal medicine, to produce further useful information for herbal-drug development. Methods: All papers reporting RCT with herbal drugs were collected via public database of Korea Science and Technology Integration Services, and various Oriental medicine journals. Then, the clinical question, herbal medicine, result, RCT design, and its conductor were analyzed. Results: A total of 20 RCTs were finally selected, and most of them were performed after 2003. The main subjects of RCT were related to heart and blood circulation, dermatitis, respiration disorder, Sasang constitution, or psychiatric disorders. Eight RCTs were done with a single herb while 12 RCTs were with multiple herbal formulae. In particular, three RCTs for atopic dermatitis with three formulae showed positive results. The quality of RCT was considered as better than average. Conclusions: This study revealed the current status of RCT using herbal drugs. This result would provide helpful information for research and drug development using traditional herbal medicine.

Systematic Review of Randomized Controlled Trials on Herbal Medicine for Treatment of Human Obesity (비만 치료 한약의 무작위 대조임상시험에 대한 체계적 분석)

  • Park, Jung-Hyun;Nam, Jong-Kyung;Kwon, Dong-Hyun;Kim, Ho-Jun;Lee, Myeong-Jong
    • Journal of Korean Medicine Rehabilitation
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    • v.19 no.3
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    • pp.33-46
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    • 2009
  • Objectives : The objective of the study was to summarize randomized clinical trials(RCTs) that have assessed the effectiveness of herbal medicine on treatment of obesity and to propose better process of study. Methods : NLM Medline(pubmed), EMBASE, the Cochrane library, Science Direct, EBSCO, 4 Korean medical databases were systematically searched and 4 Korean medical journals were manually searched for clinical trials investigating the efficacy of herbal medicines on treatment of overweight or obese people from 1998 to 2008. The methodological quality was assessed using a Jadad score and validity was assessed using Oxford Pain Validity Scale(OPVS). Results : 14 RCTs met all the inclusion criteria. The methodological and ethical quality of the trials was generally low. The mean score by Jadad was 2.6 and the mean score of validity was 11.2. Complex herbal medicine was used in 8 RCTs and single herbal medicine was used in 6 RCTs. Except 1 RCT, the other RCTs reported positive effects of herbal medicine on treatment of obesity. Herbal medicines didn't seem to affect toxicity. In general adverse events relevant with the therapy were minor, but more than half of RCTs did not report about the safety or adverse events of herbal medicine, questioning their reliability. Conclusions : Although most RCTs concluded the efficacy and safety of herbal medicines on treatment of obesity, the quality of trials was low in general. Further rigorous clinical trials using complex herbal medicine should be performed.

Comparison of Extracorporeal Shock Wave Therapy Versus Injection Therapy for Shoulder Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • Dajeong Kim;Hyunjoong Kim
    • Physical Therapy Rehabilitation Science
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    • v.12 no.1
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    • pp.48-55
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    • 2023
  • Objective: The purpose of this study is to compare the effects of extracorporeal shock wave therapy (ESWT) and injection therapy through qualitative and quantitative analysis by synthesizing randomized controlled trials (RCTs) conducted on patients with various shoulder diseases. Design: A systematic review and meta-analysis of randomized controlled trials Methods: This review conducted a literature search through international electronic databases in January 2023 to compare the effects of ESWT and injection therapy. Qualitative analysis was performed as a risk of bias tool, and quantitative analysis was synthesized with a random effect model to show the effect size as a standardized mean difference (SMD). Results: Five RCTs involving 298 individuals with shoulder disorders were included in this systematic review and meta-analysis. ESWT showed a moderate effect on pain (SMD=-0.44; 95% CI, -0.95 to 0.06) and a large effect on shoulder function (SMD =-0.81; 95% CI, -1.70 to 0.07) than injection therapy. A significant difference was found in the shoulder range of motion, showing a large effect size (SMD=1.50; 95% CI, 0.58 to 2.43). Conclusions: When considering treatment options for the management of patients complaining of shoulder disorders, it is appropriate to recommend ESWT first rather than injection therapy to increase the range of motion of the joint. In addition, ESWT is safe for pain control and shoulder function improvement, and a positive prognosis could be expected.

Effect of Robot-Assisted Wearable Exoskeleton on Gait Speed of Post-Stroke Patients: A Systematic Review and Meta-Analysis of a Randomized Controlled Trials

  • Chankyu Kim;Hyun-Joong Kim
    • Physical Therapy Rehabilitation Science
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    • v.11 no.4
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    • pp.471-477
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    • 2022
  • Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.