Synergic effect of the combination of mirror therapy and electrical stimulation for lower extremity motor function recovery in stroke survivors: a meta-analysis of randomized controlled trials

Objective: To evaluate the current evidence on the effectiveness of simultaneous combination of mirror therapy and electrical stimulation in the recovery of upper limb motor function after stroke, compared with conventional therapy, mirror therapy or electrical stimulation isolated. Data sources: Articles published in PubMed, Web of Science, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Central register of controlled trials and ScienceDirect up to July 2020. Review methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Methodological quality was assessed using the PEDro tool. The RevMan 5.4 statistical software was used to obtain the meta-analysis, through the standardized mean difference and 95% confidence intervals (CI), and to evaluate the risk of bias. The GRADE approach was employed to assess the certainty of evidence. Results: Eight articles were included in this systematic review, seven were included in the meta-analysis. A total of 314 participants were analyzed. The overall quality of the articles included in this review was good. There was no overall significant mean difference on upper limb motor function after stroke using the Upper-Extremity Fugl-Meyer Assessment by 1.56 (95% CI = –2.08, 5.20; P = 0.40; moderate-certainty evidence) and the Box and Block Test results by 1.39 (95% CI = –2.14, 4.92; P = 0.44; high-certainty evidence). There was overall significant difference in the Action Research Arm Test by 3.54 (95% CI = 0.18, 6.90; P = 0.04; high-certainty evidence). Conclusion: Direct scientific evidence about the effectiveness of the combined therapy of mirror therapy and electrical stimulation simultaneously for the improvement of the upper limb motor function after stroke is lacking. Further high-quality and well-designed research is needed.

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Meta-Analysis of Randomized Controlled Trials of Xueshuantong Injection in Prevention of Deep Venous Thrombosis of Lower Extremity after Orthopedic Surgery

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/8877791 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Shu-ting Yan ◽

Feng Gao ◽

Tai-wei Dong ◽

Hao Fan ◽

Miao-miao Xi ◽

...

Keyword(s):

Lower Extremity ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Randomized Controlled Trials ◽

Orthopedic Surgery ◽

Meta Analysis ◽

Control Group ◽

Controlled Trials ◽

Randomized Controlled ◽

Experimental Group

Objective. To systematically evaluate the clinical efficacy of Xueshuantong injection (Panax notoginseng saponins) in preventing deep venous thrombosis (DVT) of lower extremity after orthopedic surgery. Methods. The randomized controlled trials (RCTs) of Xueshuantong injection in prevention of lower extremity DVT after orthopedic surgery were retrieved from CNKI, Wanfang database, VIP, PubMed, and Cochrane Library by August 2020. Revman5.2 was used to analyze the results. Results. A total of 20 articles including 2336 patients were included. The results of meta-analysis showed that the incidence of DVT in the experimental group was lower than that in the control group; after operation, the D-dimer (Ddimer), thrombin time (APTT), and prothrombin time (PT) in the experimental group were significantly improved compared with those in the control group, and the difference between the two groups was statistically significant. Conclusion. Xueshuantong injection can effectively prevent the formation of lower extremity DVT after orthopedic surgery and antagonize the postoperative hypercoagulable state of blood, which has high clinical value.

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Electrical Stimulation in Spine Fusion: A Meta-Analysis of Randomized Controlled Trials

The Spine Journal ◽

10.1016/j.spinee.2010.07.297 ◽

2010 ◽

Vol 10 (9) ◽

pp. S113

Author(s):

Christina Goldstein ◽

Brian Drew ◽

Mohit Bhandari ◽

Brad Petrisor

Keyword(s):

Electrical Stimulation ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Spine Fusion ◽

Controlled Trials ◽

Randomized Controlled

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Effects of Neuromuscular Electrical Stimulation on Hemiplegic Upper Limb of Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials

10.21203/rs.2.19509/v1 ◽

2019 ◽

Author(s):

Wenyue Zhang ◽

Shuye Pei ◽

Juan Huang ◽

Yao Tang ◽

Huaidong Hu

Keyword(s):

Electrical Stimulation ◽

Randomized Controlled Trials ◽

Upper Extremity ◽

Upper Limb ◽

Meta Analysis ◽

Neuromuscular Electrical Stimulation ◽

Cochrane Library ◽

Control Group ◽

Controlled Trials ◽

Randomized Controlled

Abstract Background: Whether NMES helps the recovery of upper limb function in patients with hemiparesis has not been confirmed. We conducted this meta-analysis to examine the effectiveness of neuromuscular electrical stimulation (NMES) for upper limb hemiparesis after stroke.Methods: Data sources such as Pubmed, Embase and Cochrane library databases were searched for all relevant studies that were carried out before December 1, 2018.We selected the randomized controlled trials (RCTs) which included chronic and acute stroke patients with upper extremity dysfunction. Then the intervention group which applied NMES was compared with a control group without NMES. Results: A total of 16 RCTs involving 691 patients were discerned from 248 searched articles. According to the forest plot ,NMES had a significant benefit on FMA-ue scale(SMD=0.44,95%CI 0.13 to 0.74,P=0.006).Also, NMES was positive for ARAT(SMD=0.31,95%CI 0.05 to 0.58,P=0.019)and MAL-AOU(SMD=0.59,95%CI 0.15 to1.04,P=0.009),but not for wrist MAS(SMD=-0.12,95%CI -0.43 to 0.19,P=0.434) or BI(SMD=0.51,95%CI -0.65 to 1.66,P=0.392).Conclusion: NMES application has beneficial impacts on upper extremity motor function in patients with stroke. This study suggests that NMES ought to be applied as a beneficial rehabilitation means in improving the upper function.

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

Journal of Korean Medicine ◽

10.13048/jkm.21039 ◽

2021 ◽

Vol 42 (4) ◽

pp. 75-112

Author(s):

Mikyung Kim ◽

Chang-ho Han

Keyword(s):

Randomized Controlled Trials ◽

Motor Function ◽

Upper Limb ◽

Meta Analysis ◽

Mean Difference ◽

Cochrane Library ◽

Controlled Trials ◽

Stroke Survivors ◽

Randomized Controlled ◽

Standard Mean Difference

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.

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