Robot-assisted therapy for upper extremity motor impairment after stroke: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jingyi Wu ◽  
Hao Cheng ◽  
Jiaqi Zhang ◽  
Shanli Yang ◽  
Sufang Cai
Keyword(s):  
Randomized Controlled Trials ◽  
Upper Extremity ◽  
Meta Analysis ◽  
Motor Impairment ◽  
Controlled Trials ◽  
Robot Assisted ◽  
Randomized Controlled ◽  
Small Effect Size ◽  
Evidence Database ◽  
Upper Extremity Motor Impairment

Abstract Objective The purpose of this study was to review the effects of robot-assisted therapy (RT) for improving poststroke upper extremity motor impairment. Methods The PubMed, EMBASE, Medline, and Web of Science databases were searched from inception to April 8, 2020. Randomized controlled trials that were conducted to evaluate the effects of RT on upper extremity motor impairment poststroke and that used Fugl-Meyer Assessment Upper Extremity (FMA-UE) scores as an outcome were included. Two authors independently screened articles, extracted data, and assessed the methodological quality of the included studies using the Physiotherapy Evidence Database (PEDro) scale. A random-effects meta-analysis was performed to pool the effect sizes across the studies. Results Forty-one randomized controlled trials with 1916 stroke patients were included. Compared with dose-matched conventional rehabilitation, RT significantly improved the FMA-UE scores of the patients with stroke, with a small effect size (Hedges g = 0.25; 95% CI = 0.11 to 0.38; I2 = 45.9%). The subgroup analysis revealed that the effects of unilateral RT, but not that of bilateral RT, was superior to conventional rehabilitation (Hedges g = 0.32; 95% CI = 0.15 to 0.50; I2 = 55.9%). Regarding the type of robot devices, the effects of the end effector device (Hedges g = 0.22; 95% CI = 0.09 to −0.36; I2 = 35.4%), but not the exoskeleton device, were superior to conventional rehabilitation. Regarding the stroke stage, the between-group difference (ie, RT vs convention rehabilitation) was significant only for people with late subacute or chronic stroke (Hedges g = 0.33; 95% CI = 0.16 to 0.50; I2 = 34.2%). Conclusion RT might be superior to conventional rehabilitation in improving upper extremity motor impairment in people after stroke with notable upper extremity hemiplegia and limited potential for spontaneous recovery.

scholarly journals Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1992
Author(s):  
Shu-Fen Chu ◽  
Tsan-Hon Liou ◽  
Hung-Chou Chen ◽  
Shih-Wei Huang ◽  
Chun-De Liao
Keyword(s):  
Randomized Controlled Trials ◽  
Weight Management ◽  
Muscle Mass ◽  
Lower Limb ◽  
Meta Analysis ◽  
Combined Treatment ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Standard Mean Difference ◽  
Evidence Database

Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4–8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.

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

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.

Comparison of Pet Robot Assisted Therapy and Animal Assisted Therapy Intervention: A Systematic Review and Meta-analysis of Randomized Controlled Trials for Old Adults with Dementia (Preprint)

2020 ◽  
Author(s):  
Junseo Lim ◽  
Jinhyun Kim
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Animal Assisted Therapy ◽  
Controlled Trials ◽  
Robot Assisted ◽  
Screening Process ◽  
Old Adults ◽  
Randomized Controlled

BACKGROUND The increase in the number of dementia patients is a burden on caregivers as well as a socioeconomic burden. However, technical innovation is becoming a major critical factor in addressing such burdens. Studies are emerging that verify the effectiveness of robots in treating old adults with dementia. Therefore, we would like to determine and compare the effects of interventions that use robots and living animals, respectively. OBJECTIVE This study is a meta-analysis that analyzes four variables (cognition function, agitation, depression, and quality of life (QoL)) by selecting randomized controlled trials (RCTs) of old adults with dementia in order to determine and compare the effectiveness of pet robot-assisted therapy (PRAT) and animal-assisted therapy (AAT). METHODS The literature selected was limited to RCTs written in English. Four databases were used in the search and selection therefor: EMBASE, PsycINFO, PubMed, and Web of Science. Two independent reviewers completed the search and screening process. RESULTS The systematic review included seven articles on PRAT, seven articles on AAT, and one article on both PRAT and AAT—for a total of fifteen articles. The meta-analysis showed that both PRAT and AAT interventions did not have a statistically significant impact on the cognition function, depression, and QoL of older adults with dementia. However, they did have a statistically significant impact on agitation. CONCLUSIONS Previous studies have shown that the current method of treating older adults with dementia—whether using robots or living animals—is ineffective. Thus, in the development of intelligent active techniques (IATs), standardized robot arbitration programs—and the necessary measurement tools therefor—should be created instead of simply borrowing the program used in AAT.

scholarly journals Proprioceptive Training and Outcomes of Patients With Knee Osteoarthritis: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 54 (4) ◽  
pp. 418-428 ◽  
Author(s):  
Hee Seong Jeong ◽  
Sung-Cheol Lee ◽  
Hyunseok Jee ◽  
Jun Bom Song ◽  
Hyun Sik Chang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Proprioceptive Training ◽  
Evidence Database ◽  
Based Medicine ◽  
Test Outcomes

Objective To describe the effects of proprioceptive training on pain, stiffness, function, and functional test outcomes among patients with knee osteoarthritis (OA). Data Sources All studies completed from 1946 to 2017 were obtained from 4 databases (PubMed, MEDLINE, CINAHL, and SPORTDiscus). Study Selection Three reviewers independently identified appropriate studies and extracted data. Data Extraction Methodologic quality and level of evidence were assessed using the Physiotherapy Evidence Database scale and Oxford Centre for Evidence-Based Medicine guidelines. The standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for pain, stiffness, function, and functional test outcomes. Data Synthesis Seven randomized controlled trials involving 558 patients with knee OA met the inclusion criteria. The selected studies had Physiotherapy Evidence Database scores of 6 to 8. All randomized controlled trials had an Oxford Centre for Evidence-Based Medicine level of evidence of 2. Meta-analysis of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (SMD = −0.56; 95% CI = −1.06, −0.07; P = .026), function subscale (SMD = −0.40; 95% CI = −0.59, −0.21; P < .001), and non-WOMAC walking speed test (SMD = −1.07; 95% CI = −2.12, −0.01; P = .048) revealed that proprioceptive training had significant treatment effects. Proprioceptive training was not associated with reductions in WOMAC stiffness subscale scores and did not improve non-WOMAC get-up-and-go scores. Conclusions Proprioceptive training effectively promoted pain relief and completion of functional daily activity among patients with knee OA and should be included in rehabilitation programs. Stiffness and other mobility measures were unchanged after proprioceptive training. Modified proprioceptive training programs are needed to target stiffness and improve additional physical function domains.

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