Acupuncture for Amnestic Mild Cognitive Impairment: A Meta-Analysis of Randomised Controlled Trials

2016 ◽  
Vol 34 (5) ◽  
pp. 342-348 ◽  
Author(s):  
Min Deng ◽  
Xu-Feng Wang
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Adjunctive Treatment ◽  
Controlled Trials ◽  
Randomised Controlled

Objective Mild cognitive impairment (MCI) is a pre-dementia state; 5–10% of cases per year will evolve into dementia. MCI can be amnestic (AMCI) or non-amnestic. AMCI is associated with a higher risk of progression. In recent years, interest in acupuncture as a potential treatment for AMCI has grown. The aim of this meta-analysis was to estimate the clinical effectiveness and safety of acupuncture for AMCI. Methods Randomised controlled trials (RCTs) of acupuncture versus medical treatment for AMCI were identified using the following databases from inception to July 2015: PubMed; Medline; CENTRAL; Chinese Scientific Journal Database; The Chinese Acupuncture Trials Register; China National Knowledge Infrastructure (CNKI); and Wanfang database. Data were extracted from RCTs meeting the inclusive criteria according to Cochrane methods. Meta-analyses were conducted using Rev Man V.5.3 software. Results Five trials involving 568 subjects were included. Meta-analysis showed that participants receiving acupuncture had better outcomes than those receiving nimodipine with greater clinical efficacy rates (odds ratio (OR) 1.78, 95% CI 1.19 to 2.65; p<0.01), mini-mental state examination (MMSE) scores (mean difference (MD) 0.99, 95% CI 0.71 to 1.28; p<0.01), and picture recognition score (MD 2.12, 95% CI 1.48 to 2.75; p<0.01). Meta-analysis also showed acupuncture in conjunction with nimodipine significantly improved MMSE scores (MD 1.09, 95% CI 0.29 to 1.89; p<0.01) compared to nimodipine alone. Three trials reported adverse events. Methodological quality of the included studies was judged to be generally poor. Conclusions Acupuncture appears effective for AMCI when used as an alternative or adjunctive treatment; however, caution must be exercised given the low methodological quality of included trials. Further, more rigorously designed studies are needed.

scholarly journals Acupuncture for Vascular Mild Cognitive Impairment: A Systematic Review of Randomised Controlled Trials

2013 ◽  
Vol 31 (4) ◽  
pp. 368-374 ◽  
Author(s):  
Huijuan Cao ◽  
Yuyi Wang ◽  
Dennis Chang ◽  
Li Zhou ◽  
Jianping Liu
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Vascular Cognitive Impairment ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Randomised Controlled ◽  
State Examination

Background Vascular mild cognitive impairment (VMCI) is the most common type of vascular cognitive impairment induced by cerebrovascular disease. No effective medicines are currently available for VMCI. Objective To assess the effectiveness and safety of acupuncture for VMCI. Methods Seven electronic databases were searched for randomised controlled trials which investigated the effects of acupuncture compared with no treatment, placebo or conventional therapies on cognitive function or other clinical outcomes in patients with VMCI. The quality of the trials selected was evaluated according to the ‘risk of bias’ assessment provided by the Cochrane Handbook for Systematic Reviews of Interventions. RevMan V.5.1 software was employed for data analysis. Results Twelve trials with 691 participants were included. The methodological quality of all included trials was unclear and/or they had a high risk of bias. Meta-analysis showed acupuncture in conjunction with other therapies could significantly improve Mini-Mental State Examination scores (mean difference 1.99, 95% CI 1.09 to 2.88, random model, p<0.0001, 6 trials). No included trials mentioned any adverse events of the treatment. Conclusions The current clinical evidence is not of sufficient quality for wider application of acupuncture to be recommended for the treatment of VMCI, and further large, rigorously designed trials are warranted.

scholarly journals The methodological quality of individual participant data meta-analysis on intervention effects: systematic review

BMJ ◽  
2021 ◽  
pp. n736
Author(s):  
Huan Wang ◽  
Yancong Chen ◽  
Yali Lin ◽  
Julius Abesig ◽  
Irene XY Wu ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
A Priori ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Individual Participant ◽  
Randomised Controlled ◽  
Meta Analyses

Abstract Objective To assess the methodological quality of individual participant data (IPD) meta-analysis and to identify areas for improvement. Design Systematic review. Data sources Medline, Embase, and Cochrane Database of Systematic Reviews. Eligibility criteria for selecting studies Systematic reviews with IPD meta-analyses of randomised controlled trials on intervention effects published in English. Results 323 IPD meta-analyses covering 21 clinical areas and published between 1991 and 2019 were included: 270 (84%) were non-Cochrane reviews and 269 (84%) were published in journals with a high impact factor (top quarter). The IPD meta-analyses showed low compliance in using a satisfactory technique to assess the risk of bias of the included randomised controlled trials (43%, 95% confidence interval 38% to 48%), accounting for risk of bias when interpreting results (40%, 34% to 45%), providing a list of excluded studies with justifications (32%, 27% to 37%), establishing an a priori protocol (31%, 26% to 36%), prespecifying methods for assessing both the overall effects (44%, 39% to 50%) and the participant-intervention interactions (31%, 26% to 36%), assessing and considering the potential of publication bias (31%, 26% to 36%), and conducting a comprehensive literature search (19%, 15% to 23%). Up to 126 (39%) IPD meta-analyses failed to obtain IPD from 90% or more of eligible participants or trials, among which only 60 (48%) provided reasons and 21 (17%) undertook certain strategies to account for the unavailable IPD. Conclusions The methodological quality of IPD meta-analyses is unsatisfactory. Future IPD meta-analyses need to establish an a priori protocol with prespecified data syntheses plan, comprehensively search the literature, critically appraise included randomised controlled trials with appropriate technique, account for risk of bias during data analyses and interpretation, and account for unavailable IPD.

A systematic review of randomised controlled trials of psychosocial interventions for acute mental health inpatients

2021 ◽  
Vol 10 (3) ◽  
pp. 1-17
Author(s):  
Laura D Wainwright ◽  
Gillian Haddock ◽  
Charlotte Dunster-Page ◽  
Katherine Berry
Keyword(s):  
Quality Of Life ◽  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Social Care ◽  
Psychosocial Interventions ◽  
Controlled Trials ◽  
Patient Functioning ◽  
Electronic Search ◽  
Randomised Controlled

Background/Aims Inpatient wards provide an opportunity to intervene with medical, psychological and social care to contain distress and prevent future relapse. However, they have been criticised for an over-reliance on medication and risk management with limited psychosocial interventions. The aim of this study was to investigate clinical trials of psychosocial interventions for inpatients to identify interventions that are effective at improving quality of life, symptoms or patient functioning. Methods An electronic search of six databases was conducted for papers published from 1806 up until February 2017. A total of 18 randomised controlled trials was identified in which outcomes for symptoms, quality of life or functioning were reported. Results Overall, 15 trials showed a statistically significant result for at least one outcome. Seven categories were identified from the 18 studies, at least one in each category was found to be effective for symptoms, quality of life or functioning. The majority were effective (15 out of 18). Conclusions Given that the methodological quality was generally low and number of randomised controlled trials were small, it is difficult to draw definitive conclusions. Recommendations include more and repeated trials using rigorous methods of testing and reporting.

scholarly journals The role of animal-assisted therapy in the management of people with dementia: a systematic literature review

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S276-S276
Author(s):  
Syed Nabeel Javaid
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Randomised Controlled Trials ◽  
Animal Assisted Therapy ◽  
Controlled Trials ◽  
People With Dementia ◽  
Randomised Controlled

AimsThe aim of this systematic literature review was to determine the evidence-based effectiveness of animal assisted interventions and to look at the factors that limit implementation of this intervention.BackgroundDementia is a major health issue worldwide impacting not only on the people diagnosed with dementia, but also on their families and caregivers, and the healthcare professionals. The symptoms of dementia include cognitive impairment that can range from mild to severe, and behavioural and psychological symptoms which have debilitating effects on functional capacity and quality of life. A number of non-pharmacological interventions are being developed to help people with dementia. Animal assisted therapy is one of those interventions that has demonstrated positive effects on various aspects of dementia (Filan and Llewellyn-Jones, 2006). However, there are limitations to its use and feasibility of animal assisted therapy programmes is unclear.MethodOnly randomised-controlled trials (RCTs) were to be included to evaluate high quality evidence. A systematic literature search was carried out to find using the PubMed and Cochrane databases and a search of the NICE website. Literature was screened according to inclusion and exclusion criteria. Eight randomised-controlled trials were selected to be used in this systematic review to assess the effectiveness of animal-assisted therapy.ResultThe results regarding the effectiveness of animal assisted therapy were variable. There was some improvement demonstrated in symptoms of depression, agitation, behaviour and cognitive impairment. Quality of life and activities of daily living also demonstrated positive outcomes. There was a reduction in the risk of falls in people with dementia. However, the studies conducted demonstrated limited methodologies. The factors limiting the use of animal assisted therapy were found to be concerns around adverse events to animals, issues of animal welfare and economic feasibility of animal assisted therapy programmes.ConclusionFurther research needs to be done using properly conducted randomised controlled trials with larger sample sizes to formally assess people's perceptions regarding therapy animals and develop clear guidelines and protocols for integrating these interventions in healthcare.

Effect of action observation therapy on motor function in children with cerebral palsy: a systematic review of randomized controlled trials with meta-analysis

2020 ◽  
pp. 026921552095434
Author(s):  
Naglaa Abdelhaleem ◽  
Samar Taher ◽  
Menna Mahmoud ◽  
Ahmad Hendawy ◽  
Maged Hamed ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Action Observation ◽  
Meta Analysis ◽  
Post Treatment ◽  
Controlled Trials ◽  
Children With Cerebral Palsy ◽  
Randomised Controlled

Objective: To evaluate the evidence of using Action Observation Therapy in the rehabilitation of children with Cerebral Palsy. Study design: Systematic review with meta-analysis of Randomised Controlled Trials. Methods: For the purpose of identifying relevant studies, six databases were searched from inception until July 2020. The methodological quality was assessed by Physiotherapy Evidence Database scale. The outcomes were classified within the framework of the International Classification of Functioning. A pooled meta-analysis was performed on studies that demonstrated homogeneity. Results: Twelve randomised controlled trials with 307 participants were included with six of them were included in the meta-analysis. Non-significant difference between the groups was demonstrated by meta-analysis. Results of capacity assessed in post treatment and follow up evaluation were (0.06, –0.22 to 0.34, 95% (CI); P = 0.69 and (–0.35, –0.96 to 0.27, 95% (CI); P = 0.27); respectively. Actual performance in post-treatment and follow up were (0.10, –0.22 to 0.48, 95% (CI); P = 0.62) and (0.01, –0.40 to 0.41, 95% (CI); P = 0.97); respectively. Perceived performance evaluated using (ABILHAND-KIDS) were (0.30, –0.28 to 0.89, 95% (CI); P = 0.31) and (0.15, –0.43 to 0.73, 95% (CI); P = 0.61) for post treatment and follow up; respectively. Overall effect on activity domain was (0.08, –0.11 to 0.28, 95% (CI); P = 0.86) immediately and (0.04, –0.33 to 0.26, 95% (CI); P = 0.49) at follow-up; respectively. Conclusion: No evidence of benefit had been found to draw a firm conclusion regarding the effectiveness of action observation therapy in the rehabilitation of children with cerebral palsy due to limitations in methodological quality and variations between studies.

Effects of jump training on jumping performance of handball players: A systematic review with meta-analysis of randomised controlled trials

2020 ◽  
Vol 15 (4) ◽  
pp. 584-594 ◽  
Author(s):  
Rodrigo Ramirez-Campillo ◽  
Cristian Alvarez ◽  
Antonio Garcia-Hermoso ◽  
Justin WL Keogh ◽  
Felipe García-Pinillos ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Control Group ◽  
Controlled Trials ◽  
Countermovement Jump ◽  
Jumping Performance ◽  
Jump Training ◽  
Jump Exercise ◽  
Randomised Controlled

This study aimed to assess the effects of jump training on the jumping performance of handball players compared with a control condition. The data sources utilised were PubMed, MEDLINE, Web of Science Core Collection and SCOPUS. Only peer-review randomised controlled trials were included. The inclusion criteria comprised: a jump training programme of at least 2 weeks; a control group; the assessment of the countermovement jump. The Physiotherapy Evidence Database scale was used to assess the risk of bias and methodological quality of eligible studies included in the meta-analysis. Risk of publication bias across studies was assessed using the extended Egger’s test. Cohen’s d effect sizes (ESs) were calculated from the countermovement jump and presented together with 95% confidence intervals (CIs). From 6108 records initially identified through database searching, 5 were eligible for meta-analysis. A significant improvement in countermovement jump height was observed, corresponding to 6.4 cm (95% CI = 4.9–7.9; Z = 8.4, p < 0.001), showing moderate heterogeneity ( I2 = 51.4%). The magnitude of the main effect was very large (ES = 2.2 (95% CI = 0.95–3.4), Z = 3.5, p < 0.001). Jump training is effective in increasing vertical jump performance in handball players. However, the insufficient number of studies conducted precluded analyses of moderator variables. In future, researchers are advised to conduct jump training studies of high methodological quality (e.g. randomised controlled trials) and assess different jump exercise prescriptions across handball players of different sexes, ages and competitive levels to analyse if exercise prescription and player characteristics may influence training responses.

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