scholarly journals Comparison of Different Physical Therapies Combined with Acupuncture for Poststroke Cognitive Impairment: a Network Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-13
Author(s):  
Ruo-Yang Li ◽  
Rui-Jue Huang ◽  
Qian Yu
Keyword(s):  
Cognitive Impairment ◽  
Physical Therapy ◽  
Randomized Controlled Trials ◽  
Hyperbaric Oxygen Therapy ◽  
Oxygen Therapy ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Treatment Plans ◽  
Physical Therapies

Objective. Physical therapy combined with acupuncture is the current research hotspot in the treatment of poststroke cognitive impairment, but which combination treatment is the best is still controversial. Based on the network meta-analysis method, we evaluated the efficacy of various physical therapies combined with acupuncture for the treatment of poststroke cognitive impairment. Methods. We retrieved diverse randomized controlled trials of various physical therapies combined with acupuncture for the treatment of cognitive dysfunction after stroke. We selected studies, extracted data, and evaluated the risk of literature bias for the included randomized controlled trials. We used STATA 14.0 for the current network meta-analysis. Results. Fifteen randomized controlled trials involving 1288 patients were included, which involved 7 treatment plans that included 3 control treatment plans and 4 acupuncture treatment plans combined with physical therapy. The best treatment plan for improving the Mini-Mental State Examination score of poststroke cognitive impairment is acupuncture combined with hyperbaric oxygen therapy. The best treatment option for improving the Montreal Cognitive Assessment score of poststroke cognitive impairment is acupuncture combined with hyperbaric oxygen therapy. The best option for improving the Barthel index score of poststroke cognitive impairment is acupuncture combined with transcranial magnetic stimulation. In terms of improving the overall clinical effectiveness of poststroke cognitive impairment, the best treatment option is acupuncture combined with transcranial magnetic stimulation. Conclusion. The analysis of all the results shows that acupuncture combined with hyperbaric oxygen therapy can significantly improve poststroke cognitive impairment compared with other combined treatments. However, due to the overall quality and quantity of the included studies, more randomized controlled trials focusing on clinical research on acupuncture combined with physical therapy for poststroke cognitive impairment are required to support the current evidence. This trial is registered with CRD42020200092.

scholarly journals Conservative oxygen therapy for critically ill patients: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Xiao-Li Chen ◽  
Bei-Lei Zhang ◽  
Chang Meng ◽  
Hui-Bin Huang ◽  
Bin Du
Keyword(s):  
Sensitivity Analysis ◽  
Randomized Controlled Trials ◽  
Critically Ill Patients ◽  
Oxygen Therapy ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Icu Patients ◽  
Randomized Controlled

Abstract Objective Conservative oxygen strategy is recommended in acute illness while its benefit in ICU patients remains controversial. Therefore, we sought to conduct a systematic review and meta-analysis to examine such oxygen strategies’ effect and safety in ICU patients. Methods We searched PubMed, Embase, and the Cochrane database from inception to Feb 15, 2021. Randomized controlled trials (RCTs) that compared a conservative oxygen strategy to a conventional strategy in critically ill patients were included. Results were expressed as mean difference (MD) and risk ratio (RR) with a 95% confidence interval (CI). The primary outcome was the longest follow-up mortality. Heterogeneity, sensitivity analysis, and publication bias were also investigated to test the robustness of the primary outcome. Results We included seven trials with a total of 5265 patients. In general, the conventional group had significantly higher SpO2 or PaO2 than that in the conservative group. No statistically significant differences were found in the longest follow-up mortality (RR, 1.03; 95% CI, 0.97–1.10; I2=18%; P=0.34) between the two oxygen strategies when pooling studies enrolling subjects with various degrees of hypoxemia. Further sensitivity analysis showed that ICU patients with mild-to-moderate hypoxemia (PaO2/FiO2 >100 mmHg) had significantly lower mortality (RR, 1.24; 95% CI, 1.05–1.46; I2=0%; P=0.01) when receiving conservative oxygen therapy. These findings were also confirmed in other study periods. Additional, secondary outcomes of the duration of mechanical ventilation, the length of stay in the ICU and hospital, change in sequential organ failure assessment score, and adverse events were comparable between the two strategies. Conclusions Our findings indicate that conservative oxygen therapy strategy did not improve the prognosis of the overall ICU patients. The subgroup of ICU patients with mild to moderate hypoxemia might obtain prognosis benefit from such a strategy without affecting other critical clinical results.

scholarly journals Acupuncture for Improving Cognitive Impairment After Stroke: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 11 ◽  
Author(s):  
Liang Zhou ◽  
Yao Wang ◽  
Jun Qiao ◽  
Qing Mei Wang ◽  
Xun Luo
Keyword(s):  
Cognitive Impairment ◽  
Randomized Controlled Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Sham Acupuncture ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Post Stroke ◽  
Randomized Controlled ◽  
Therapeutic Benefits

Objective: This meta-analysis evaluated the efficacy of acupuncture in improving cognitive impairment of post-stroke patients.Design: Randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or sham acupuncture on post-stroke cognitive impairment (PSCI) before December 2019 were identified from databases (PubMed, EMBASE, Ovid library, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Chinese Periodical Database, Wanfang Database, and SinoMed). The literature searching and data extracting were independently performed by two investigators. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed for the eligible RCTs with Revman 5.3 software.Results: Thirty-seven RCTs (2,869 patients) were included in this meta-analysis. Merged Random-effects estimates of the gain of MMSE (Mini-Mental State Examination) or MoCA (Montreal Cognitive Assessment) were calculated for the comparison of acupuncture with no acupuncture or sham acupuncture. Following 2–8 weeks of intervention with acupuncture, pooled results demonstrated significant effects of acupuncture in improving PSCI assessed by MMSE (MD [95% CI] = 2.88 [2.09, 3.66], p < 0.00001) or MoCA (MD [95% CI] = 2.66 [1.95, 3.37], p < 0.00001).Conclusion: The results suggest that acupuncture was effective in improving PSCI and supported the needs of more rigorous design with large-scale randomized clinical trials to determine its therapeutic benefits.

scholarly journals Additional Physical Interventions to Conventional Physical Therapy in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

2020 ◽  
Vol 9 (4) ◽  
pp. 1038 ◽  
Author(s):  
Ruben D. Hidalgo-Agudo ◽  
David Lucena-Anton ◽  
Carlos Luque-Moreno ◽  
Alberto Marcos Heredia-Rizo ◽  
Jose A. Moral-Munoz
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Physical Therapy ◽  
Randomized Controlled Trials ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Balance Confidence ◽  
Randomized Controlled

Parkinson’s disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to conventional physical therapy in Parkinson’s disease. A systematic review and meta-analysis of randomized controlled trials were performed. The literature search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), Scopus, SciELO and Web of Science. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 11 randomized controlled trials were included in this review. Five of them contributed information to the meta-analysis. The statistical analysis showed favorable results for dance-based therapy in motor balance: (Timed Up and Go: standardized mean difference (SMD) = −1.16; 95% Confidence Interval (CI):(−2.30 to −0.03); Berg Balance Scale: SMD = 4.05; 95%CI:(1.34 to 6.75)). Aquatic interventions showed favorable results in balance confidence (Activities-Specific Balance Confidence: SMD=10.10; 95%CI:(2.27 to 17.93)). The results obtained in this review highlight the potential benefit of dance-based therapy in functional balance for people with Parkinson’s disease, recommending its incorporation in clinical practice. Nonetheless, many aspects require clarification through further research and high-quality studies on this subject.

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