Systematic Review of the Effectiveness of Pharmacological Interventions in the Treatment of Spasticity of the Hemiparetic Lower Extremity More Than Six Months Post Stroke

2012 ◽  
Vol 19 (6) ◽  
pp. 479-490 ◽  
Author(s):  
Amanda McIntyre ◽  
Taeweon Lee ◽  
Shannon Janzen ◽  
Rachel Mays ◽  
Swati Mehta ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Pharmacological Interventions ◽  
Post Stroke

scholarly journals Non-Pharmacological Interventions for Post-Stroke Fatigue: Systematic Review and Network Meta-Analysis

2020 ◽  
Vol 9 (3) ◽  
pp. 621 ◽  
Author(s):  
Ya Su ◽  
Michiko Yuki ◽  
Mika Otsuki
Keyword(s):  
Systematic Review ◽  
Health Management ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Pharmacological Intervention ◽  
Pharmacological Interventions ◽  
Post Stroke ◽  
Equivalent Efficacy ◽  
Fatigue Severity

Post-stroke fatigue (PSF) is one of the most serious sequelae, which often interferes with the rehabilitation process and impairs the functional recovery of patients. Due to insufficient evidence, it is unclear which specific pharmacological interventions should be recommended. Therefore, in this paper, we compare the effectiveness of non-pharmacological interventions in PSF. A systematic review and network meta-analysis of randomized controlled trials were performed using EMBASE, MEDLINE, CINAHL, Cochrane library, ClinicalTrials.gov, CNKI, and CQVIP, from inception to January 2018, in the English and Chinese languages. RCTs involving different non-pharmacological interventions for PSF with an outcome of fatigue measured using the Fatigue Severity Scale were included. Multiple intervention comparisons based on a Bayesian network are used to compare the relative effects of all included interventions. Ten RCTs with eight PSF non-pharmacological interventions were identified, comprising 777 participants. For effectiveness, most interventions did not significantly differ from one another. The cumulative probabilities of the best non-pharmacological intervention for fatigue reduction included Community Health Management (CHM), followed by Traditional Chinese Medicine (TCM) and Cognitive Behavioral Therapy (CBT). Network meta-analysis based on data from the selected RCTs indicated that the eight PSF non-pharmacological interventions shared equivalent efficacy, but CHM, TCM, and CBT showed potentially better efficacy. In the future, fatigue needs to be recognized and more accurate assessment methods for PSF are required for diagnosis and to develop more effective clinical interventions.

Use of Kinesio taping in lower-extremity rehabilitation of post-stroke patients: A systematic review and meta-analysis

2019 ◽  
Vol 35 ◽  
pp. 22-32 ◽  
Author(s):  
Mian Wang ◽  
Zi-wen Pei ◽  
Bei-dou Xiong ◽  
Xian-mei Meng ◽  
Xiao-li Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Meta Analysis ◽  
Stroke Patients ◽  
Post Stroke ◽  
Kinesio Taping

scholarly journals Systematic Review: Effectiveness of Mirror Therapy for Lower Extremity Post-Stroke

2015 ◽  
Vol 26 (1) ◽  
pp. 51-59 ◽  
Author(s):  
Goris Kin Nga Hung ◽  
Cabbee Tsz Lui Li ◽  
Alexander Miles Yiu ◽  
Kenneth N.K. Fong
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Mirror Therapy ◽  
Post Stroke

scholarly journals Non-pharmacological interventions for the improvement of post-stroke activities of daily living and disability amongst older stroke survivors: A systematic review

PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0204774 ◽  
Author(s):  
Carrie Stewart ◽  
Selvarani Subbarayan ◽  
Pamela Paton ◽  
Elliot Gemmell ◽  
Iosief Abraha ◽  
...  
Keyword(s):  
Systematic Review ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Stroke Survivors ◽  
Pharmacological Interventions ◽  
Post Stroke

scholarly journals Efficacy and Optimal Dose of Botulinum Toxin A in Post-Stroke Lower Extremity Spasticity: A Systematic Review and Meta-Analysis

Toxins ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 428
Author(s):  
Thanh-Nhan Doan ◽  
Mei-Ying Kuo ◽  
Li-Wei Chou
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Optimal Dose ◽  
Rehabilitation Program ◽  
Functional Improvement ◽  
Optimum Dose ◽  
Post Stroke

Post-stroke spasticity impedes patients’ rehabilitation progress. Contradictory evidence has been reported in using Botulinum Neurotoxin type A (BoNT-A) to manage post-stroke lower extremity spasticity (PLES); furthermore, an optimum dose of BoNT-A for PLES has not yet been established. Therefore, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to identify the efficacy and optimal dose of BoNT-A on PLES. "Meta" and "Metafor" packages in R were used to analyze the data. Hedges’ g statistic and random effect model were used to calculate and pool effect sizes. Twelve RCTs met the eligibility criteria. Muscle tone significantly improved in week four, week eight, and maintained to week twelve after BoNT-A injection. Improvements in functional outcomes were found, some inconsistencies among included studies were noticed. Dosage analysis from eight studies using Botox® and three studies using Dysport® indicated that the optimum dose for the commonest pattern of PLES (spastic plantar flexors) is medium-dose (approximately 300U Botox® or 1000 U Dysport®). BoNT-A should be regarded as part of a rehabilitation program for PLES. Furthermore, an optimal rehabilitation program combined with BoNT-A management needs to be established. Further studies should also focus on functional improvement by BoNT-A management in the early stage of stroke.

Therapy of post-stroke depression – a systematic review

2013 ◽  
Vol 10 (02) ◽  
pp. 108-129 ◽  
Author(s):  
W. Gaebel ◽  
W. Wannagat ◽  
J. Zielasek
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Placebo Control ◽  
Post Stroke ◽  
Pharmacological Studies ◽  
Post Stroke Depression ◽  
Control Procedures ◽  
Antidepressant Pharmacotherapy

SummaryWe performed a systematic review of randomized placebo-controlled pharmacological and non-pharmacological trials for the therapy and prevention of post-stroke depression that have been published between 1980 and 2011. We initially identified 2 260 records of which 28 studies were finally included into this review. A meta-analytic approach was hampered by considerable differences regarding the kinds of therapeutic regimens and the study durations. Modest effects favoring treatment of post-stroke depression could be found for pharmacological treatment as well as repetitive transcranial magnetic stimulation. For the prevention of post-stroke depression, antidepressant pharmacotherapy showed promising results. However, large-scale studies with better standardized study populations, optimized placebo control procedures in non-pharmacological studies, and replication in larger follow-up studies are still necessary to find the optimal therapeutic regimens to prevent and treat post-stroke depression.

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