Effect of Ankle-Foot Orthoses on Functional Outcome Measurements in Individuals with Stroke: A Systematic Review and Meta-Analysis

ObjectiveContrast extravasation (CE) after endovascular therapy (EVT) is commonly present in acute ischaemic stroke (AIS) patients. Substantial uncertainties remain about the relationship between CE and the outcomes of EVT in patients with AIS. Therefore, we aimed to evaluate this association.DesignA systematic review and meta-analysis of published studies were performed.Data sourceWe systematically searched the Medline and Embase databases for relevant clinical studies. The last literature search in databases was performed in June 2020.Eligibility criteria for study selectionWe included studies exploring the associations between CE and the outcomes of EVT in patients with AIS undergoing EVT.Data extraction and synthesisTwo reviewers extracted relevant information and data from each article independently. We pooled ORs with CIs using a random-effects meta-analysis to calculate the associations between CE and outcomes of EVT. The magnitude of heterogeneity between estimates was quantified with the I2 statistic with 95% CIs.ResultsFifteen observational studies that enrolled 1897 patients were included. Patients with CE had higher risks of poor functional outcome at discharge (2.38, 95% CI 1.45 to 3.89 p=0.001; n=545) and poor functional outcome at 90 days (OR 2.16, 95% CI 1.20 to 3.90; n=1194). We found no association between CE and in-hospital mortality (OR 0.95, 95% CI 0.27 to 3.30; n=376) or 90-day mortality (OR 1.38, 95% CI 0.81 to 2.36; n=697) after EVT. Moreover, CE was associated with higher risks of post-EVT intracranial haemorrhage (ICH) (OR 6.68, 95% CI 3.51 to 12.70; n=1721) and symptomatic ICH (OR 3.26, 95% CI 1.97 to 5.40; n=1092).ConclusionsThis systematic review and meta-analysis indicates that in patients with AIS undergoing EVT, CE is associated with higher risks of unfavourable functional outcomes and ICH. Thus, we should pay more attention to CE in patients with AIS undergoing EVT.

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Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials

Physiotherapy ◽

10.1016/j.physio.2020.08.002 ◽

2020 ◽

Vol 109 ◽

pp. 43-53

Author(s):

Lucas Rodrigues Nascimento ◽

Layla Alvarenga da Silva ◽

João Victor Matos Araújo Barcellos ◽

Luci Fuscaldi Teixeira-Salmela

Keyword(s):

Systematic Review ◽

Electrical Stimulation ◽

Functional Electrical Stimulation ◽

Walking Speed ◽

Controlled Trials ◽

Foot Orthoses ◽

Continuous Functional ◽

Randomized Controlled ◽

Ankle Foot Orthoses ◽

Meta Analyses

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Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044771 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044771

Author(s):

Jeremiah Hadwen ◽

Woojin Kim ◽

Brian Dewar ◽

Tim Ramsay ◽

Alexandra Davis ◽

...

Keyword(s):

Systematic Review ◽

Insulin Resistance ◽

Ischaemic Stroke ◽

Functional Outcome ◽

Recurrent Stroke ◽

Meta Analysis ◽

Secondary Outcome ◽

Stroke Outcome ◽

Post Stroke ◽

Meta Analyses

IntroductionInsulin resistance is an independent risk factor for atherosclerosis, coronary artery disease and ischaemic stroke. Currently, insulin resistance is not usually included in post-stroke risk stratification. This systematic review and meta-analysis intends to determine if available scientific knowledge supports an association between insulin resistance and post-stroke outcomes in patients without diabetes.Methods and analysisThe authors will conduct a literature search in Medline, Embase, Web of Science and Cochrane Central. The review will include studies that assess the association between elevated insulin homeostasis model of insulin resistance (HOMA-IR) and post-stroke outcome (functional outcome and recurrent stroke). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines will be used. The primary outcome will be post-stroke functional outcome (Modified Rankin Scale), and the secondary outcome will be recurrent ischaemic stroke. Comparison of outcome will be made between highest and lowest HOMA-IR range (as defined in each article included in this systematic review). Risk of bias will be assessed qualitatively. Meta-analysis will be performed if sufficient homogeneity exists between studies. Heterogeneity of outcomes will be assessed by I².Ethics and disseminationNo human or animal subjects or samples were/will be used. The results will be published in a peer-reviewed journal, and will be disseminated at local and international neurology conferences.PROSPERO registration numberCRD42020173608.

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Isolated Posterior Cruciate Reconstruction Results in Improved Functional Outcome but Low Rates of Return to Preinjury Level of Sport: A Systematic Review and Meta-analysis

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118804478 ◽

2018 ◽

Vol 6 (10) ◽

pp. 232596711880447 ◽

Cited By ~ 3

Author(s):

Brian M. Devitt ◽

Ruchith Dissanayake ◽

Joseph Clair ◽

Richard J. Napier ◽

Tabitha J. Porter ◽

...

Keyword(s):

Systematic Review ◽

Functional Outcome ◽

Meta Analysis ◽

Rates Of Return

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Arthroscopic debridement has lower re-operation rates than arthrotomy in the treatment of acute septic arthritis of the knee: a meta-analysis

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine ◽

10.1136/jisakos-2018-000269 ◽

2019 ◽

Vol 4 (6) ◽

pp. 307-312

Author(s):

Taufiq Panjwani ◽

Keng Lin Wong ◽

Si Heng Sharon Tan ◽

Glen Liau ◽

Narendra Vaidya ◽

...

Keyword(s):

Systematic Review ◽

Relative Risk ◽

Knee Joint ◽

Septic Arthritis ◽

Functional Outcome ◽

Meta Analysis ◽

Cochrane Central Register ◽

Arthroscopic Debridement ◽

Pertinent Data ◽

Operation Rate

ImportanceSeptic arthritis of the native knee joint is the most common bacterial joint infection. The management involves prompt surgical debridement and joint irrigation by arthroscopy or arthrotomy. This is the first systematic review and meta-analysis to compare arthroscopic debridement with arthrotomy for septic arthritis of native knee joint.ObjectiveThe purpose of this systematic review and meta-analysis is to compare re-operation rates, length of inpatient hospital stay (LOS) and functional outcome between arthroscopy and arthrotomy in the treatment of acute septic arthritis of the native knee joint.Evidence reviewThis study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase and Cochrane Central Register of Controlled Trials databases were searched from database inception to 31 May 2019. All original studies that compared re-operation rates and LOS between arthroscopy and arthrotomy for septic arthritis of knee were included. The research question and eligibility criteria were established a priori. Pertinent data were extracted and random-effects model was used to pool the data where possible.FindingsA total of seven studies with 1089 knees were included, of which 723 underwent arthroscopic surgery and 366 knees underwent arthrotomy. The relative risk of re-operation was significantly lower in the arthroscopy group with a pooled relative risk of 0.69 (95% CI 0.56 to 0.86; p=0.0006). All studies reported shorter LOS and one study reported better functional outcomes in the arthroscopy group as compared with arthrotomy. However, the data could not be quantitatively synthesised due to variation in reporting among the studies included.Conclusions and relevanceBased on the available evidence, we conclude that arthroscopy for the treatment of septic arthritis of the knee results in a lower re-operation rate than arthrotomy. It cannot be concluded whether arthroscopic treatment results in shorter LOS or better functional outcome as compared with arthrotomy.Level of evidenceIV

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