Faculty Opinions recommendation of Effect of low-frequency rTMS on aphasia in stroke patients: a meta-analysis of randomized controlled trials.

There are numerous trials, showing positive results for using the music therapy for stroke patient rehabilitation. Therefore, summarizing the data from these trials is an actual topic. The objective, of this research, was to summarize the data from trials about the use of music therapy methods and techniques, especially the rhythmic auditory stimulation, for improving of the motor functions for stroke patients, by creating a systematic review of randomized controlled trials, with meta-analysis. The trials where searched in MEDLINE, Cochrane Trial Register and EBSO databases. The trial quality was evaluated by the PEDro scale. 20 randomized controlled trials were included in the systematic review. The meta-analysis for 5 gait outcomes, including gait speed, steps per minute, step length, gait symmetry, Time up and go test, and 7 arm function outcomes, including Fugl-Meyer test, ARAT test, Box and blocks test, Wolf motor function test, Nine hole peg test, shoulder flexion, elbow extension, was conducted. According to the results of the meta-analysis, gait exercises, combined with rhythmic auditory stimulation, provide statistically significant improvement, compared with gait exercises alone. Concerning the use of rhythmic auditory stimulation and other music therapy interventions for arm function rehabilitation, a statistically significant improvement was not detected.

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Individual Patient Data Meta-Analysis of Randomized Controlled Trials of Community Occupational Therapy for Stroke Patients

Stroke ◽

10.1161/01.str.0000137766.17092.fb ◽

2004 ◽

Vol 35 (9) ◽

pp. 2226-2232 ◽

Cited By ~ 72

Author(s):

M.F. Walker ◽

J. Leonardi-Bee ◽

P. Bath ◽

P. Langhorne ◽

M. Dewey ◽

...

Keyword(s):

Occupational Therapy ◽

Randomized Controlled Trials ◽

Individual Patient Data ◽

Meta Analysis ◽

Patient Data ◽

Controlled Trials ◽

Stroke Patients ◽

Randomized Controlled

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The Impact of Immersive and Non-Immersive Virtual Reality Trends in Sensorimotor Recovery of Post-Stroke Patients-A Meta-Analysis

Journal of Intellectual Disability - Diagnosis and Treatment ◽

10.6000/2292-2598.2021.09.05.14 ◽

2021 ◽

Vol 9 (5) ◽

pp. 555-564

Author(s):

Jaza Rizvi ◽

◽

Abid Khan ◽

Sumaira Imran Farooqui ◽

Bashir Ahmed Soomro ◽

...

Keyword(s):

Virtual Reality ◽

Randomized Controlled Trials ◽

Meta Analysis ◽

Cochrane Library ◽

Controlled Trials ◽

Stroke Patients ◽

Post Stroke ◽

Randomized Controlled ◽

Sensorimotor Recovery ◽

The Impact

Virtual Reality (VR) is an approach in stroke rehabilitation with ever-improving technological advancement for targeted motor rehabilitation by providing a user interface in a simulated environment with proprioceptive and visual feedback. This meta-analysis intended to evaluate the impact of immersive and non-immersive VR-based interventions compared to conventional rehabilitation in sensorimotor recovery following stroke. Randomized Controlled Trials based on the impact of VR, either immersive or non-immersive type in comparison to conventional rehabilitation on post-stroke patients (>18 years) sensorimotor recovery were searched on six databases including Google Scholar, PEDro, MEDLINE, Cochrane Library, EMBASE, and Web of Science from August to November 2020. A total of 17 randomized controlled trials on VR based intervention showed significant improvement in sensorimotor recovery following a stroke in overall FMA outcomes in comparison to the control group with pool effects in terms of SMD in a random effect model showed an impact of 0.498 at 95% CI (p<0.001) depicts a moderate effect size. An immersive and non-immersive emerging VR trend appears to be a promising therapeutic tool in sensorimotor recovery following stroke.

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Percutaneous Closure versus Medical Therapy Alone for Cryptogenic Stroke Patients with a Patent Foramen Ovale: Meta-Analysis of Randomized Controlled Trials

Texas Heart Institute Journal ◽

10.14503/thij-13-3879 ◽

2014 ◽

Vol 41 (4) ◽

pp. 357-367 ◽

Cited By ~ 20

Author(s):

Christopher A. Pickett ◽

Todd C. Villines ◽

Michael A. Ferguson ◽

Edward A. Hulten

Keyword(s):

Randomized Controlled Trials ◽

Medical Therapy ◽

Meta Analysis ◽

Cryptogenic Stroke ◽

Controlled Trials ◽

Number Needed To Treat ◽

Foramen Ovale ◽

Stroke Patients ◽

Randomized Controlled ◽

Pfo Closure

Of cryptogenic stroke patients younger than 55 years of age, up to 61% have had a patent foramen ovale (PFO). Observational studies have revealed reductions in recurrent neurologic events through PFO closure versus medical therapy, and randomized controlled trials have shown nonsignificant trends toward benefit. We systematically searched for randomized controlled trials of percutaneous PFO closure with medical therapy versus medical therapy alone in patients with cryptogenic stroke and performed a meta-analysis of treatment outcomes. The primary endpoint was combined death, stroke, and transient ischemic attack. We included 3 trials. Of 2,303 total patients, 1,150 underwent PFO closure and 1,153 received medical therapy (median follow-up period, 2.6 yr). The pooled incidence of the primary endpoint was 1.2 events per 100 patient-years in the closure group (95% confidence interval [CI], 0.2–2.3) and 1.8 in the therapy group (95% CI, 0.7–2.9) (P=0.32); the number needed to treat was 167 (range, 100–500). The corresponding pooled hazard ratio was 0.67 (95% CI, 0.44–1.01; P=0.054) in favor of closure. Closure was associated with an increased risk of atrial fibrillation: relative risk=3.51 (95% CI, 1.44–8.55; P=0.006). When stratified by device, use of the Amplatzer™ PFO Occluder resulted in significant stroke-prevention benefit over medical therapy alone: hazard ratio=0.44 (95% CI, 0.21–0.95; P=0.037). When compared with medical therapy alone, PFO closure with medical therapy showed a trend toward a decreased hazard of combined events, although the absolute event reduction was small and the number needed to treat was high.

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Effect of Buyang Huanwu decoction for the rehabilitation of ischemic stroke patients: a meta-analysis of randomized controlled trials

Health and Quality of Life Outcomes ◽

10.1186/s12955-021-01728-6 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Li Gao ◽

Zhuoran Xiao ◽

Chunhua Jia ◽

Wei Wang

Keyword(s):

Ischemic Stroke ◽

Randomized Controlled Trials ◽

Clinical Efficacy ◽

Meta Analysis ◽

Controlled Trials ◽

Efficacy And Safety ◽

Stroke Patients ◽

Buyang Huanwu Decoction ◽

Randomized Controlled ◽

Clinical Recommendation

Abstract Purpose Buyang Huanwu decoction (BHD) is a widely used traditional Chinese medicine for the rehabilitation of ischemic stroke patients in China, but its clinical efficacy and safety have not been adequately assessed. In this paper, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of BHD. Methods We searched seven electronic databases from inception to 31 March 2019. The language was limited to Chinese and English. Randomized controlled trials evaluating the efficacy and safety of BHD for the rehabilitation of ischemic stroke patients were included in the meta-analysis. Reviewers independently performed the screening, data extraction, bias assessment, and data analysis. The treatment efficacy was pooled in a meta-analysis using RevMan 5.3 software with a random-effect model. Any disagreement was resolved by discussion among all reviewers. The PRISMA statement was used in the review process. Results A total of 11 studies with 1084 patients were included in the meta-analysis. The results suggested that BHD was superior to other treatments in terms of clinical efficacy in symptoms and daily activities (n = 684, RR = 1.12, 95% CI: 0.99 to 1.27), clinical efficacy in TCM symptoms (n = 280, RR = 1.45, 95% CI: 1.03 to 2.03), National Institute of Health stroke scale (n = 192, MD = 1.66, 95% CI: -1.08 to 4.40), and activities of daily living (n = 200, MD = 8.20, 95% CI: -3.95 to 20.35). Conclusions The results supported the clinical use of BHD for the rehabilitation of ischemic stroke patients. However, the methodological qualities of the included studies were relatively low, and there were limited reports on adverse events. The clinical efficacy and safety of BHD need to be further confirmed by more well-designed and high-quality randomized controlled trials to warrant the clinical recommendation of BHD for the rehabilitation of ischemic stroke patients.

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Efficacy and Safety of Acupuncture at Tianshu (ST25) for Functional Constipation: Evidence from 10 Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/2171587 ◽

2020 ◽

Vol 2020 ◽

pp. 1-14

Author(s):

Pengfan Li ◽

Yue Luo ◽

Qi Wang ◽

Shi Shu ◽

Kanjun Chen ◽

...

Keyword(s):

Randomized Controlled Trials ◽

High Frequency ◽

Meta Analysis ◽

Low Frequency ◽

Functional Constipation ◽

Colonic Transit ◽

Controlled Trials ◽

Efficacy And Safety ◽

Randomized Controlled ◽

Dilatational Wave

Objective. To evaluate the evidence for the efficacy and safety of acupuncture at Tianshu (ST25) for functional constipation (FC). Methods. We systematically searched seven databases to identify randomized controlled trials of acupuncture at ST25 alone or in combination with conventional therapy in the treatment of FC. Risk ratios (RRs) and mean differences (MDs) were calculated using RevMan 5.3 with 95% confidence interval (CI). Results. The study included ten trials with 1568 participants. Meta-analysis showed that the Cleveland Constipation Score (CCS) for deep needling was significantly lower than that for lactulose (deep needling with low-frequency dilatational wave: MD −0.58, 95% CI −0.94 to −0.22; deep needling with sparse wave: MD −3.67, 95% CI −6.40 to −0.94; deep needling with high-frequency dilatational wave: MD −3.42, 95% CI −5.03 to −1.81). Furthermore, CCS for shallow needling with high-frequency dilatational wave was lower than that for lactulose (MD −1.77, 95% CI −3.40 to −0.14). In addition, when deep needling was combined with high-frequency dilatational wave, the weekly frequency of spontaneous defecation (FSD) was significantly higher than that for lactulose (MD 1.57, 95% CI 0.93 to 2.21). Colonic Transit Time (CTT) scores were significantly higher when deep needling was combined with sparse wave (MD −14.36, 95% CI −18.31 to −10.41) or high-frequency dilatational wave (MD −11.53, 95% CI −19.25 to −3.81). The time of first defecation after treatment (TFD) of the shallow needling therapy was significantly longer than that of the lactulose (MD 13.67, 95% CI 5.66 to 21.67). The CCS 6 months after treatment (CCS6m) for deep needling was significantly lower than that for lactulose (MD −4.90, 95% CI −5.97 to −3.84). Moreover, the FSD 6 months after treatment (FSD6m) for shallow needling was significantly higher than that for lactulose (MD 0.49, 95% CI 0.02 to 0.97). The adverse event (AE) rate for lactulose was significantly higher than that achieved with the needling treatments, and this held true for both deep needling therapy (RR 0.41, 95% CI 0.23 to 0.72) and shallow needling therapy (RR 0.33, 95% CI 0.15 to 0.77). Conclusions. The meta-analysis demonstrates that acupuncture at ST25 appears to be more effective than lactulose in the treatment of functional constipation. This was found to be especially true for deep needling with high-frequency dilatational wave, which had a greater impact on improving CCS, FSD, CTT, and CCS6m. Additionally, acupuncture at ST25 was shown to be safer than conventional treatment, with the rate of AE being significantly lower for both deep needling and shallow needling. The trial is registered with https://www.crd.york.ac.uk/prospero/(CRD42019141017)).

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