Effectiveness of infantile tuina for improving motor dysfunction in children with spastic cerebral palsy: A systematic review and meta-analysis of randomized controlled trials

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine Pub Date : 2024-06-26 DOI:10.1016/j.eujim.2024.102382

Zicheng Wei , Zhen Liu , Hongjiao Wu , Kaizheng Wang , Shuang Wu , Lijiang Lv , Zhizhen Lv

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引用次数: 0

Abstract

Introduction

Infantile cerebral palsy (ICP) is a disease that causes cognitive and motor dysfunction in children, severely affecting their growth and mental health. Infantile tuina is a prominent treatment modality in traditional Chinese medicine (TCM). However, the effectiveness of infantile tuina remains uncertain. This systematic review aimed to assess the efficacy of infantile tuina in enhancing motor dysfunction in ICP through randomized controlled trials (RCTs).

Methods

We completed the meta-analysis according to the PRISMA 2020 checklist. Randomized controlled trials (RCTs) were searched for in seven databases including Medline, Ovid EMBASE, Cochrane Library, Web of Science, China national knowledge infrastructure, Chinese biomedical literature, and Wan Fang from the establishment of the database until November 7, 2023. The effectiveness of infantile tuina to treat motor dysfunction in children with spastic cerebral palsy was evaluated using outcome indexes such as effective rate, Gross motor function measure (GMFM), Modified Ashworth Scale (MAS), and ankle passive dorsiflexion angle.

Results

A total of 12 RCTs were included in this systematic review, which included 950 patients. Meta-analysis of the results indicated that infantile tuina combined with conventional rehabilitation treatment for ICP produced better results than conventional rehabilitation treatment alone. The experimental group intervention had a significant effect on the improvement of ICP treatment efficiency [Relative Risk (RR) = 1.21; 95% Confidence Interval (CI) = 1.10, 1.33], GMFM [MD = 4.76, 95% CI = 3.23, 3.29], MAS [Mean difference (MD) = -0.83, 95% CI = -1.02, -0.64], and ankle dorsiflexion angle [MD = -4.82, 95% CI = -7.45, -2.18]. The results were statistically significant (P < 0.05).

Conclusions

As a complementary therapy to conventional rehabilitation therapy, infantile tuina produced significant improvements in ICP treatment effectiveness in this systematic review. The main limitation in the evidence was a lack of high-quality studies and many studies had small sample sizes.

Registration

PROSPERO ID: CRD42023446889.

查看原文本刊更多论文

婴儿推拿对改善痉挛性脑瘫儿童运动功能障碍的效果：随机对照试验的系统回顾和荟萃分析

导言小儿脑瘫（ICP）是一种导致儿童认知和运动功能障碍的疾病，严重影响儿童的生长发育和心理健康。小儿推拿是传统中医的一种重要治疗方法。然而，小儿推拿的有效性仍不确定。本系统综述旨在通过随机对照试验（RCTs）评估婴幼儿推拿在改善 ICP 运动功能障碍方面的疗效。我们在 Medline、Ovid EMBASE、Cochrane Library、Web of Science、中国国家知识基础设施、中国生物医学文献和万方等 7 个数据库中检索了自数据库建立以来至 2023 年 11 月 7 日的随机对照试验（RCT）。采用有效率、大运动功能测量（GMFM）、改良阿什沃斯量表（MAS）和踝关节被动外展角度等结果指标评价小儿推拿治疗痉挛性脑瘫患儿运动功能障碍的有效性。元分析结果表明，小儿推拿与传统康复治疗相结合治疗ICP的效果优于单纯的传统康复治疗。实验组干预对ICP治疗有效率[相对风险（RR）=1.21；95%置信区间（CI）=1.10，1.33]、GMFM[MD=4.76，95%CI=3.23，3.29]、MAS[平均差（MD）=-0.83，95%CI=-1.02，-0.64]和踝关节背屈角度[MD=-4.82，95%CI=-7.45，-2.18]的改善有显著效果。结论作为传统康复治疗的一种辅助疗法，小儿推拿在本系统综述中显著改善了ICP的治疗效果。证据的主要局限性在于缺乏高质量的研究，而且许多研究的样本量较小：CRD42023446889。

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来源期刊

European Journal of Integrative Medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

4.70

自引率

4.00%

发文量

102

审稿时长

33 days

期刊介绍： The European Journal of Integrative Medicine (EuJIM) considers manuscripts from a wide range of complementary and integrative health care disciplines, with a particular focus on whole systems approaches, public health, self management and traditional medical systems. The journal strives to connect conventional medicine and evidence based complementary medicine. We encourage submissions reporting research with relevance for integrative clinical practice and interprofessional education. EuJIM aims to be of interest to both conventional and integrative audiences, including healthcare practitioners, researchers, health care organisations, educationalists, and all those who seek objective and critical information on integrative medicine. To achieve this aim EuJIM provides an innovative international and interdisciplinary platform linking researchers and clinicians. The journal focuses primarily on original research articles including systematic reviews, randomized controlled trials, other clinical studies, qualitative, observational and epidemiological studies. In addition we welcome short reviews, opinion articles and contributions relating to health services and policy, health economics and psychology.