比较不同穴位刺激疗法对缓解老年中风幸存者中风后痉挛和运动功能障碍的效果:随机试验网络荟萃分析

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Guan-Cheng Zhu , Kuei-Min Chen , Frank Belcastro
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引用次数: 0

摘要

穴位刺激疗法通常用于控制中风相关的痉挛和运动功能障碍。然而,不同穴位刺激疗法对老年中风幸存者的影响尚不明确。本系统综述和网络荟萃分析比较了不同穴位刺激疗法对老年中风患者痉挛和运动功能障碍的治疗效果。该研究遵循了《系统综述和荟萃分析首选报告项目》指南。我们检索了 7 个数据库中截至 2023 年 7 月发表的研究。纳入标准为(1) 中风患者为老年人;(2) 治疗方法为穴位刺激疗法;(3) 对照组未接受穴位刺激疗法,或研究比较了不同的穴位刺激疗法;(4) 结果包括痉挛和运动功能。我们使用随机试验风险偏倚工具(Risk-of-bias tool for randomized trials version 2)对方法学质量进行了评估,并使用 R 和 Metainsight 进行了网络荟萃分析。我们对27项研究进行了分析,结果显示非侵入性电针和温针灸比传统针灸(标准化平均差和95%置信区间=1.35/1.19 [0.57;2.13/0.54;1.83])和侵入性电针(标准化平均差和95%置信区间=0.96/0.80 [0.12;1.80/0.08;1.51])更能有效减轻痉挛。传统针灸和有创电针对改善运动功能有效(标准化平均差和 95 % 置信区间 = 0.99/1.41 [0.42; 1.56/0.54; 2.28])。然而,不同研究之间有创电针的效果存在明显的不一致性。我们的研究结果表明,对于患有痉挛的老年中风幸存者,无创电针和温针灸是合适的,而传统针灸更适合以运动恢复为目标的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparing the effects of different acupoint-stimulating therapies in mitigating post-stroke spasticity and motor dysfunction in older stroke survivors: A network meta-analysis of randomized trials

Acupoint-stimulating therapies have often been used to manage stroke-related spasticity and motor dysfunction. However, the effects of different acupoint-stimulating therapies in older stroke survivors have been unclear. This systematic review and network meta-analysis compared the effects of different acupoint-stimulating therapies in managing spasticity and motor dysfunction in older stroke survivors. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched 7 databases for studies published up to July 2023. Inclusion criteria were: (1) older adults with strokes; (2) treatments were acupoint-stimulating therapies; (3) a control group did not receive acupoint-stimulating therapy, or the study compared different acupoint-stimulating therapies; and (4) outcomes included spasticity and motor function. Methodological quality was assessed with Risk-of-bias tool for randomized trials version 2, while R and Metainsight were used to conduct the network meta-analysis. We analyzed 27 studies and the results showed that non-invasive electroacupuncture and warm acupuncture were more effective in reducing spasticity than conventional acupuncture (standardized mean difference and 95 % confidence intervals = 1.35/1.19 [0.57; 2.13/0.54; 1.83]) and invasive electroacupuncture (standardized mean difference and 95 % confidence intervals = 0.96/0.80 [0.12; 1.80/0.08; 1.51]). Conventional acupuncture and invasive electroacupuncture were effective in improving motor function (standardized mean difference and 95 % confidence intervals = 0.99/1.41 [0.42; 1.56/0.54; 2.28]). However, there was significant inconsistency for the effects of invasive electroacupuncture between studies. Our findings suggest that for older stroke survivors with spasticity, non-invasive electroacupuncture and warm acupuncture are appropriate, whereas conventional acupuncture is more appropriate for patients aiming for motor recovery.

Systematic review registration

This study was registered in the PROSPERO database (CRD42023442202).

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CiteScore
7.20
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