动作观察疗法对脑卒中患者认知功能的影响：系统回顾和meta分析

IF 2.6 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior Pub Date : 2025-04-21 DOI:10.1002/brb3.70474

Xuewei Guan, Meijuan Lan, Leiwen Tang, Hongyan Yang, Yuanyuan Chen, Lan Ge, Yumei Zhong

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引用次数: 0

摘要

动作观察疗法（Action Observation Therapy， AOT）是一种激活镜像神经元系统的康复方法，可能有助于认知功能的恢复。由于不同的干预特征，以往的研究显示出不同的结果。本文将探讨AOT对脑卒中患者临床认知功能的影响。方法：采用随机对照试验（rct）比较AOT与非AOT干预对认知功能的影响。检索的数据库包括PubMed、Cochrane Library、Embase、Web of Science、EBSCO、CNKI、万方、VIP数据库，检索时间从成立到2024年5月6日。采用Cochrane's risk of bias Assessment Tool 2.0评估偏倚风险，采用GRADE方法评估证据质量。meta分析采用RevMan 5.4和Stata 18.0。在对认知功能进行分析后，进行meta回归以探索异质性的可能来源。随机效应荟萃分析模型采用反方差和Hartung-Knapp方法计算合并估计和95%置信区间（CI）值。我们检查了漏斗图，并使用Egger回归检验来评估发表偏倚。本研究按照PRISMA报告指南（附录S1）进行。该搜索协议已在PROSPERO （CRD42024571694）中前瞻性注册。结果：共纳入6项随机对照试验，共400名受试者。所有纳入的文章均被评为b级质量。荟萃分析显示，辅助治疗可显著改善脑卒中患者的认知功能。meta回归未发现异质性的来源。GRADE结果表明该发现的确定性非常低。结论：基于AOT的认知干预可改善脑卒中患者的认知功能。然而，由于异质性和低确定性，应谨慎解释。为了加强循证实践，我们提倡采用更高质量和更均匀的随机对照试验，包括严格的随机化程序、大样本量、延长随访期和专注于特定疾病亚型的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta-Analysis

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Efficacy of Action Observation Therapy on Cognitive Function in Stroke: A Systematic Review and Meta-Analysis

Introduction: Action Observation Therapy (AOT) is a rehabilitation method believed to activate the mirror neuron system, which may contribute to cognitive recovery. Previous studies have shown varying results due to different intervention characteristics. This review will examine the efficacy of AOT on clinical cognitive function in stroke.

Methods: Randomized controlled trials (RCTs) comparing AOT with non-AOT interventions in cognitive function were included. Databases searched included PubMed, Cochrane Library, Embase, Web of Science, EBSCO, CNKI, WanFang, and VIP database from inception to May 6, 2024. The risk of bias was assessed using Cochrane's Risk of Bias Assessment Tool 2.0, and the quality of evidence was evaluated with the GRADE approach. RevMan 5.4 and Stata 18.0 were used for the meta-analysis. After the analysis of cognitive function, meta-regression was performed to explore the possible sources of heterogeneity. A random-effects meta-analysis model using the inverse-variance and Hartung–Knapp methods was used to calculate pooled estimates and 95% confidence interval (CI) values. We examined the funnel plot and used Egger's regression test to assess for publication bias. This study was conducted by PRISMA reporting guidelines (Appendix S1). The search protocol was prospectively registered in PROSPERO (CRD42024571694).

Results: A total of 6 RCTs with 400 participants were included. All the included articles were rated as having B-level quality. Meta-analysis showed that AOT significantly improved cognitive function in stroke. Meta-regression did not find the source of heterogeneity. The GRADE result indicated that the finding was of very low certainty.

Conclusions: Cognitive interventions based on AOT can improve cognitive function in stroke patients. However, it should be interpreted cautiously due to heterogeneity and low certainty. To strengthen evidence-based practices, we advocate for higher-quality and more homogeneous RCTs, including strict randomization procedures, large sample sizes, extended follow-up periods, and studies focused on specific disease subtypes.

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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