{"title":"远程医疗干预对脑卒中后认知障碍患者认知功能的影响：一项系统综述和荟萃分析。","authors":"Qiqing Zhong, Yifan Wu, Shengze Zhi, Shuyan Fang, Mengyuan Li, Jiaxin Li, Huizhen Zhang, Jianing Lang, Rui Wang, Jiao Sun","doi":"10.1177/1357633X251357996","DOIUrl":null,"url":null,"abstract":"<p><p>BackgroundPost-stroke cognitive impairment is characterized by cognitive dysfunction occurring within 6 months post-stroke. Telemedicine uses communication technologies to deliver healthcare remotely and has shown efficacy in improving cognitive impairment. However, a systematic review specifically evaluating telemedicine's effects on cognitive outcomes in post-stroke cognitive impairment is lacking.ObjectivesThis systematic review aimed to examine the effectiveness of telemedicine interventions for cognitive function in post-stroke cognitive impairment.MethodsA comprehensive search was performed across 10 electronic databases, including PubMed, Web of Science, CINAHL, EMBASE, Cochran library, Scopus, and ProQuest Dissertations and three Chinese-language databases (CNKI, Wan Fang, and Vip) from their respective inception dates to May 2025. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Meta-analysis was performed by the use of Review Manager 5.3 and Stata 15.ResultsThe initial search yielded 10,365 articles, with 19 studies included in the systematic review. The results showed that telemedicine interventions had a significant moderate effect on global cognition (standardized mean difference (SMD = 0.69, <i>Z</i> = 4.23, <i>P</i> < 0.01) and significantly improved visuospatial function (SMD = 0.57, <i>Z</i> = 2.76, <i>P</i> < 0.05) and language (SMD = 0.62, <i>Z</i> = 2.59, <i>P</i> < 0.05). Sub-group analyses showed significant effects for both online tools or computer software and mobile apps, though high heterogeneity was noted. Additionally, telemedicine interventions had a significant effect on activities of daily living (SMD = 0.64, <i>Z</i> = 5.16, <i>P</i> < 0.01).ConclusionConsidering the obstacles and limitations of traditional face-to-face rehabilitation, telemedicine is an effective approach for treating post-stroke cognitive impairment that can significantly improve cognitive function. Future studies should address heterogeneity through rigorous designs, long-term follow-ups, neuroimaging, and biomarker integration to elucidate underlying mechanisms.The protocol was registered on PROSPERO (CRD42024502185).</p>","PeriodicalId":50024,"journal":{"name":"Journal of Telemedicine and Telecare","volume":" ","pages":"1357633X251357996"},"PeriodicalIF":3.5000,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of telemedicine interventions on cognitive function in post-stroke cognitive impairment: A systematic review and meta-analysis.\",\"authors\":\"Qiqing Zhong, Yifan Wu, Shengze Zhi, Shuyan Fang, Mengyuan Li, Jiaxin Li, Huizhen Zhang, Jianing Lang, Rui Wang, Jiao Sun\",\"doi\":\"10.1177/1357633X251357996\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>BackgroundPost-stroke cognitive impairment is characterized by cognitive dysfunction occurring within 6 months post-stroke. Telemedicine uses communication technologies to deliver healthcare remotely and has shown efficacy in improving cognitive impairment. However, a systematic review specifically evaluating telemedicine's effects on cognitive outcomes in post-stroke cognitive impairment is lacking.ObjectivesThis systematic review aimed to examine the effectiveness of telemedicine interventions for cognitive function in post-stroke cognitive impairment.MethodsA comprehensive search was performed across 10 electronic databases, including PubMed, Web of Science, CINAHL, EMBASE, Cochran library, Scopus, and ProQuest Dissertations and three Chinese-language databases (CNKI, Wan Fang, and Vip) from their respective inception dates to May 2025. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Meta-analysis was performed by the use of Review Manager 5.3 and Stata 15.ResultsThe initial search yielded 10,365 articles, with 19 studies included in the systematic review. The results showed that telemedicine interventions had a significant moderate effect on global cognition (standardized mean difference (SMD = 0.69, <i>Z</i> = 4.23, <i>P</i> < 0.01) and significantly improved visuospatial function (SMD = 0.57, <i>Z</i> = 2.76, <i>P</i> < 0.05) and language (SMD = 0.62, <i>Z</i> = 2.59, <i>P</i> < 0.05). Sub-group analyses showed significant effects for both online tools or computer software and mobile apps, though high heterogeneity was noted. Additionally, telemedicine interventions had a significant effect on activities of daily living (SMD = 0.64, <i>Z</i> = 5.16, <i>P</i> < 0.01).ConclusionConsidering the obstacles and limitations of traditional face-to-face rehabilitation, telemedicine is an effective approach for treating post-stroke cognitive impairment that can significantly improve cognitive function. Future studies should address heterogeneity through rigorous designs, long-term follow-ups, neuroimaging, and biomarker integration to elucidate underlying mechanisms.The protocol was registered on PROSPERO (CRD42024502185).</p>\",\"PeriodicalId\":50024,\"journal\":{\"name\":\"Journal of Telemedicine and Telecare\",\"volume\":\" \",\"pages\":\"1357633X251357996\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-07-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Telemedicine and Telecare\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/1357633X251357996\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Telemedicine and Telecare","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/1357633X251357996","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0
摘要
脑卒中后认知障碍的特征是脑卒中后6个月内出现认知功能障碍。远程医疗使用通信技术远程提供医疗保健，并已显示出改善认知障碍的功效。然而，缺乏专门评估远程医疗对脑卒中后认知障碍患者认知结果影响的系统综述。目的本系统综述旨在探讨远程医疗干预脑卒中后认知功能障碍的有效性。方法综合检索PubMed、Web of Science、CINAHL、EMBASE、Cochran library、Scopus、ProQuest Dissertations等10个电子数据库和3个中文数据库（CNKI、万方、Vip），检索时间从各自数据库成立日期至2025年5月。本综述遵循系统评价和荟萃分析的首选报告项目。meta分析采用Review Manager 5.3和Stata 15进行。最初的搜索产生了10365篇文章，其中19项研究被纳入了系统综述。结果显示，远程医疗干预对整体认知（标准化平均差）有显著的中等影响（SMD = 0.69, Z = 4.23, P Z = 2.76, P Z = 2.59, P Z = 5.16, P Z = 2.76）
Effects of telemedicine interventions on cognitive function in post-stroke cognitive impairment: A systematic review and meta-analysis.
BackgroundPost-stroke cognitive impairment is characterized by cognitive dysfunction occurring within 6 months post-stroke. Telemedicine uses communication technologies to deliver healthcare remotely and has shown efficacy in improving cognitive impairment. However, a systematic review specifically evaluating telemedicine's effects on cognitive outcomes in post-stroke cognitive impairment is lacking.ObjectivesThis systematic review aimed to examine the effectiveness of telemedicine interventions for cognitive function in post-stroke cognitive impairment.MethodsA comprehensive search was performed across 10 electronic databases, including PubMed, Web of Science, CINAHL, EMBASE, Cochran library, Scopus, and ProQuest Dissertations and three Chinese-language databases (CNKI, Wan Fang, and Vip) from their respective inception dates to May 2025. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Meta-analysis was performed by the use of Review Manager 5.3 and Stata 15.ResultsThe initial search yielded 10,365 articles, with 19 studies included in the systematic review. The results showed that telemedicine interventions had a significant moderate effect on global cognition (standardized mean difference (SMD = 0.69, Z = 4.23, P < 0.01) and significantly improved visuospatial function (SMD = 0.57, Z = 2.76, P < 0.05) and language (SMD = 0.62, Z = 2.59, P < 0.05). Sub-group analyses showed significant effects for both online tools or computer software and mobile apps, though high heterogeneity was noted. Additionally, telemedicine interventions had a significant effect on activities of daily living (SMD = 0.64, Z = 5.16, P < 0.01).ConclusionConsidering the obstacles and limitations of traditional face-to-face rehabilitation, telemedicine is an effective approach for treating post-stroke cognitive impairment that can significantly improve cognitive function. Future studies should address heterogeneity through rigorous designs, long-term follow-ups, neuroimaging, and biomarker integration to elucidate underlying mechanisms.The protocol was registered on PROSPERO (CRD42024502185).
期刊介绍：
Journal of Telemedicine and Telecare provides excellent peer reviewed coverage of developments in telemedicine and e-health and is now widely recognised as the leading journal in its field. Contributions from around the world provide a unique perspective on how different countries and health systems are using new technology in health care. Sections within the journal include technology updates, editorials, original articles, research tutorials, educational material, review articles and reports from various telemedicine organisations. A subscription to this journal will help you to stay up-to-date in this fast moving and growing area of medicine.
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