• 제목/요약/키워드: Meta-analysis.

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The Effectiveness of Acupuncture for Herpes Zoster: A Systematic Review and Meta-Analysis

  • Seong-Kyeong Choi;Jeong-Hyun Moon;Woo-Seok Jang;Jung-Eun Jang;Si-Hyun Park;Won-Suk Sung;Chan-Yung Jung;Byung-Kwan Seo;Seung-Deok Lee;Kyung-Ho Kim;Eun-Jung Kim
    • Journal of Acupuncture Research
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    • 제40권1호
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    • pp.16-34
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    • 2023
  • Herpes zoster (HZ) results from the reactivation of a varicella-zoster virus infection and is accompanied by moderate-to-severe pain in most patients. The most common treatment is medication; however, there are still limitations. Acupuncture reportedly has meaningful therapeutic effects and is a possible alternative option in HZ. However, no systematic reviews examining the use of acupuncture and electro-acupuncture (EA) alone have been published; in this study, we therefore aimed to systematically review those techniques. We searched for clinical trials of acupuncture and EA treatment for HZ up to October 2022. Trials that used acupuncture were included. Outcomes were visual analog scale (VAS) and effective rate. Secondary outcomes were time to pain relief, time to pain elimination, incrustation, decrustation, lastly incidence of post-herpetic neuralgia (PHN). In total, 22 randomized controlled trials were included in this research. Compared with conventional medication therapy, acupuncture was associated with a significant improvement in VAS, effective rate, and times to pain relief and elimination. Times to new blister cessation, incrustation, and decrustation (days) were significantly improved. Furthermore, the incidence rate of PHN was lower in acupuncture groups. The results suggest that acupuncture could be a reasonable treatment option for patients with HZ who suffer from pain and accompanying symptoms.

Volumetric measurement of the tongue and oral cavity with cone-beam computed tomography: A systematic review

  • Kannitha Alina, Aflah;Winny, Yohana;Fahmi, Oscandar
    • Imaging Science in Dentistry
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    • 제52권4호
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    • pp.333-342
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    • 2022
  • Purpose: The goal of this systematic review was to compare the use of cone-beam computed tomography (CBCT) with that of computed tomography (CT) for volumetric evaluations of the tongue and oral cavity. Materials and Methods: A search for articles was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. The PubMed, Scopus, ScienceDirect, and SAGE Journals databases were searched for articles published between 2011 and 2021. Articles were screened and assessed for eligibility. Screening involved checking for duplication, reading the title and abstract, and reading the full text. Results: The initial search retrieved 25,780 articles. Application of the eligibility criteria yielded 16 articles for qualitative analysis. Multiple uses of CBCT were identified. In several studies, researchers assessed the volumetric correlation between tongue and oral cavity volumes, as well as other parameters. Post-treatment volumetric evaluations of the oral cavity were also reported, and the reliability of CBCT was assessed. The use of CT resembled that of CBCT. Conclusion: CBCT has been used in the evaluation of tongue and oral cavity volumes to assess correlations between those volumes and with the upper airway. It has also been used for volumetric evaluation after surgical and nonsurgical procedures and to assess the relationships between tongue volume, tooth position, occlusion, and body mass index. Participants with obstructive sleep apnea and malocclusion have been evaluated, and the reliability of CBCT has been assessed. In the included studies, CT was utilized for similar purposes as CBCT, but its reliability was not assessed.

Effectiveness of Acupuncture and Acupotomy for Trigger Finger: A Systematic Review and Meta-Analysis

  • Hae-Won Hong;Myung-In Jeong;Hyun-Il Jo;Sun-Ho Lee;Ka-Hyun Kim;Sung-Won Choi;Jae-Won Park;Ji-Su Ha
    • Journal of Acupuncture Research
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    • 제40권2호
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    • pp.111-128
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    • 2023
  • Trigger finger is a common cause of hand disability that results in finger catching, clicking, or locking. Conventional treatment options such as medication, injection, and surgery have limitations. Studies have indicated that acupuncture and acupotomy can be effective in treating trigger finger. However, no review regarding these treatment modalities has been published yet. This review included randomized controlled trials published until January 2023, investigating acupuncture-related interventions. The primary outcomes of interest included the effectiveness rate (ER) and pain intensity, measured using a visual analog scale (VAS) and Numerical Rating Scale (NRS), and secondary outcomes were the Quinnell grade (QG) and recurrence rate (RR). Adverse events (AEs) have also been reported wherever available. Overall, 19 studies were included, and results demonstrated that arcedge acupuncture improved the ER and QG and reduced NRS, and acupuncture was effective in reducing VAS. Compared with conventional surgery, acupotomy alone improved the ER and QG and lowered VAS and RR, with relatively fewer AEs. Acupotomy add-on treatment was more effective than conventional treatment; however, careful interpretation is needed for VAS. Acupotomy add-on treatment was more effective than acupotomy alone. However, the overall results must be interpreted with caution because of study quality, small sample size, and heterogeneity of the results.

불면장애에 대한 부항요법의 체계적 문헌고찰 (A Systematic Review of Cupping Therapy for Insomnia Disorder)

  • 이정한;최미라;임정화;김보경
    • 동의신경정신과학회지
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    • 제34권3호
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    • pp.181-212
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    • 2023
  • Objectives: To examine the efficacy and safety of cupping therapy for insomnia disorder and provide clinical evidence that could contribute to further research. Methods: We searched randomized controlled trials (RCTs) that verified effects of cupping therapy for insomnia disorder from 11 domestic and foreign databases. Included studies were evaluated using Risk of Bias (RoB). Results: Nineteen RCTs were selected. Wet cupping was more frequently used than dry cupping. Moving cupping was mostly used among dry cupping methods. Dry cupping was mainly performed in Bladder Meridian on the back. Wet cupping was mainly performed on BL18, LR14, and BL15. The most common treatment period was 4 weeks. The average number of treatments per week was about 2.4 times for all types of cupping, about 3.2 times for dry cupping and about 1.9 times for wet cupping. All selected studies showed a significant sleep improvement compared to the control group. As a result of the meta-analysis, in terms of effective rate, SAS score, and SDS score, the wet cupping in combination with acupuncture was significantly more effective than acupuncture alone, although the quality of selected RCTs was low. Conclusions: Cupping therapy is effective for insomnia disorder. Based on results of this study, it is reasonable to use wet cupping two times per week on BL18, LR14, and BL15 or use moving cupping three times per week in Bladder Meridian on the back for 4 weeks to treat insomnia disorder.

Diagnostic accuracy of clinical tests to rule out elbow fracture: a systematic review

  • Giorgio Breda;Gianluca De Marco;Pierfranco Cesaraccio;Paolo Pillastrini
    • Clinics in Shoulder and Elbow
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    • 제26권2호
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    • pp.182-190
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    • 2023
  • Elbow traumas represent a relatively common condition in clinical practice. However, there is a lack of evidence regarding the most accurate tests for screening these potentially serious conditions and excluding elbow fractures. The purpose of this investigation was to analyze the literature concerning the diagnostic accuracy of clinical tests for the detection or exclusion of suspected elbow fractures. A systematic review was performed using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines. Literature databases including PubMed, Cumulative Index to Nursing and Allied Health Literature, Diagnostic Test Accuracy, Cochrane Library, the Web of Science, and ScienceDirect were searched for diagnostic accuracy studies of subjects with suspected traumatic elbow fracture investigating clinical tests compared to imaging reference tests. The risk of bias in each study was assessed independently by two reviewers using the Quality Assessment of Diagnostic Accuracy Studies 2 checklist. Twelve studies (4,485 patients) were included. Three different types of index tests were extracted. In adults, these tests were very sensitive, with values up to 98.6% (95% confidence interval [CI], 95.0%-99.8%). The specificity was very variable, ranging from 24.0% (95% CI, 19.0%-30.0%) to 69.4% (95% CI, 57.3%-79.5%). The applicability of these tests was very high, while overall studies showed a medium risk of bias. Elbow full range of motion test, elbow extension test, and elbow extension and point tenderness test appear to be useful in the presence of a negative test to exclude fracture in a majority of cases. The specificity of all tests, however, does not allow us to draw useful conclusions because there was a great variability of results obtained.

Influences of Aerobic and Resistance Exercise on Health-related Problems in Cancer Patients: A review of the literature

  • Ye-Na Jeon;Jeongwoo Jeon;Jihoen Hong;Jaeho Yu;Jinseop Kim;Seong-Gil Kim;Dongyeop Lee
    • 대한통합의학회지
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    • 제11권3호
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    • pp.79-89
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    • 2023
  • Purpose : Until recently, the number of cancer patients continues to increase, and these patients have many limitations in their activities of daily living. In the republic of Korea, cancer patients are showing an increasing trend every year. Cancer disease not only significantly reduces the quality of life in individuals, but also causes various side effects if not managed. The purpose of this study was to investigate the effects of aerobic exercise and resistance exercise on health-related problems in cancer patients. Methods : This study searched for studies that applied aerobic exercise and resistance exercise to cancer patients reported in search engines (google scala, dbpia, and pubmed) from 2017 to 2022. Six randomized controlled trials and two systematic reviews and meta-analyses were used for analysis in our study. "physical activity", "exercise", "aerobic exercise", "resistance exercise", and "cancer patient" were the main search terms. The data included aerobic exercise, resistance exercise, cancer patients' muscle strength, physical strength, quality of life, and physical activity. Results : According to the eight studies that met the criteria included in this review study, it was found that aerobic exercise and resistance exercise had an effect on the increase in physical fitness, muscular strength, quality of life, and range of motion in cancer survivors. Conclusion : It was confirmed that aerobic exercise and resistance exercise are safe and effective interventions that can be applied to cancer patients without side effects. A limitation of this study is that it did not examine cancer diseases in various population groups such as the elderly and children. Therefore, in future studies, studies that consider specific details such as age, gender, type of cancer, and physical differences are needed.

Systematic Review of Patient-Reported Outcomes and Complications of Pedicled Latissimus Flap Breast Reconstruction

  • Emanuela C. Peshel;Claire M. McNary;Catherine Barkach;Elizabeth M. Boudiab;Daniella Vega;Farid Nossoni;Kongkrit Chaiyasate;Jeremy M. Powers
    • Archives of Plastic Surgery
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    • 제50권4호
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    • pp.361-369
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    • 2023
  • The latissimus dorsi (LD) flap is a reliable option for breast reconstruction. This is particularly true in patients with contraindications to abdominally based autologous breast reconstruction. A systematic review of patient satisfaction and health related quality of life following LD breast reconstruction using the BREAST-Q survey was conducted. The scope of the review was to determine the degree of patient satisfaction following the procedure and to examine how patient satisfaction from the pedicled LD flap compares to other breast reconstructive procedures. A literature search on BREAST-Q in LD flap reconstruction was performed. Only articles written in English and in published peer-reviewed journals were included. Studies with less than 20 patients in their sample and those with a follow-up period of less than 1 year were excluded. Five articles representing 331 patients were reviewed, including one case-control study and four retrospective cohort studies. Level of evidence was either III (4) or IV (1). The average age was 53 with average body mass index of 25. Most reconstructions were delayed (67%) and unilateral (88%), and most patients required radiation (79%). The average length of follow-up was 36 months, and the response rate was 75%. Overall, patients who underwent LD flap reconstruction reported favorable outcomes in satisfaction domains and quality of life domains with few complications. A meta-analysis also demonstrated higher satisfaction in LD flap without implants compared with LD flap with implants. Patient-reported outcomes following LD breast reconstruction compare favorably with other techniques of breast reconstruction.

Meta-heuristic optimization algorithms for prediction of fly-rock in the blasting operation of open-pit mines

  • Mahmoodzadeh, Arsalan;Nejati, Hamid Reza;Mohammadi, Mokhtar;Ibrahim, Hawkar Hashim;Rashidi, Shima;Mohammed, Adil Hussein
    • Geomechanics and Engineering
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    • 제30권6호
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    • pp.489-502
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    • 2022
  • In this study, a Gaussian process regression (GPR) model as well as six GPR-based metaheuristic optimization models, including GPR-PSO, GPR-GWO, GPR-MVO, GPR-MFO, GPR-SCA, and GPR-SSO, were developed to predict fly-rock distance in the blasting operation of open pit mines. These models included GPR-SCA, GPR-SSO, GPR-MVO, and GPR. In the models that were obtained from the Soungun copper mine in Iran, a total of 300 datasets were used. These datasets included six input parameters and one output parameter (fly-rock). In order to conduct the assessment of the prediction outcomes, many statistical evaluation indices were used. In the end, it was determined that the performance prediction of the ML models to predict the fly-rock from high to low is GPR-PSO, GPR-GWO, GPR-MVO, GPR-MFO, GPR-SCA, GPR-SSO, and GPR with ranking scores of 66, 60, 54, 46, 43, 38, and 30 (for 5-fold method), respectively. These scores correspond in conclusion, the GPR-PSO model generated the most accurate findings, hence it was suggested that this model be used to forecast the fly-rock. In addition, the mutual information test, also known as MIT, was used in order to investigate the influence that each input parameter had on the fly-rock. In the end, it was determined that the stemming (T) parameter was the most effective of all the parameters on the fly-rock.

아급성 편마비 뇌졸중 환자의 보행에 로봇-보조훈련이 미치는 영향에 관한 체계적 고찰 (A Systematic Review of the Effects of Robotic-Assisted Training on Gait Performance in Persons with Subacute Hemiparetic Stroke)

  • 박세인;황수진
    • PNF and Movement
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    • 제21권1호
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    • pp.1-10
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    • 2023
  • Purpose: This systematic review aims to determine whether robot-assisted training is more effective in gait training for persons with subacute hemiparetic stroke. Methods: This study adopted a systematic review study design focused on subacute hemiparetic stroke, and four core academic databases were searched until June 11, 2021, for relevant studies, including PubMed, Embase, the Cochrane Library, and ProQuest Central. The review included randomized controlled trials (RCTs) evaluating the effects of robotic-assisted training on gait performance in persons with a diagnosis of subacute hemiparetic stroke. The selected RCT studies were qualitatively synthesized based on the population, intervention, comparison, outcome, settings, and study design (PICOS-SD). Results: The study selected five RCTs involving 253 subacute hemiparetic stroke patients and performing robotic-assisted gait training using the following devices: the Lokomat, Morning Walk, Walkbot, ProStep Plus, or Gait Trainer II. Five RCTs were eligible for the meta-analysis after quantitative synthesis, and the results showed that the robot-assisted gait training group had a greater gait performance than the control group based on the 10-meter walk test, Berg balance scale, Rivermed mobility index, functional ambulation category, and modified Barthel index. Conclusion: The results of this study showed that the gait performance of subacute hemiparetic stroke patients changes throughout robot-assisted gait training, but there were no indications that any of the clinically relevant effects of robot-assisted training are greater than those of conventional gait training. Further, the small sample size and different therapeutic intensities indicate that definitive conclusions could not be made.

국내 물리치료분야에 대한 질적 평가와 근거 수준 및 권고 등급 모형 개발 방안 (Qualitative Assessment and Development of Level of Evidence and Strength of Recommendation Models in the Field of Physical Therapy in Korea)

  • 조성현;이정우
    • 대한통합의학회지
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    • 제11권2호
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    • pp.231-242
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    • 2023
  • Purpose : This study aimed to identify ways to improve the quality of physical therapy research and ultimately review the current situation to improve evidence-based decision-making in physical therapy. Methods : For better evidence-based decision-making in physical therapy, researchers should review the quality assessment of articles in more detail and report their findings for valid and appropriate level of evidence and strength of recommendations. The level of evidence affects how well the findings are derived from well-designed literature. The evaluation of the evidence focuses primarily on the study design and the degree of bias that may compromise the validity of the findings. The final recommendation is based on a combination of the study design and literature quality. To uncover gems of information in each paper, a risk of bias assessment should be performed after the literature has been initially selected. Results : Researchers should consider the complexity of the intervention, appropriate grouping, and calculation of effect sizes for the intervention. Researchers conducting systematic reviews should provide a detailed description of the quality assessment performed and present a detailed analysis of their interpretation of the results. The results of systematic reviews and meta-analyses should be interpreted with caution and include a risk of bias assessment. Guidelines for the level of evidence and strength of recommendations should be developed and utilized more broadly to improve reporting practices in physical therapy. Conclusion : Researchers should be knowledgeable about the strengths and limitations of each study design and methodology. In the future, researchers will also need to improve their ability to critically evaluate their findings, given the potential for their results to influence clinical practice.