• Journal of Korean Medicine Rehabilitation
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• v.25 no.4
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• pp.41-46
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• 2015

Objectives This systematic review will analyse randomised controlled trials (RCTs) of manual therapy in patients with temporomandibular disorders (TMDs) to evaluate the efficacy of this approach. Methods RCTs will be identified in the following ten databases based on searches starting with their inception: MEDLINE, EMBASE, CENTRAL, four Korean databases as KoreaMed, DBPIA, NDSL, and RISS and three Chinese databases as CNKI, VIP and Wanfang. The quality of these studies will be analysed using the Cochrane risk of bias. A meta-analysis will be conducted, and subgroup analysis will be considered if comparatively large heterogeneity is detected. Conclusions We plan to publish this systematic review in a peer-reviewed journal. Findings from this review may contribute to the treatment process in clinical situations. Trial registration number: PROSPERO 2015: CRD42015024090

• The Journal of Korean Obstetrics and Gynecology
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• v.32 no.3
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• pp.162-173
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• 2019

Objectives: The purpose of this review was to overview and evaluate the efficacy of acupoint sticking therapy for women with endometriosis. Methods: We searched for randomized controlled clinical trials (RCTs) using acupoint sticking therapy on endometriosis in 5 electronic databases such as EMBASE, Pubmed, and CAJ. The results of the studies were analyzed and the risk of bias was assessed by using Cochrane risk of bias tool. Results: Two RCTs were included for analysis. In the selected studies, Treatment group was higher effective cure rate than any control group. In one RCT, Acupoint sticking therapy was only used, but the other RCT was treated acupoint sticking therapy combined with acupuncture. So, Interventions in 2 studies were not same, Quantitative synthesis was impossible. Conclusion: The limitation of this review is that the number of studies included is small. However, our systematic review provides a basis for acupoint sticking therapy for endometriosis. Acupoint sticking therapy was considered as one of external treatment method for patients with endometriosis.

• Physical Therapy Rehabilitation Science
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• v.12 no.1
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• pp.48-55
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• 2023

Objective: The purpose of this study is to compare the effects of extracorporeal shock wave therapy (ESWT) and injection therapy through qualitative and quantitative analysis by synthesizing randomized controlled trials (RCTs) conducted on patients with various shoulder diseases. Design: A systematic review and meta-analysis of randomized controlled trials Methods: This review conducted a literature search through international electronic databases in January 2023 to compare the effects of ESWT and injection therapy. Qualitative analysis was performed as a risk of bias tool, and quantitative analysis was synthesized with a random effect model to show the effect size as a standardized mean difference (SMD). Results: Five RCTs involving 298 individuals with shoulder disorders were included in this systematic review and meta-analysis. ESWT showed a moderate effect on pain (SMD=-0.44; 95% CI, -0.95 to 0.06) and a large effect on shoulder function (SMD =-0.81; 95% CI, -1.70 to 0.07) than injection therapy. A significant difference was found in the shoulder range of motion, showing a large effect size (SMD=1.50; 95% CI, 0.58 to 2.43). Conclusions: When considering treatment options for the management of patients complaining of shoulder disorders, it is appropriate to recommend ESWT first rather than injection therapy to increase the range of motion of the joint. In addition, ESWT is safe for pain control and shoulder function improvement, and a positive prognosis could be expected.

• Physical Therapy Rehabilitation Science
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• v.12 no.1
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• pp.12-18
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• 2023

Objective: Chemotherapy is usually given to inhibit cancer progression. It is the most common side effect of chemotherapyinduced peripheral neuropathy (CIPN) after chemotherapy, and its symptoms include pain such as paresthesia, dysesthesia, allodynia, hyperalgesia, and electrical stimulation. Therefore, in this review, randomized controlled trials (RCTs) were combined to analyze the effect qualitatively and quantitatively in order to find out the effect of manual therapy on patients with CIPN through a meta-analysis. Design: A systematic review and meta-analysis Methods: This review conducted a literature search through international databases (CINAHL, Embase, MEDLINE, Web of Science) in December 2022 to synthesize the effect of manual therapy on the symptomatic improvement of CIPN. Qualitative evaluation (risk of bias) and quantitative evaluation using ReVMan provided by the Cochrane Group were expressed as a random effect model and standardized mean difference (SMD). Results: In four RCTs 165 patients with CIPN were evaluated for symptoms of neuropathy. The experimental group consisting of manual therapy and its subcategories showed significant improvement compared to the control group. The results analyzed through the random effects model were SMD=-1.11; 95% confidence interval, -1.97 to -0.24. Conclusions: We came to the conclusion that manual therapy could significantly contribute to improving the symptoms of CIPN, and since it may vary depending on the technique of manual therapy, further studies on manual therapy suitable for neuropathy are needed.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.471-477
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• 2022

Objective: The greatest motor impairment after stroke is a decreased ability to walk. Most stroke patients achieve independent gait, but approximately 70% do not reach normal speed, making it difficult to reach a standard of daily living. Therefore, a wearable exoskeleton is recommended for optimal independent gait because different residual disorders hinder motor function after stroke. This review synthesized the effect on gait speed in randomized controlled trials (RCTs) in which gait training using a wearable exoskeleton was performed on post-stroke patients for qualitative and quantitative analysis. Design: A systematic review and meta-analysis of a randomized controlled trials Methods: RCTs using wearable exoskeletons in robotic rehabilitation of post-stroke patients were extracted from an international electronic database. For quality assessment and quantitative analysis, RevMan 5.4 was used. Quantitative analysis was calculated as the standardized mean difference (SMD) and presented as a random effect model. Results: Five studies involving 197 post-stroke patients were included in this review. As a result of the analysis using a random effect model, gait training using a wearable exoskeleton in post-stroke patients showed a significant improvement in gait speed compared to the non-wearing exoskeleton (SMD=1.15, 95% confidence interval: 0.52 to 1.78). Conclusions: This study concluded that a wearable exoskeleton was more effective than conventional gait training in improving the gait speed in post-stroke patients.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.115-122
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• 2023

Objective: A previous study reported that cardiovascular training (CT) decreased interleukin-6 (IL-6), a pro-inflammatory cytokine with bidirectional effects. However, because of conflicting results of increasing and decreasing IL-6 levels in stroke patients, it is essential to clarify the effects of CT on IL-6 levels in this population. Therefore, this review aimed to investigate the effects of CT on IL-6 levels in stroke patients through a meta-analysis of randomized controlled trials (RCTs), synthesizing and analyzing the effects qualitatively and quantitatively. Design: A systematic review and meta-analysis of randomized controlled trials. Methods: In this review, conducted in April 2023, electronic databases (Web of Science, CINAHL, Embase, MEDLINE, Google Scholar) were searched to ascertain the effects of CT on IL-6 levels in stroke patients. For qualitative evaluation, ReVMan, provided by the Cochrane Group, was used, and for quantitative evaluation, a random-effects model and SMD (Standardized Mean Difference) were used. Results: Three RCTs measured IL-6 in 117 patients with stroke. The experimental group to which CT was applied showed no significant change compared to the control group.The result of analysis using the random effect model is SMD=-0.23; 95% confidence interval, -0.66 to 0.20. Conclusions: CT does not affect IL-6 levels in stroke patients. These results suggest that CT can be applied regardless of its positive or negative effect on IL-6 levels in stroke patients.

• Journal of Oriental Neuropsychiatry
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• v.28 no.4
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• pp.319-332
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• 2017

Objectives: The present study aimed to provide clinical evidence on the effect of herbal medicine, Hyeolbuchukeo-tang or Xuefu Zhuyu decoction for the treatment of primary insomnia using a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: This study included RCTs that verified the effects of Hyeolbuchukeo-tang or Xuefu Zhuyu decoction for the treatment of primary insomnia. Literature searches of English, Chinese and Korean databases were performed, and the selected literature was assessed for investigating the risk of bias. Results: The analysis included 10 RCTs. The Chinese Classification of Mental Disorders-3 was most frequently used to define the diagnostic criteria for Hyeolbuchukeo-tang or Xuefu Zhuyu decoction intervention in patients with primary insomnia. The effective rate was the most commonly used outcome measure. A meta-analysis revealed that the effective rate, the Pittsburgh Sleep Quality Index, and the Athens Insomnia Scale in the Modified Xuefu Zhuyu decoction (MXZD) group were higher compared to Western Medicine (WM) group (RR: 1.17, 95% Cl: 1.08 to 1.26, p<0.0001, $I^2$=0/MD: -1.29, 95% Cl: -2.09 to -0.49, p=0.002, $I^2$=0%/MD: -0.99, 95% Cl: -1.81 to -0.18, p=0.02, $I^2$=15%). The effective rate of the MXZD+WM group was significantly different compared to the WM group (RR: 1.28, 95% Cl: 1.11 to 1.47, p=0.0006, $I^2$=2%). The included RCTs were of relatively poor quality and had small sample sizes. Conclusions: Treatment with Hyeolbuchukeo-tang or Xuefu Zhuyu decoction was found to be effective in treating primary insomnia. However, the included RCTs were of relatively poor quality and had small sample sizes. It is hypothesized that this study could serve as a foundation for further clinical studies on the development of diagnosis and treatment methods for primary insomnia based on Korean medicine.

• Korean Journal of Acupuncture
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• v.36 no.1
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• pp.1-18
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• 2019

Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF). Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods. Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD -1.05 point on a 0 to 10 point scale, 95% CI -1.45 to -0.65, $I^2=74%$). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF. Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.

• The Journal of Internal Korean Medicine
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• v.40 no.1
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• pp.13-37
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• 2019

Objectives: The purpose of this study was to assess the effects of Korean medicine for non-alcoholic fatty liver disease (NAFLD). We analyzed the result of randomized controlled trials (RCTs) that applied Korean medicine to NAFLD patients through meta analysis and systematic review. Methods: The key question was to the effects of Korean medicine for NAFLD patients according to the PICO-SD (participants, intervention, comparison, outcome, study design) and we included only RCTs. We searched 10 databases including NDSL, KMBASE, KISS, KISTI, KoreaMed, Koreantk, OASIS, Cochrane, Pubmed, EMBASE without a language restriction. We assessed risk of bias by Cochrane group's Risk of Bias tool. Results: The finally selected 12 RCTs were analyzed. Total number of participants was 1189 (male 719, female 470) as 684 and 505 in the oriental medicine group (i.e. herbal drugs, acupuncture, acupoint embedding therapy) and control group (conventional drugs, placebo), respectively. The meta analysis results of examining 7 RCTs comparing the therapeutic efficacy of herbal medicine with that of Western medicine showed statistically significant (p<0.05) differences in the efficacy evaluation, liver function test results, blood lipids, and TNF-${\alpha}$. Furthermore, the meta analysis results of investigating 3 RCTs comparing the therapeutic efficacy of herbal medicine with that of a placebo showed statistically significant (p<0.05) differences in the liver function test results, blood lipids, and waist circumference. Conclusions: The research showed that Korean medicine for NAFLD can be effective treatment. But more studies are required to enhance the level of evidence and we should report on safety.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.3
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• pp.42-73
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• 2023

Objectives : In order to investigate the current status of recent clinical evidence related to complementary and alternative medicine(CAM) treatment for burns and to inform research and treatment strategies for future, we publish a scoping review(ScR) of randomized controlled trials(RCTs). Methods : The research question of the ScR was "Are there any RCTs of CAM treatment for burn?". RCTs published from 2000 to 2022 were identified in 7 databases(PubMed, Cochrane, CNKI, OASIS, RISS, KCI, KMbase) in March 2023. Data were tabulated and analyzed descriptively with respect to the research questions. Results : 41 RCTs were included. 21(51.2%) were conducted in China, 13(31.7%) in Iran. The main treatment criteria were herbal medicine in 28 cases, acupuncture in 9 cases, chuna therapy in 4 cases, and psychotherapy in 3 cases. Among the herbal medicine, there were 19 topical medications, 5 injections(intravenous pharmacopuncture), 4 aerosol drugs(aromatherapy), and 1 oral drug. Among the acupuncture, there were 4 plum blossom needles(seven-star needles), 2 wrist-ankle acupunctures, 2 press needles, and 1 electroacupuncture. CAM treatments were effective in treating burns. It reduced pain and pruritus at the burn site, helped recovery and management of the donor site, reduced anxiety and pain during dressing change, improved hematological problems and vital signs, and finally lowered the mortality rate. CAM treatments also lowered health care costs. Conclusions : CAM treatments for burns is prospective, and that it deserves to make high-quality studies including additional large-scale RCTs.