{"title":"针灸结合镜像疗法治疗中风后肢体运动障碍的疗效：随机对照试验的系统回顾和荟萃分析。","authors":"Weihao Ke, Hongxin Cheng, Xiaoxuan Ren, Liang Yang, Xiaomin Lai, Zhenyu Wang","doi":"10.3389/fresc.2024.1464502","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether the combination of acupuncture and mirror therapy can improve motor impairment in stroke patients.</p><p><strong>Design: </strong>A systematic review and meta-analysis of randomised controlled trials.</p><p><strong>Data sources: </strong>CNKI, Wanfang, PubMed, Embase, Vip, web of since, Cochrane database and CBM database.</p><p><strong>Eligibility criteria for selecting studies: </strong>The included randomized controlled trials compared the efficacy of acupuncture therapy (AT) combined with mirror therapy (MT) against AT, MT, and conventional rehabilitation therapy on limb motor impairment in stroke patients, with independent data extraction and study quality assessment conducted. A META analysis using fixed-effect and random-effect models was performed to calculate the mean difference (MD) in motor scores and the Total effective rate RR (Risk ratio) between the AT combined with MT group and the control group.</p><p><strong>Main outcome measures: </strong>The Fugl-Meyer Assessment (FMA) for motor function includes the FMA-T (total FMA), FMA-UE (upper extremity FMA), and FMA-L (lower extremity FMA).</p><p><strong>Results: </strong>A total of 42 randomized controlled trials were included, involving 3,340 patients with post-stroke motor impairment. AT combined with MT was more favorable for FMA-UE (mean difference [MD] = 6.67, 95% CI [5.60-7.93], Z = 11.42, <i>P</i> < 0.0001), FMA-L [MD = 3.37, 95% CI (2.99-3.76), Z = 17.31, <i>P</i> < 0.001], and FMA-T [MD = 6.84, 95% CI (5.92-7.77), Z = 14.48, <i>P</i> < 0.001]. The combined AT and MT treatment was more favorable for the Modified Barthel Index (MBI) score in post-stroke motor impairment [MD = 10.82, 95% CI (8.52-13.12), Z = 9.22, <i>P</i> < 0.001]. AT combined with MT was more favorable for the Modified Ashworth Scale (MAS) [MD = -0.34, 95% CI (-0.66 to -0.03), Z = 14.48, <i>P</i> < 0.001]. AT combined with MT was more favorable for the Total effective rate in treating post-stroke motor impairment (relative risk = 1.27, 95% confidence interval [CI] [1.19-1.37], Z = 6.54, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>AT combined with MT can effectively improve patients' motor function and daily living abilities.</p><p><strong>Systematic review registration: </strong>PROSPERO, identifier, CRD42024559992.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1464502"},"PeriodicalIF":1.3000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580039/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy of acupuncture combined with mirror therapy in the treatment of post-stroke limb movement disorders: a systematic review and meta-analysis of randomised controlled trials.\",\"authors\":\"Weihao Ke, Hongxin Cheng, Xiaoxuan Ren, Liang Yang, Xiaomin Lai, Zhenyu Wang\",\"doi\":\"10.3389/fresc.2024.1464502\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate whether the combination of acupuncture and mirror therapy can improve motor impairment in stroke patients.</p><p><strong>Design: </strong>A systematic review and meta-analysis of randomised controlled trials.</p><p><strong>Data sources: </strong>CNKI, Wanfang, PubMed, Embase, Vip, web of since, Cochrane database and CBM database.</p><p><strong>Eligibility criteria for selecting studies: </strong>The included randomized controlled trials compared the efficacy of acupuncture therapy (AT) combined with mirror therapy (MT) against AT, MT, and conventional rehabilitation therapy on limb motor impairment in stroke patients, with independent data extraction and study quality assessment conducted. A META analysis using fixed-effect and random-effect models was performed to calculate the mean difference (MD) in motor scores and the Total effective rate RR (Risk ratio) between the AT combined with MT group and the control group.</p><p><strong>Main outcome measures: </strong>The Fugl-Meyer Assessment (FMA) for motor function includes the FMA-T (total FMA), FMA-UE (upper extremity FMA), and FMA-L (lower extremity FMA).</p><p><strong>Results: </strong>A total of 42 randomized controlled trials were included, involving 3,340 patients with post-stroke motor impairment. AT combined with MT was more favorable for FMA-UE (mean difference [MD] = 6.67, 95% CI [5.60-7.93], Z = 11.42, <i>P</i> < 0.0001), FMA-L [MD = 3.37, 95% CI (2.99-3.76), Z = 17.31, <i>P</i> < 0.001], and FMA-T [MD = 6.84, 95% CI (5.92-7.77), Z = 14.48, <i>P</i> < 0.001]. The combined AT and MT treatment was more favorable for the Modified Barthel Index (MBI) score in post-stroke motor impairment [MD = 10.82, 95% CI (8.52-13.12), Z = 9.22, <i>P</i> < 0.001]. AT combined with MT was more favorable for the Modified Ashworth Scale (MAS) [MD = -0.34, 95% CI (-0.66 to -0.03), Z = 14.48, <i>P</i> < 0.001]. AT combined with MT was more favorable for the Total effective rate in treating post-stroke motor impairment (relative risk = 1.27, 95% confidence interval [CI] [1.19-1.37], Z = 6.54, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>AT combined with MT can effectively improve patients' motor function and daily living abilities.</p><p><strong>Systematic review registration: </strong>PROSPERO, identifier, CRD42024559992.</p>\",\"PeriodicalId\":73102,\"journal\":{\"name\":\"Frontiers in rehabilitation sciences\",\"volume\":\"5 \",\"pages\":\"1464502\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-11-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11580039/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in rehabilitation sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fresc.2024.1464502\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in rehabilitation sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fresc.2024.1464502","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0
摘要
目的研究针灸与镜像疗法的结合能否改善中风患者的运动障碍：数据来源：CNKI、万方、PubMed、Embase、Vip、web of since、Cochrane 数据库和 Cochrane 数据库：数据来源：CNKI、万方、PubMed、Embase、Vip、web of since、Cochrane 数据库和 CBM 数据库：纳入的随机对照试验比较了针灸疗法（AT）联合镜像疗法（MT）与针灸疗法、镜像疗法和常规康复疗法对脑卒中患者肢体运动障碍的疗效，并进行了独立的数据提取和研究质量评估。采用固定效应和随机效应模型进行META分析，计算AT联合MT组与对照组之间运动评分的平均差异（MD）和总有效率RR（风险比）：Fugl-Meyer 运动功能评估（FMA）包括 FMA-T（FMA 总分）、FMA-UE（上肢 FMA）和 FMA-L（下肢 FMA）：结果：共纳入了 42 项随机对照试验，涉及 3340 名中风后运动障碍患者。AT 联合 MT 更有利于 FMA-UE（平均差 [MD] = 6.67，95% CI [5.60-7.93]，Z = 11.42，P P P P P P 结论：AT 联合 MT 能有效改善患者的运动障碍：AT联合MT能有效改善患者的运动功能和日常生活能力：系统综述注册：PROSPERO，标识符：CRD42024559992。
Efficacy of acupuncture combined with mirror therapy in the treatment of post-stroke limb movement disorders: a systematic review and meta-analysis of randomised controlled trials.
Objective: To investigate whether the combination of acupuncture and mirror therapy can improve motor impairment in stroke patients.
Design: A systematic review and meta-analysis of randomised controlled trials.
Data sources: CNKI, Wanfang, PubMed, Embase, Vip, web of since, Cochrane database and CBM database.
Eligibility criteria for selecting studies: The included randomized controlled trials compared the efficacy of acupuncture therapy (AT) combined with mirror therapy (MT) against AT, MT, and conventional rehabilitation therapy on limb motor impairment in stroke patients, with independent data extraction and study quality assessment conducted. A META analysis using fixed-effect and random-effect models was performed to calculate the mean difference (MD) in motor scores and the Total effective rate RR (Risk ratio) between the AT combined with MT group and the control group.
Main outcome measures: The Fugl-Meyer Assessment (FMA) for motor function includes the FMA-T (total FMA), FMA-UE (upper extremity FMA), and FMA-L (lower extremity FMA).
Results: A total of 42 randomized controlled trials were included, involving 3,340 patients with post-stroke motor impairment. AT combined with MT was more favorable for FMA-UE (mean difference [MD] = 6.67, 95% CI [5.60-7.93], Z = 11.42, P < 0.0001), FMA-L [MD = 3.37, 95% CI (2.99-3.76), Z = 17.31, P < 0.001], and FMA-T [MD = 6.84, 95% CI (5.92-7.77), Z = 14.48, P < 0.001]. The combined AT and MT treatment was more favorable for the Modified Barthel Index (MBI) score in post-stroke motor impairment [MD = 10.82, 95% CI (8.52-13.12), Z = 9.22, P < 0.001]. AT combined with MT was more favorable for the Modified Ashworth Scale (MAS) [MD = -0.34, 95% CI (-0.66 to -0.03), Z = 14.48, P < 0.001]. AT combined with MT was more favorable for the Total effective rate in treating post-stroke motor impairment (relative risk = 1.27, 95% confidence interval [CI] [1.19-1.37], Z = 6.54, P < 0.001).
Conclusions: AT combined with MT can effectively improve patients' motor function and daily living abilities.
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