Long-Term Efficacy of Extracorporeal Shock Wave Therapy on Lower Limb Post-Stroke Spasticity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Long-Term Efficacy of Extracorporeal Shock Wave Therapy on Lower Limb Post-Stroke Spasticity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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DOI：
10.3390/jcm10010086
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发表时间：
2020-12-29
影响因子：
3.9
通讯作者：
Berteanu M
中科院分区：
文献类型：
--
作者：
Mihai EE;Dumitru L;Mihai IV;Berteanu M
本系统性综述和荟萃分析的目的是评价体外冲击波治疗（ESWT）在减少成人卒中后下肢痉挛方面的长期疗效。对PubMed/ MEDLINE、物理治疗证据数据库（PEDro）、Scopus、奥维德MEDLINE（R）和Google Scholar搜索引擎进行了系统性电子检索。2010年1月至2020年8月期间以英语、法语、西班牙语、葡萄牙语和意大利语出版的出版物以及全文均符合纳入条件，并且检索时不受国家限制。本研究根据系统性综述和荟萃分析的首选报告项目（PRISMA）指南进行，并遵循科克伦干预措施系统性综述手册的建议。两位作者筛选了参考文献，提取了数据，并评估了偏倚风险。主要结局是主要通过改良Ashworth量表（MAS）评估的痉挛等级。次要结局为被动活动度（PROM）、疼痛强度、电生理参数、步态评估和不良事件。本系统综述和荟萃分析共纳入了7项近期随机对照试验（RCT），发现ESWT对痉挛状态有有益作用。本文提供的高水平证据表明，ESWT改善痉挛状态的参数为：MAS：标准化均值差（SMD）= 0.53; 95%置信区间（95% CI）：（0.07-0.99）;改良Tardieu量表（MTS）：SMD = 0.56; 95% CI：（0.01-1.12）;视觉焦虑量表（VAS）：SMD = 0.35; 95% CI：（−0.21-0.91）; PROM：SMD = 0.69; 95% CI：（0.20-1.19）。ESWT对卒中后下肢痉挛具有长期疗效，可减轻疼痛强度并增加活动度。这种新的非侵入性治疗的效果是显著的，干预没有出现不良事件，证明了令人满意的安全性。
The purpose of this systematic review and meta-analysis is to evaluate the long-term efficacy of Extracorporeal Shock Wave Therapy (ESWT) on reducing lower limb post-stroke spasticity in adults. A systematic electronic search of PubMed/ MEDLINE, Physiotherapy Evidence Database (PEDro), Scopus, Ovid MEDLINE(R), and search engine of Google Scholar was performed. Publications that ranged from January 2010 to August 2020, published in English, French, Spanish, Portuguese, and Italian language and available as full texts were eligible for inclusion and they were searched without any restrictions of country. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Two authors screened the references, extracted data, and assessed the risk of bias. The primary outcome was spasticity grade mainly assessed by the Modified Ashworth Scale (MAS). Secondary outcomes were passive range of motion (PROM), pain intensity, electrophysiological parameters, gait assessment, and adverse events. A total of seven recent randomized controlled trials (RCTs) were included in the systematic review and meta-analysis, and a beneficial effect on spasticity was found. The high level of evidence presented in this paper showed that ESWT ameliorates spasticity considering the parameters: MAS: standardized mean difference (SMD) = 0.53; 95% confidence interval (95% CI): (0.07–0.99); Modified Tardieu Scale (MTS): SMD = 0.56; 95% CI: (0.01–1.12); Visual Analogue Scale (VAS): SMD = 0.35; 95% CI: (−0.21–0.91); PROM: SMD = 0.69; 95% CI: (0.20–1.19). ESWT presented long-term efficacy on lower limb post-stroke spasticity, reduced pain intensity, and increased range of motion. The effect of this novel and non-invasive therapy was significant and the intervention did not present adverse events, proving a satisfactory safety profile.
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DOI：
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发表时间：
2017-02-01
影响因子：
4.5
作者：
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影响因子：
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DOI：
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发表时间：
2017-02-01
期刊：
Continuum (Minneapolis, Minn.)
影响因子：
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作者：
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通讯作者：
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