Tai Chi for Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Tai Chi for Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
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太极拳促进中风康复：随机对照试验的系统回顾和荟萃分析
DOI：
10.3389/fphys.2018.00983
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发表时间：
2018
影响因子：
4
通讯作者：
Li Z
中科院分区：
文献类型：
--
作者：
Lyu D;Lyu X;Zhang Y;Ren Y;Yang F;Zhou L;Zou Y;Li Z
背景：中风是健康状况不佳的主要原因，并有许多并发症。太极拳（TC）可能对中风幸存者的康复有积极影响，但最近的临床研究结果尚未包括在先前发表的综述中。目的：我们进行了这项系统回顾和荟萃分析，以确定所有类型的TC与传统康复治疗在卒中幸存者康复的各个方面的有效性。方法：我们检索了7个电子文献数据库（3个英文数据库，4个中文数据库）和一个临床注册平台，使用既定的策略来识别截至2017年10月进行的随机对照试验。筛选、质量评估和数据收集由两位研究者分别使用相同的标准进行。使用RevMan 5.3.0软件对结果进行分析。使用GRADEpro评估证据质量。结果：共有21项研究，1293名中风幸存者符合纳入标准；14例纳入定量综合，评估4个方面和5个结果。9项研究表明，TC能够改善独立日常生活活动（ADL），尤其是与常规康复治疗相比[95%可信区间（CI）] = 9.92 [6.82, 13.02], P < 0.00001]。有5项研究报道了TC联合常规康复治疗在提高上肢Fugl-Meyer评估得分方面的显著作用[MD (95%CI) = 8.27 [4.69, 11.84], P < 0.0001]，下肢[MD (95%CI) = 2.75 [0.95, 4.56], P = 0.003]，总体[MD (95%CI) = 4.49 [1.92, 7.06], P = 0.0006]。根据Berg平衡量表的汇总估计，TC与常规康复治疗相比有显著改善[MD (95%CI) = 5.23 [3.42, 7.05], P < 0.00001]。TC加常规康复治疗可改善Holden量表的行走能力[MD (95%CI) = 0.61 [0.38, 0.85], P < 0.00001]和起跑时间[MD (95%CI) = 2.59 [1.76, 3.43], P < 0.00001]。结论：基于非常低质量的证据，TC对卒中幸存者的ADL、平衡、肢体运动功能和行走能力有总体有益的影响，也可能改善睡眠质量、情绪、心理健康和其他运动功能。需要设计良好、质量更高、随访时间更长的试验来获得质量更高的证据。
Background: Stroke is a major cause of poor health and has numerous complications. Tai Chi (TC) may have positive effects on the rehabilitation of stroke survivors, but recent clinical findings have not been included in previously published reviews. Objectives: We conducted this systematic review and meta-analysis to determine the effectiveness of all types of TC vs. conventional rehabilitation therapy for all aspects of stroke survivors' rehabilitation that have been studied. Method: We searched seven electronic literature databases (three in English, four in Chinese) and one clinical registry platform using established strategies to identify randomized controlled trials performed up to October 2017. Screening, quality assessment, and data collection were performed by two researchers separately, using the same standard. The results were analyzed using RevMan 5.3.0. The quality of evidence was evaluated with GRADEpro. Results: A total of 21 studies with 1,293 stroke survivors met inclusion criteria; 14 were included in the quantitative synthesis to evaluate four aspects and five outcomes. Nine studies indicated that TC was able to improve independent activities of daily living (ADL), especially TC vs. conventional rehabilitation therapy [mean difference (MD) [95% confidence interval (CI)] = 9.92 [6.82, 13.02], P < 0.00001]. Five studies reported significant effects of TC plus conventional rehabilitation therapy in increasing scores on the Fugl–Meyer Assessment for the upper limb [MD (95%CI) = 8.27 [4.69, 11.84], P < 0.0001], lower limb [MD (95%CI) = 2.75 [0.95, 4.56], P = 0.003], and overall [MD (95%CI) = 4.49 [1.92, 7.06], P = 0.0006]. The Berg Balance Scale revealed significant improvements according to pooled estimates for TC vs. conventional rehabilitation therapy [MD (95%CI) = 5.23 [3.42, 7.05], P < 0.00001]. TC plus conventional rehabilitation therapy also improved walking ability as measured by the Holden scale [MD (95%CI) = 0.61 [0.38, 0.85], P < 0.00001] and up-and-go time [MD (95%CI) = 2.59 [1.76, 3.43], P < 0.00001]. Conclusion: TC has an overall beneficial effect on ADL, balance, limb motor function, and walking ability among stroke survivors, based on very low-quality evidence, and may also improve sleep quality, mood, mental health, and other motor function. Well-designed, higher-quality trials with longer-term follow-up periods are needed to develop better-quality evidence.
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影响因子：
3.7
作者：
Chen BL;Guo JB;Liu MS;Li X;Zou J;Chen X;Zhang LL;Yue YS;Wang XQ
通讯作者：
Wang XQ
影响因子：
7.2
作者：
Guyatt, Gordon H.;Oxman, Andrew D.;Schuenemann, Holger J.
通讯作者：
Schuenemann, Holger J.
影响因子：
168.9
作者：
Feigin, Valery L.;Forouzanfar, Mohammad H.;Krishnamurthi, Rita;Mensah, George A.;Connor, Myles;Bennett, Derrick A.;Moran, Andrew E.;Sacco, Ralph L.;Anderson, Laurie;Truelsen, Thomas;O'Donnell, Martin;Venketasubramanian, Narayanaswamy;Barker-Collo, Suzanne;Lawes, Carlene M. M.;Wang, Wenzhi;Shinohara, Yukito;Witt, Emma;Ezzati, Majid;Naghavi, Mohsen;Murray, Christopher
通讯作者：
Murray, Christopher
影响因子：
4.2
作者：
Au-Yeung, Stephanie S. Y.;Hui-Chan, Christina W. Y.;Tang, Jervis C. S.
通讯作者：
Tang, Jervis C. S.
影响因子：
3.2
作者：
Blum, Lisa;Korner-Bitensky, Nicol
通讯作者：
Korner-Bitensky, Nicol