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Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis

Background: Neurostimulations for the post-stroke recovery of upper extremity function has been explored in previous research, but there remains a controversy about the superiority of different neurostimulations. Methods: Randomized controlled trials (RCTs) were searched in MEDLINE, Embase, Cochrane...

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Autores principales: Xue, Tao, Yan, Zeya, Meng, Jiahao, Wang, Wei, Chen, Shujun, Wu, Xin, Gu, Feng, Tao, Xinyu, Wu, Wenxue, Chen, Zhouqing, Bai, Yutong, Wang, Zhong, Zhang, Jianguo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605313/
https://www.ncbi.nlm.nih.gov/pubmed/36294485
http://dx.doi.org/10.3390/jcm11206162
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author Xue, Tao
Yan, Zeya
Meng, Jiahao
Wang, Wei
Chen, Shujun
Wu, Xin
Gu, Feng
Tao, Xinyu
Wu, Wenxue
Chen, Zhouqing
Bai, Yutong
Wang, Zhong
Zhang, Jianguo
author_facet Xue, Tao
Yan, Zeya
Meng, Jiahao
Wang, Wei
Chen, Shujun
Wu, Xin
Gu, Feng
Tao, Xinyu
Wu, Wenxue
Chen, Zhouqing
Bai, Yutong
Wang, Zhong
Zhang, Jianguo
author_sort Xue, Tao
collection PubMed
description Background: Neurostimulations for the post-stroke recovery of upper extremity function has been explored in previous research, but there remains a controversy about the superiority of different neurostimulations. Methods: Randomized controlled trials (RCTs) were searched in MEDLINE, Embase, Cochrane Library and ClinicalTrials.gov, from 1 January 2000 to 1 June 2022. A conventional pair-wise meta-analysis with a random-effect model was used to evaluate direct evidence. Bayesian random effect models were used for network meta-analysis. The grading of the recommendations assessment, development and evaluation (GRADE) approach was applied to assess the clinical quality of the results. Results: A total of 88 RCTs, which enrolled 3491 participants, were included. For the Fugl-Meyer Assessment-Upper Extremity score change from the baseline to the longest follow-up, the following interventions showed a significant difference: VNS (MD = 4.12, 95%CrI: 0.54 to 7.80, moderate certainty), cNMES (MD = 3.98, 95%CrI: 1.05 to 6.92, low certainty), FES (MD = 7.83, 95%CrI: 4.42 to 11.32, very low certainty), drTMS (MD = 7.94, 95%CrI: 3.71 to 12.07, moderate certainty), LFrTMS (MD = 2.64, 95%CrI: 1.20 to 4.11, moderate certainty), HFrTMS (MD = 6.73, 95%CrI: 3.26 to 10.22, moderate certainty), and iTBS combined with LFrTMS (MD = 5.41, 95%CrI: 0.48 to 10.35, moderate certainty). Conclusions: The neurostimulations above the revealed significant efficacy for improving the upper limb function after stroke eased the suffering of the patient.
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spelling pubmed-96053132022-10-27 Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis Xue, Tao Yan, Zeya Meng, Jiahao Wang, Wei Chen, Shujun Wu, Xin Gu, Feng Tao, Xinyu Wu, Wenxue Chen, Zhouqing Bai, Yutong Wang, Zhong Zhang, Jianguo J Clin Med Article Background: Neurostimulations for the post-stroke recovery of upper extremity function has been explored in previous research, but there remains a controversy about the superiority of different neurostimulations. Methods: Randomized controlled trials (RCTs) were searched in MEDLINE, Embase, Cochrane Library and ClinicalTrials.gov, from 1 January 2000 to 1 June 2022. A conventional pair-wise meta-analysis with a random-effect model was used to evaluate direct evidence. Bayesian random effect models were used for network meta-analysis. The grading of the recommendations assessment, development and evaluation (GRADE) approach was applied to assess the clinical quality of the results. Results: A total of 88 RCTs, which enrolled 3491 participants, were included. For the Fugl-Meyer Assessment-Upper Extremity score change from the baseline to the longest follow-up, the following interventions showed a significant difference: VNS (MD = 4.12, 95%CrI: 0.54 to 7.80, moderate certainty), cNMES (MD = 3.98, 95%CrI: 1.05 to 6.92, low certainty), FES (MD = 7.83, 95%CrI: 4.42 to 11.32, very low certainty), drTMS (MD = 7.94, 95%CrI: 3.71 to 12.07, moderate certainty), LFrTMS (MD = 2.64, 95%CrI: 1.20 to 4.11, moderate certainty), HFrTMS (MD = 6.73, 95%CrI: 3.26 to 10.22, moderate certainty), and iTBS combined with LFrTMS (MD = 5.41, 95%CrI: 0.48 to 10.35, moderate certainty). Conclusions: The neurostimulations above the revealed significant efficacy for improving the upper limb function after stroke eased the suffering of the patient. MDPI 2022-10-19 /pmc/articles/PMC9605313/ /pubmed/36294485 http://dx.doi.org/10.3390/jcm11206162 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Xue, Tao
Yan, Zeya
Meng, Jiahao
Wang, Wei
Chen, Shujun
Wu, Xin
Gu, Feng
Tao, Xinyu
Wu, Wenxue
Chen, Zhouqing
Bai, Yutong
Wang, Zhong
Zhang, Jianguo
Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis
title Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis
title_full Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis
title_fullStr Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis
title_full_unstemmed Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis
title_short Efficacy of Neurostimulations for Upper Extremity Function Recovery after Stroke: A Systematic Review and Network Meta-Analysis
title_sort efficacy of neurostimulations for upper extremity function recovery after stroke: a systematic review and network meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9605313/
https://www.ncbi.nlm.nih.gov/pubmed/36294485
http://dx.doi.org/10.3390/jcm11206162
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