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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...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9605313 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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