RESUMO
We carried out a systematic review and meta-analysis to determine the effectiveness and safety of non-invasive electrical stimulation (NES) for vision restoration. We systematically searched for randomised controlled trials (RCTs) comparing NES with sham stimulation, for vision restoration between 2000 and 2022 in CENTRAL, MEDLINE, EMBASE, and LILACS. The main outcomes were as follows: visual acuity (VA); detection accuracy; foveal threshold; mean sensitivity as the parameter for the visual field; reading performance; contrast sensitivity (CS); electroencephalogram; quality of life (QoL), and safety. Two reviewers independently selected studies, extracted data, and evaluated the risk of bias using the Cochrane risk of bias 2.0 tool. The certainty in the evidence was determined using the GRADE framework. Protocol registration: CRD42022329342. Thirteen RCTs involving 441 patients with vision impairment indicate that NES may improve VA in the immediate post-intervention period (mean difference [MD] = -0.02 logMAR, 95% confidence intervals [CI] -0.08 to 0.04; low certainty), and probably increases QoL and detection accuracy (MD = 0.08, 95% CI -0.25 to 0.42 and standardised MD [SMD] = 0.09, 95% CI -0.58 to 0.77, respectively; both moderate certainty). NES likely results in little or no difference in mean sensitivity (SMD = -0.03, 95% CI -0.53 to 0.48). Compared with sham stimulation, NES increases the risk of minor adverse effects (risk ratio = 1.24, 95% CI 0.99 to 1.54; moderate certainty). The effect of NES on CS, reading performance, and electroencephalogram was uncertain. Our study suggests that although NES may slightly improve VA, detection accuracy, and QoL, the clinical relevance of these findings remains uncertain. Future research should focus on improving the available evidence's precision and consistency.
RESUMO
OBJECTIVE: To compare pulsed radiofrequency (PRF) treatment with continuous radiofrequency (CRF) to improve pain, functionality, and safety profile in patients with facet joint chronic low back pain. METHODS: A systematic, critical review of recent literature was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase, Cochrane, Clinical Trials, and LILACS databases were searched. Medical Subject Heading terms were "low back pain," "zygapophyseal joint," and "pulsed radiofrequency treatment." Original research articles in peer-reviewed journals were included in the review. The articles were thoroughly examined and compared on the basis of study design and outcomes. Only studies that met the eligibility criteria were included. RESULTS: Three randomized clinical trials comprising 103 patients (39 in PRF group, 44 in CRF group, and 20 in control group) were included in the final analysis. Two trials compared PRF with CRF, and 1 trial compared 3 groups: PRF, CRF, and control with intervention as conventional treatment. The studies reported greater pain control and better functionality with CRF compared with PRF. PRF showed a decrease in visual analog scale and Oswestry Disability Index in 2 studies, and 1 study reported increased pain and disability after the intervention. No side effects were reported. CONCLUSIONS: PRF treatment is less effective than CRF regarding pain control and return of functionality in patients with facet joint chronic low back pain. We recommend CRF with a large safety profile after conventional treatment.