Comparative effects of combined physical therapy with Kinesio taping and physical therapy in patients with knee osteoarthritis: a systematic review and meta-analysis.

OBJECTIVE: To compare therapeutic effects between physical therapy (PT) combined with Kinesio taping (KT) and PT alone in knee osteoarthritis treatment. DATA SOURCES: PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, CNKI, WangFang Data, and Google Scholar were searched until 16 April 2020. REVIEW METHODS: Randomized controlled trials comparing pain reduction (visual analogue scale and numeric pain rating scale) and functional improvement (Western Ontario and McMaster Universities Osteoarthritis Index) between PT + KT and PT in knee osteoarthritis treatment were included. The risk of bias was assessed using the Cochrane Collaboration's tool. RESULTS: A total of 15 studies with 546 patients were included, and their outcomes for one to six weeks after initial treatments were compared. An overall trend favoring PT + KT over PT alone was indicated by greater pain score reduction (mean difference (MD) = -0.70, 95% confidence interval (CI) = -1.14 to -0.26; P = 0.002) and functional improvement (MD = -5.45, 95% CI = -10.23 to -0.66; P = 0.03) with the former. Significant pain reduction (MD = -0.72, 95% CI = -1.18 to -0.26; P = 0.002) and functional improvement (MD = -6.05, 95% CI = -11.18 to -0.93; P = 0.02) were reported within six weeks after initial treatments. CONCLUSION: Compared with PT alone, PT combined with KT provided better therapeutic effect regarding pain reduction and functional improvement in patients with knee osteoarthritis. The additional pain reduction and functional improvement could last at least six weeks after initial treatments.

Economic evaluation of transferring first-stroke survivors to rehabilitation wards: A 10-year longitudinal, population-based study.

Background: Transferring stroke survivors to the rehabilitation ward for rehabilitation reduces long-term mortality; however, the long-term economic impact remains unknown.Objective: We aimed to assess the 10-year economic outcome of transferring first-stroke survivors to the rehabilitation ward.Methods: In this population-based, retrospective study, we examined the incremental costs per life year gained (ICLYG) for stroke survivors who were transferred to the rehabilitation ward (TR) as compared to that for those who underwent rehabilitation without being transferred to the rehabilitation ward (R) and those who did not undergo rehabilitation (NR). The differences in the daily medical expenditures among the three groups during the 10-year post-stroke period were examined.Results: After balancing characteristics of the three groups, the data of 14,544 first-stroke survivors between 1999 and 2003 were collected. The medical expenditure of index hospitalization was the lowest and the survival period was the longest in the TR group. The ICLYG of TR vs. NR (reference) was -388.5 (95% CI -396.2, -380.8) USD/year and that of TR vs. R (reference) was -121.5 (95% CI -130.4, -112.6) USD/year. The daily medical expenditure of the post-stroke survival period was significantly lower in the TR group (median 11.0, IQR 5.7-22.5 USD) than in the R (median 14.2, IQR 6.4-41.4 USD) and NR (median 19.5, IQR 6.4-88.2 USD) groups.Conclusions: The 10-year post-stroke follow-up showed that transferring patients to the rehabilitation ward is more cost effective than rehabilitation without transfer to the rehabilitation ward and no rehabilitation.

Factors affecting long-term mortality rate after diagnosis of syringomyelia in disabled spinal cord injury patients: a population-based study.

STUDY DESIGN: A retrospective, population-based study. OBJECTIVES: To identify factors affecting long-term mortality and medical resources use in disabled spinal cord injury (SCI) patients after syringomyelia diagnosis. SETTING: A National Health Insurance Research Database containing 10,374 patients with SCI. METHODS: Data recorded between 1997 and 2012 for 376 disabled SCI patients with syringomyelia and 376 characteristics-matched disabled SCI patients without syringomyelia were collected. The index date was the date of syringomyelia diagnosis. Cox proportional hazards regression model was used to investigate the factors affecting 10-year mortality in these patients. Medical resources use was compared for 1 year before and after index date. RESULTS: The survival rate at 10-year follow-up after syringomyelia diagnosis was estimated at 68.6%. The 10-year survival rate was comparable between the two groups. Age ≥ 60 (adjusted hazard ratios (aHR) 4.21, 95% confidence interval (CI) 2.97 to 5.96) and < 30 years (aHR 0.25, 95% CI 0.10 to 0.62), spinal cord or spinal canal operations within 1 year after the index date (aHR 1.84, 95% CI 1.19 to 2.84), history of pneumonia (aHR 1.55, 95% CI 1.07 to 2.26), and history of coronary heart disease (CHD) (aHR 1.85, 95% CI 1.18 to 2.89) were significantly associated with long-term mortality. Outpatient prescription costs were higher during 1 year after the diagnosis than those of 1 year before the diagnosis. CONCLUSION: Age, spinal operations, history of pneumonia, and history of CHD are associated with 10-year mortality in disabled SCI patients with syringomyelia.

Association between Clinical and Laboratory Markers and 5-year Mortality among Patients with Stroke.

Factors influencing long-term stroke mortality have not been comprehensively investigated. This study aimed to identify the baseline clinical, laboratory, demographic/socioeconomic, and hospital factors influencing 5-year mortality in patients with first stroke. Total 3,956 patients with first-stroke hospitalization from 2004 to 2008 were connected to the longitudinal National Health Insurance Research Database. Post-admission baseline data that significantly increased 5-year mortality were red cell distribution width (RDW) >0.145 (adjusted hazard ratio [aHR] = 1.71), hemoglobin <120 g/L (aHR = 1.25), blood sugar <3.89 mmol/L (70 mg/dL)(aHR = 2.57), serum creatinine >112.27 µmol/L (aHR = 1.76), serum sodium <134 mmol/L (aHR = 1.73), body mass index (BMI) < 18.5 kg/m2 (aHR = 1.33), Glasgow Coma Scale <15 (aHR = 1.43), Stroke Severity Index ≥20 (aHR = 3.92), Charlson-Deyo Comorbidity Index ≥3 (aHR = 4.21), no rehabilitation (aHR = 1.86), and age ≥65 years (aHR = 2.25). Hemoglobin, RDW, blood sugar, serum creatinine and sodium, BMI, consciousness, stroke severity, comorbidity, rehabilitation, and age were associated with 5-year mortality in patients with first stroke.