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1.
JMIR Mhealth Uhealth ; 9(9): e24402, 2021 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-34473067

RESUMO

BACKGROUND: For rehabilitation training systems, it is essential to automatically record and recognize exercises, especially when more than one type of exercise is performed without a predefined sequence. Most motion recognition methods are based on feature engineering and machine learning algorithms. Time-domain and frequency-domain features are extracted from original time series data collected by sensor nodes. For high-dimensional data, feature selection plays an important role in improving the performance of motion recognition. Existing feature selection methods can be categorized into filter and wrapper methods. Wrapper methods usually achieve better performance than filter methods; however, in most cases, they are computationally intensive, and the feature subset obtained is usually optimized only for the specific learning algorithm. OBJECTIVE: This study aimed to provide a feature selection method for motion recognition of upper-limb exercises and improve the recognition performance. METHODS: Motion data from 5 types of upper-limb exercises performed by 21 participants were collected by a customized inertial measurement unit (IMU) node. A total of 60 time-domain and frequency-domain features were extracted from the original sensor data. A hybrid feature selection method by combining filter and wrapper methods (FESCOM) was proposed to eliminate irrelevant features for motion recognition of upper-limb exercises. In the filter stage, candidate features were first selected from the original feature set according to the significance for motion recognition. In the wrapper stage, k-nearest neighbors (kNN), Naïve Bayes (NB), and random forest (RF) were evaluated as the wrapping components to further refine the features from the candidate feature set. The performance of the proposed FESCOM method was verified using experiments on motion recognition of upper-limb exercises and compared with the traditional wrapper method. RESULTS: Using kNN, NB, and RF as the wrapping components, the classification error rates of the proposed FESCOM method were 1.7%, 8.9%, and 7.4%, respectively, and the feature selection time in each iteration was 13 seconds, 71 seconds, and 541 seconds, respectively. CONCLUSIONS: The experimental results demonstrated that, in the case of 5 motion types performed by 21 healthy participants, the proposed FESCOM method using kNN and NB as the wrapping components achieved better recognition performance than the traditional wrapper method. The FESCOM method dramatically reduces the search time in the feature selection process. The results also demonstrated that the optimal number of features depends on the classifier. This approach serves to improve feature selection and classification algorithm selection for upper-limb motion recognition based on wearable sensor data, which can be extended to motion recognition of more motion types and participants.

2.
Clin Rehabil ; 35(8): 1103-1116, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33706572

RESUMO

OBJECTIVE: To evaluate the effects and safety of repetitive transcranial magnetic stimulation (rTMS) on aphasia in stroke patients. METHODS: We searched databases from inception to January 28, 2021. Randomized control trials investigating the effects and safety of rTMS for aphasia patients after stroke were included. Study screening, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted with Review Manager 5.3 software. The quality of the evidence was assessed by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS: Twenty-eight studies with 1287 patients were included. All studies were assessed at low or unclear risk of bias in one or more domains. The meta-analysis exhibited rTMS was better than sham rTMS and conventional rehabilitation in language recovery. Low-frequency rTMS showed greater improvement in language recovery except for comprehension than sham rTMS. Low-frequency and bilateral rTMS were superior to conventional rehabilitation in language recovery. High-frequency rTMS was no better than sham rTMS and conventional rehabilitation for improving aphasia. The rTMS had better effects in naming, comprehension and aphasia quotient at 20 sessions. Eleven studies reported rTMS was safe for aphasia patients after stroke. The quality of evidence for all outcomes was low or very low, and publication bias may exist. CONCLUSIONS: rTMS may be relatively effective and safe for aphasia patients after stroke. However, these findings should be treated with caution due to high heterogeneity and potential biases.


Assuntos
Afasia/etiologia , Afasia/reabilitação , Acidente Vascular Cerebral/complicações , Estimulação Magnética Transcraniana , Humanos , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral , Resultado do Tratamento
3.
BMC Complement Med Ther ; 21(1): 23, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-33413354

RESUMO

BACKGROUND: Evidence showed that Tai Chi may have beneficial effects among hypertensive individuals, although the results are not convincing. We aim to conduct a high-quality clinical trial with 24-h BP measurement to provide robust evidence of Tai Chi for essential hypertension. METHODS: This is an open-label single-center randomized controlled trial with 3 parallel arms. We will compare Tai Chi with walking and waiting-list control. We will recruit 234 hypertensive patients with mild to moderate essential hypertension and randomly assign them to 3 different groups. Participants in Tai Chi group will receive a group-format Yang style 24-form Tai Chi exercise program, 3 sessions per week for 12 weeks. The walking group will be asked to walk, 3 sessions per week for 12 weeks. The waiting-list group will not receive any interventions and/or exercise training. The primary outcome is the change in average 24-h systolic blood pressure (SBP) between baseline and 12 weeks after randomization. The secondary outcomes include 24-h Diastolic Blood Pressure (DBP), average SBP and average DBP during the daytime and night-time, blood pressure (BP) variability, SBP load and DBP load, circadian rhythm of BP, and morning BP surge, endothelial functional indicators, home measured BP, quality of life, adverse events and so on. DISCUSSION: We expect findings of this trial will provide important insight into application of Tai Chi as an effective and acceptable method for hypertensive patients. Successful completion of this proposed study will also contribute to promotion of Tai Chi in the community in the future. TRIAL REGISTRATION: Clinicaltrials.gov registry: https://clinicaltrials.gov/ct2/show/NCT04267471 , date: February 12, 2020.


Assuntos
Hipertensão Essencial/terapia , Tai Ji , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Humanos , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Caminhada
4.
Front Neurol ; 11: 984, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33250835

RESUMO

Objective: This study aimed to review the research status and to demonstrate the hot spots and frontiers of epilepsy and circadian rhythm via CiteSpace. Method: We searched Web of Science (WoS) for studies related to epilepsy and circadian rhythm from inception to 2020. CiteSpace was used to generate network maps about the collaborations between authors, countries, and institutions and reveal hot spots and frontiers of epilepsy and circadian rhythm. Results: A total of 704 studies related to epilepsy and circadian rhythm from the WoS were retrieved. Sanchez-Vazquez FJ was the most prolific author (17 articles). The USA and University of Murcia were the leading country and institution in this field with 219 and 22 publications, respectively. There were active collaborations among the authors, countries, and institutions. Hot topics focused on the interaction between epilepsy and circadian rhythm, as well as possible novel treatments. Conclusions: Based on the results of CiteSpace, the current study suggested active cooperation between authors, countries, and institutions. Major ongoing research trends include the circadian rhythm of epilepsy based on different epileptic focus and the interaction between epilepsy and circadian rhythm, especially through melatonin, sleep-wake cycles, and clock genes, which may implicate possible treatments (such as chronotherapy, neural stem cells transplantation) for epilepsy in the future.

6.
Comput Math Methods Med ; 2020: 1862168, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32952598

RESUMO

The Traditional Chinese Medicine (TCM) formula is the main treatment method of TCM. A formula often contains multiple herbs where core herbs play a critical therapeutic effect for treating diseases. It is of great significance to find out the core herbs in formulae for providing evidences and references for the clinical application of Chinese herbs and formulae. In this paper, we propose a core herb discovery model CHDSC based on semantic analysis and community detection to discover the core herbs for treating a certain disease from large-scale literature, which includes three stages: corpus construction, herb network establishment, and core herb discovery. In CHDSC, two artificial intelligence modules are used, where the Chinese word embedding algorithm ESSP2VEC is designed to analyse the semantics of herbs in Chinese literature based on the stroke, structure, and pinyin features of Chinese characters, and the label propagation-based algorithm LILPA is adopted to detect herb communities and core herbs in the herbal semantic network constructed from large-scale literature. To validate the proposed model, we choose chronic glomerulonephritis (CGN) as an example, search 1126 articles about how to treat CGN in TCM from the China National Knowledge Infrastructure (CNKI), and apply CHDSC to analyse the collected literature. Experimental results reveal that CHDSC discovers three major herb communities and eighteen core herbs for treating different CGN syndromes with high accuracy. The community size, degree, and closeness centrality distributions of the herb network are analysed to mine the laws of core herbs. As a result, we can observe that core herbs mainly exist in the communities with more than 25 herbs. The degree and closeness centrality of core herb nodes concentrate on the range of [15, 40] and [0.25, 0.45], respectively. Thus, semantic analysis and community detection are helpful for mining effective core herbs for treating a certain disease from large-scale literature.


Assuntos
Descoberta de Drogas/métodos , Medicamentos de Ervas Chinesas/classificação , Medicamentos de Ervas Chinesas/uso terapêutico , Glomerulonefrite/tratamento farmacológico , Fitoterapia , Algoritmos , Inteligência Artificial , China , Doença Crônica , Biologia Computacional , Mineração de Dados , Bases de Dados de Produtos Farmacêuticos , Descoberta de Drogas/estatística & dados numéricos , Humanos , Conceitos Matemáticos , Medicina Tradicional Chinesa/métodos , Medicina Tradicional Chinesa/estatística & dados numéricos , Semântica
7.
Syst Rev ; 9(1): 170, 2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746913

RESUMO

BACKGROUND: The World Health Organization declared on March 11, 2020, that the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) has escalated from epidemic into pandemic. As the initial outbreak area, China has taken multiple active measures to deal with the epidemic. Updated versions of diagnosis and treatment guideline for novel coronavirus (COVID-19) patients have been issued, and traditional Chinese herbal medicine has been recommended as a treatment. The objective of this study will be to summarize the recommendations in current clinical practice guidelines about the use of traditional Chinese herbal medicine for COVID-19 patients. We will also evaluate and report on the methodological and reporting quality of these guidelines. METHODS: In this systematic review, we will search for guidelines, expert consensuses, and policy documents published since December 2019 in electronic databases (e.g., PubMed, EMBASE, and Chinese databases) and on websites of governments or organizations (e.g., The National Guideline Clearinghouse [NGC], Guidelines International Network [GIN], National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network [SIGN], and WHO). Eligible documents will be independently selected, and relevant data will be independently extracted by two reviewers. We will also independently evaluate the methodological quality and reporting quality of the included guidelines, using the Appraisal of Guidelines for REsearch & Evaluation (AGREE) II tool and Reporting Items for Practice Guidelines in Healthcare (RIGHT) statement, respectively. Any discrepancies will be discussed and resolved through discussion among the reviewers. We will use the extracted information to summarize their recommendations for traditional Chinese herbal formulae and Chinese patent medicine for COVID-19 patients and to summarize the strength and quality of these recommendations with reference to the results of AGREE II and RIGHT tools. DISCUSSION: This review will summarize the recommendations in current clinical practice guidelines and provide insight into the implementation strategies for traditional Chinese herbal medicine in COVID-19 patients. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020179205.


Assuntos
Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa , Pneumonia Viral/tratamento farmacológico , Guias de Prática Clínica como Assunto , Revisões Sistemáticas como Assunto , COVID-19 , China , Consenso , Infecções por Coronavirus/virologia , Humanos , Pandemias , Pneumonia Viral/virologia , Projetos de Pesquisa , SARS-CoV-2
8.
Pain Res Manag ; 2020: 3825617, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32269669

RESUMO

Background: Migraine is a common neurological disease, which burdens individuals and society all over the world. Acupuncture, an important method in Traditional Chinese Medicine, is widely used in clinical practice as a treatment for migraine. Several systematic reviews (SRs) have investigated the effectiveness and safety of acupuncture for migraine. Objective: To summarize and critically assess the quality of relevant SRs and present an objective and comprehensive evidence on the effectiveness and safety of acupuncture for migraine. Data Sources. MEDLINE, Embase, Cochrane Library, PROSPERO database, Chinese National Knowledge Infrastructure (CNKI), Chinese Biological Medicine (CBM), China Science and Technology Journal (SCTJ), and WanFang database (WF) were searched from inception to December 2019 and grey literatures were manually searched. Selection Criteria. SRs which meet the criteria were independently selected by 2 reviewers according to a predetermined protocol. Data Extraction. Characteristics of included SRs were independently extracted by 2 reviewers following a predefined data extraction form. Review Appraisal. The methodological quality, risk of bias, and reporting quality of included SRs were assessed, respectively, by a Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, the Risk of Bias in Systematic reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis-Acupuncture (PRISMA-A) statement. The quality of outcomes was evaluated by the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: A total of 15 SRs were included. All the SRs were published between 2011-2019. Based on AMSTAR 2, 14 out of 15 SRs were rated critically low quality and 1 was rated low quality. According to ROBIS tool, 9 SRs (60%) were low risk of bias. With the PRISMA-A checklist, we found 11 out of 15 SRs were found adequately reported over 70%. With the GRADE tool, we found high quality of evidence indicated that the effective rate of acupuncture was superior to western medicine in treatment of migraine. Besides, acupuncture reduced more headache days and the times of using painkiller and was more effective in reducing the frequency and degree of headache than western medicine and sham acupuncture. Limitations. There might be some missing information. The accuracy of the conclusions may be decreased reduced since we were unable to synthesis all the evidence. Conclusions: Based on high quality of evidence, we concluded that acupuncture may be an effective and safe therapy for migraine. However, the quality of SRs in acupuncture for migraine still needs more improvement.


Assuntos
Terapia por Acupuntura , Transtornos de Enxaqueca/terapia , Manejo da Dor/métodos , Revisões Sistemáticas como Assunto , Terapia por Acupuntura/efeitos adversos , Terapia por Acupuntura/métodos , China , Humanos , Manejo da Dor/efeitos adversos
9.
Syst Rev ; 9(1): 75, 2020 04 08.
Artigo em Inglês | MEDLINE | ID: mdl-32268923

RESUMO

BACKGROUND: A new type of coronavirus, novel coronavirus (COVID-19), is causing an increasing number of cases of pneumonia and was declared a Public Health Emergency of International Concern by the World Health Organization on 30 January 2020. The virus first appeared in Wuhan, China, in late December 2019, and traditional Chinese herbal medicine is being used for its treatment. This systematic review and meta-analysis will assess studies of the effects of traditional Chinese herbal medicine in COVID-19 pneumonia. METHODS: We will search electronic databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang database using keywords related to COVID-19 and traditional Chinese herbal medicine. Reference lists of relevant trials and reviews will be searched. We will manually search gray literature, such as conference proceedings and academic degree dissertations, and trial registries. Two independent reviewers will screen studies (XL and DZ), extract data (YL and LG), and evaluate risk of bias (YL and DZ). Data analysis will be conducted using the Review Manager software (version 5.3.5) and R software (version 3.6.1). Statistical heterogeneity will be assessed using a standard chi-square test with a significance level of P < 0.10. Biases associated with study size (e.g., publication bias) will be investigated using funnel plots, Egger's test and Begg's test, and Trim and Fill analysis. DISCUSSION: This study will provide a high-quality synthesis of the effects of traditional Chinese herbal medicine for COVID-19. The use of traditional Chinese herbal medicine for treatment or prevention of these novel viral infections affecting the pneumonia will be investigated. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42020168004.


Assuntos
Betacoronavirus/efeitos dos fármacos , Infecções por Coronavirus/terapia , Medicamentos de Ervas Chinesas/uso terapêutico , Medicina Tradicional Chinesa , Pneumonia Viral/terapia , COVID-19 , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Humanos , Metanálise como Assunto , Pandemias/prevenção & controle , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , SARS-CoV-2 , Revisões Sistemáticas como Assunto
10.
Curr Hypertens Rep ; 22(3): 25, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32124064

RESUMO

PURPOSE OF REVIEW: To investigate the effectiveness and safety of Tai Chi for essential hypertension (EH). RECENT FINDINGS: A total of 9 databases were searched from inception to January 1, 2020. Randomized controlled trials (RCTs) investigating the effectiveness and safety of Tai Chi for EH were included. Study selection, data extraction, and quality assessment were performed independently by 2 reviewers. A total of 28 RCTs involving 2937 participants were ultimately included in this systematic review. Meta-analysis showed that, compared with health education/no treatment, other exercise or antihypertensive drugs (AHD), Tai Chi showed statistically significant difference in lowering systolic blood pressure (SBP) and diastolic blood pressure (DBP). The trial sequential analysis suggested that the evidence in our meta-analysis was reliable and conclusive. Subgroup analyses of Tai Chi vs. AHD demonstrated Tai Chi for hypertension patients < 50 years old showed greater reduction in SBP and DBP. Intervention of 12-24 weeks could significantly lower SBP and DBP. Among 28 included RCTs, 2 RCTs reported that no adverse events occurred. The quality of evidence for the blood pressure (BP) of Tai Chi vs. AHD was moderate, and DBP of Tai Chi vs. health education (HE)/ no treatment (NT) was high. Other outcome indicators were considered low or very low quality according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Tai Chi could be recommended as an adjuvant treatment for hypertension, especially for patients less than 50 years old. However, due to poor methodological qualities of included RCTs and high heterogeneity, this conclusion warrants further investigation.


Assuntos
Hipertensão Essencial , Tai Ji , Pressão Sanguínea , Hipertensão Essencial/terapia , Humanos , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Medicine (Baltimore) ; 99(6): e18932, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32028402

RESUMO

BACKGROUND: Spasticity is one of the manifestations of motor dysfunction in upper motor neuron syndrome, which is characterized by increased muscle tone. Spasticity seriously affects the motor function and activity of daily life of patients. Some studies have shown that extracorporeal shock wave therapy (ESWT) can relieve spasticity in recent years. However, the effectiveness and safety of ESWT on spasticity after motor neuron injury have not been confirmed. The purpose of this systematic review (SR) is to evaluate the effectiveness and safety of ESWT on spasticity after upper motor neuron injury. METHODS: We will search China National Knowledge Infrastructure (CNKI), the Chinese Science and Technology Periodical Database (VIP), Wan Fang Data, China Biology Medicine (CBM), PubMed, Embase, The Cochrane Library, and Web of Science systematically from their inception dates through October 2019 to obtain randomized controlled trials (RCTs) using ESWT to relieve spasticity in patients after upper motor neuron injury. The primary outcome will be the Modified Ashworth Scale (MAS). Secondary outcomes will include Composite Spasticity Scale (CSS), Spasm Frequency Scale, Modified Tardieu Scale (MTS), electrophysiological study (ratio of maximum H reflex to maximum M response, root mean square value, integrated electromyogram, co-contraction ratio, etc.), or other spasticity-related outcomes. In addition, adverse events will also be assessed as safety measurement. Study selection, data extraction, and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be performed using Review Manager software (RevMan, version 5.3.5) and R (version 3.6.1) software. RESULTS: We will synthesize current studies to evaluate the effectiveness and safety of ESWT on spasticity after upper motor neuron injury. CONCLUSION: Our study will provide evidence of ESWT on spasticity after upper motor neuron injury. ETHICS AND DISSEMINATION: The ethical approval is not required since SR is based on published studies. The results of this SR will be published in a peer-reviewed scientific journal according to the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines. PROSPERO REGISTRATION NUMBER: CRD42019131059.


Assuntos
Braço/inervação , Tratamento por Ondas de Choque Extracorpóreas , Espasticidade Muscular/terapia , Humanos , Projetos de Pesquisa
12.
Ann Phys Rehabil Med ; 63(6): 505-517, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31981834

RESUMO

BACKGROUND: Falls play a pivotal role in the cause of injury or death and have become a public health problem, especially for older people. Tai Chi may be an effective approach to improving balance and reducing falls. However, the conclusions of systematic reviews (SRs) have been inconsistent and the quality needs to be appraised critically. OBJECTIVE: To provide an overview of the methodological quality, risk of bias and reporting quality as well as quality of evidence of SRs of Tai Chi for improving balance and reducing falls. METHODS: We conducted a systematic search of English- and Chinese-language SRs in 8 electronic databases, from inception to October 2019. The methodological quality, risk of bias, reporting quality and the quality of evidence were independently assessed by 2 reviewers who used the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), Risk of Bias in Systematic reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Grades of Recommendations, Assessment, Development and Evaluation (GRADE). Primary outcomes were fall rate and the Berg Balance Scale score in older people and people with Parkinson disease. Secondary outcomes included these outcomes in stroke, osteoarthritis and heart failure. RESULTS: A total of 14 relevant SRs were included: 13 were rated critically low quality and 1 was rated low quality by AMSTAR 2. By the ROBIS, all SRs were rated low risk in Phase 1 (assessing relevance) and Domain 1 of Phase 2 (study eligibility criteria). With regard to Domain 2, assessing the identification and selection of studies, 3 (21.4%) SRs were rated low risk. Eleven (71.4%) were rated low risk in Domain 3 (data collection and study appraisal), 11 (71.4%) were rated low risk in Domain 4 (synthesis and findings), and 9 (64.3%) were rated low risk in Phase 3 (risk of bias in the review). According to PRISMA, the reporting was relatively complete, but there were still some reporting flaws in the topic of protocol and registration (2/14, 14.3%), search strategy (5/14, 35.7%), risk of bias (6/14, 42.9%), additional analyses (6/14, 42.9%) and funding (4/14, 28.6%). Among the 14 SRs, Tai Chi had benefits for improving balance and reducing falls in older people and people with Parkinson disease; however, no definitive conclusions could be drawn for its effectiveness in stroke, osteoarthritis and heart failure. The level of evidence for fall rate was "moderate" to "high" for older people and "low" for those with Parkinson disease. The level of evidence of the Berg Balance Scale was "low" to "moderate" for older people and "low" for those with Parkinson disease. Among the downgraded factors, imprecision was the most common, followed by inconsistency and publication bias. CONCLUSIONS: Tai Chi may be beneficial for improving balance and reducing falls in older people and those with Parkinson disease. Because of limitations and inconsistent conclusions, further rigorous, normative and comprehensive SRs are needed to provide robust evidence for definitive conclusions.

13.
Medicine (Baltimore) ; 99(4): e18853, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31977884

RESUMO

BACKGROUND: Tai Chi is gaining an increasing popularity in rehabilitation management of chronic conditions. Yet no consensus has reached on its efficacy and safety of type 2 diabetes despite that several systematic reviews (SRs) were published on this topic. Therefore, we will conduct an overview to critically evaluate current SRs and implement an updated metaanalysis with recently published randomized controlled trials (RCTs). METHODS: A systematic literature search of relevant RCTs-based SRs will be conducted in electronic databases including Medline, Embase, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database from their inceptions to search date without language restrictions. Eligible SRs will be methodologically assessed by the assessment of multiple SRs 2 and Risk of Bias in SRs tool and their RCTs included will be extracted for further evidence synthesis. To update current meta-analysis on this topic, a supplementary search will be implemented for related newly emerged RCTs. Cochrane risk of bias assessment tool will be applied for RCTs quality evaluation. The grading of recommendations assessment, development and evaluation will be utilized for evidence quality assessment of outcomes. Study characteristic information on participants, interventions, outcomes, comparisons and conclusions will be described in detail. Review Manager V5.3 will be used for risk of bias assessment and Stata 14.0 for meta-analysis and sensitivity analysis. RESULTS: The study results will be disseminated through a peer-reviewed journal publication or conference presentation. CONCLUSIONS: This study finding will provide an updated evidence of Tai Chi for patients with type 2 diabetes mellitus (T2DM), thus to help inform clinical physicians, T2DM patients and their families to develop better rehabilitation plans and to draw more attention of decision-makers in exercise rehabilitation related policy-making.This study protocol has been applied for registration on PROSPERO platform (https://www.crd.york.ac.uk/PROSPERO/), with an assigned ID: CRD42019140988.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Tai Ji , Terapia por Exercício/métodos , Humanos , Metanálise como Assunto , Qualidade de Vida , Revisões Sistemáticas como Assunto , Resultado do Tratamento
14.
Curr Protein Pept Sci ; 21(1): 66-77, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31424367

RESUMO

Alzheimer's disease (AD) is the most common neurodegenerative disorder. The pathogenesis of AD is very complicated. For decades, the amyloid hypothesis has influenced and guided research in the field of AD. Meanwhile, researchers gradually realized that AD is caused by multiple concomitant factors, such as autophagy, mitochondrial quality control, insulin resistance and oxidative stress. In current clinical trials, the improvement strategies of AD, such as Aß antibody immunotherapy and gamma secretase inhibitors, are limited. There is mounting evidence of neurodegenerative disorders indicated that activation of AMP-activated protein kinase (AMPK) may have broad neuroprotective effects. We reviewed the researches on AMPK for AD, the results demonstrated that activation of AMPK is controversial in Aß deposition and tau phosphorylation, but is positive to promote autophagy, maintain mitochondrial quality control, reduce insulin resistance and relieve oxidative stress. It is concluded that AMPK might be a new target for AD by aggressively treating the risk factors in the future.


Assuntos
Proteínas Quinases Ativadas por AMP/genética , Doença de Alzheimer/tratamento farmacológico , Aminoimidazol Carboxamida/análogos & derivados , Peptídeos beta-Amiloides/metabolismo , Fármacos Neuroprotetores/uso terapêutico , Pironas/uso terapêutico , Ribonucleotídeos/uso terapêutico , Tiofenos/uso terapêutico , Proteínas tau/genética , Proteínas Quinases Ativadas por AMP/metabolismo , Doença de Alzheimer/genética , Doença de Alzheimer/metabolismo , Doença de Alzheimer/patologia , Aminoimidazol Carboxamida/uso terapêutico , Secretases da Proteína Precursora do Amiloide/genética , Secretases da Proteína Precursora do Amiloide/metabolismo , Peptídeos beta-Amiloides/genética , Autofagia/efeitos dos fármacos , Autofagia/genética , Ensaios Clínicos como Assunto , Regulação da Expressão Gênica , Humanos , Resistência à Insulina , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitocôndrias/patologia , Estresse Oxidativo/efeitos dos fármacos , Fosforilação , Proteínas tau/metabolismo
15.
Medicine (Baltimore) ; 98(52): e18561, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31876757

RESUMO

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation approach, might be a promising technique in the management of aphasia after cerebrovascular accidents (CVA). This protocol of systematic review (SR) aims to investigate the effectiveness and safety of rTMS in patients with aphasia after CVA. METHODS: The following databases will be searched: PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge infrastructure (CNKI), Technology Periodical Database (VIP), WanFang Data, and China Biology Medicine (CBM) from inception to August 2019. Randomized controlled trials (RCTs) investigating the effectiveness and safety of rTMS for aphasia patients after CVA will be included. Primary outcome will include Boston Diagnostic Aphasia Examination (BDAE). Secondary outcomes will include Aphasia Battery of Chinese (ABC), Aachen Aphasia Test (AAT), Aphasia Quotient (AQ), the Western Aphasia Battery (WAB), Standard Language Test of Aphasia (SLTA), Aphasia Severity Rating Scale (ASRS), Concise China Aphasia Test Scale (CCAT), Amsterdam-Nijmegen Everyday Language Test (ANELT), or other related outcomes. Adverse events such as headache, tinnitus, anxiety, fatigue, or epileptic seizure will be considered as safety measurement. Studies screening, data extraction, and methodological quality assessment will be performed independently by two reviewers. Meta-analysis will be conducted with Review Manager 5.3 software and R software 3.6.1. RESULTS: This study will provide a high-quality synthesis of RCTs on the effectiveness and safety of rTMS as an adjuvant therapy in the treatment of aphasia. CONCLUSION: The conclusion of this study will help clinicians and patients with aphasia after CVA to make decision. ETHICS AND DISSEMINATION: No privacy health information will be collected, thus formal ethics approval is not required. The findings of this SR will be submitted to a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42019144587.


Assuntos
Afasia/terapia , Acidente Vascular Cerebral/terapia , Estimulação Transcraniana por Corrente Contínua , Afasia/etiologia , Humanos , Acidente Vascular Cerebral/complicações , Estimulação Transcraniana por Corrente Contínua/efeitos adversos , Estimulação Transcraniana por Corrente Contínua/métodos , Resultado do Tratamento
16.
Medicine (Baltimore) ; 98(46): e17929, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31725646

RESUMO

BACKGROUND: Upper limb dysfunction is one of common sequelae of stroke which limits daily activities and decreases quality of life of patients, as well as increasing caregiving burden on families. Theta burst stimulation (TBS) is considered to be a beneficial therapy for post-stroke patients with upper limb motor dysfunction, but there is a lack of a high quality evidence. We aim to investigate the effectiveness and safety of TBS for upper limb motor dysfunction in patients with stroke. METHODS: The following databases will be searched: PubMed, EMBASE, The Cochrane Library, Web of Science, China Biology Medicine (CBM), China National Knowledge infrastructure (CNKI), Technology Periodical Database (VIP) and WanFang Data from the inception to October 2019. All relevant randomized controlled trials (RCTs) using TBS to treat poststroke patients with upper limb motor dysfunction will be included. The primary outcome is Upper Limb Fugl-Meyer Assessment (UL-FMA). Secondary outcomes will include Action Research Arm Test (ARAT), Box and Block Test (BBT), Wolf Motor Function Test (WMFT), Motor Assessment Scale (MAS), Nine Hole Peg Test (NHPT), Grip strength and other scales evaluating the upper limb motor function. Adverse effects will also be evaluated. Two reviewers will screen studies, extract data and assess the risk of bias of included studies independently. Data analysis will be conducted using Review Manager software (RevMan, version 5.3.5) and R software (version 3.6.1). RESULTS: Our SR will be conducted according to AMSTAR 2.0 and reported in compliance with PRISMA. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations. CONCLUSION: Our study will provide evidence for the effectiveness and safety of theta burst stimulation for upper limb motor dysfunction in patients with stroke. ETHICS AND DISSEMINATION: This systematic review (SR) does not require formal ethical approval since no privacy health information will be included. The findings of this SR will be disseminated through peer-reviewed publications or conference presentations. PROSPERO REGISTRATION NUMBER: CRD42019142462.


Assuntos
Paralisia/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Estimulação Magnética Transcraniana/métodos , Extremidade Superior/fisiopatologia , Força da Mão , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Reabilitação do Acidente Vascular Cerebral/efeitos adversos , Estimulação Magnética Transcraniana/efeitos adversos , Extremidade Superior/fisiologia
17.
Medicine (Baltimore) ; 98(39): e17124, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574812

RESUMO

INTRODUCTION: Spasticity is the most common complication after stroke, which is the main obstacle in the recovery of motor function. Spasticity seriously affects the quality of life and brings a heavy burden to families and society. Acupuncture is an effective method for stroke. However, whether acupuncture is effective for poststroke spasticity is still unknown. The purpose of this systematic review (SR) is to evaluate the effectiveness and safety of acupuncture for poststroke spasticity. METHODS AND ANALYSIS: We will search the following databases from inception to July 2019: China Biology Medicine (CBM), China National Knowledge Infrastructure (CNKI), Wan Fang Data, the Chinese Science and Technology Periodical Database (VIP), PubMed, Embase, The Cochrane Library, and Web of Science. All relevant randomized controlled trials (RCTs) utilizing acupuncture for poststroke spasticity will be included. The primary outcome is the modified Ashworth scale. Secondary outcomes include composite spasticity scale, clinic spasticity index, electromyographic activity, Hoffmann reflex activity, or other spasticity-related outcomes. Study selection, data extraction, and quality assessment will be performed independently by 2 reviewers. Assessment of risk of bias and data synthesis will be conducted using Review Manager V5.3 software. ETHICS AND DISSEMINATION: The ethical approval is not required since SR is based on published studies. The results of this SR will be published in a peer-reviewed scientific journal according to the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) guidelines. PROSPERO REGISTRATION NUMBER: CRD42019129779.


Assuntos
Terapia por Acupuntura/métodos , Espasticidade Muscular/terapia , Acidente Vascular Cerebral/complicações , Humanos , Metanálise como Assunto , Espasticidade Muscular/etiologia , Projetos de Pesquisa , Revisões Sistemáticas como Assunto , Resultado do Tratamento
18.
Medicine (Baltimore) ; 98(33): e16786, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31415383

RESUMO

INTRODUCTION: To investigate the effectiveness and safety of electromyography (EMG) biofeedback therapy in improving motor dysfunction among children with cerebral palsy (CP). METHODS AND ANALYSIS: The following databases will be searched: PubMed, EMBASE, ScienceDirect, the Cochrane Library, China National Knowledge infrastructure (CNKI), Technology Periodical Database (VIP), WanFang Data and China Biology Medicine (CBM) from inception to June 2019. All relevant randomized controlled trials (RCTs) utilizing EMG biofeedback therapy for CP will be included. The main outcome is the Gross Motor Function Measure (GMFM). Additional outcomes such as the Modified Ashworth Scale (MAS), Integral Electromyogram (iEMG), Composite Spasticity Scale (CSS), passive range of motion (PROM) or other related outcomes will be included, adverse effects of EMG biofeedback therapy and comparators will also be included. Two reviewers will screen studies, extract data and assess quality independently. Review Manager 5.3 will be used to assess the risk of bias, data synthesis, and subgroup analysis. ETHICS AND DISSEMINATION: This systematic review does not require formal ethical approval because all data will be analyzed anonymously. Results will provide a general overview and evidence concerning the effectiveness and safety of EMG biofeedback therapy for children with CP. The findings of this systematic review will be disseminated through peer-reviewed publications or conference presentations.


Assuntos
Biorretroalimentação Psicológica , Paralisia Cerebral/fisiopatologia , Eletromiografia , Criança , Humanos
19.
Artigo em Inglês | MEDLINE | ID: mdl-31379969

RESUMO

Objective: With the increasing social and economic burdens of balance impairment after stroke, the treatment for balance impairment after stroke becomes a major public health problem worldwide. Kinesio taping (KT) as a part of clinical practice has been used widely in the treatment of balance impairment after stroke. However, the clinical effects of KT for balance function have not been confirmed. The objective of this study is to investigate the effects and safety of KT for balance impairment after stroke. Methods: We conducted a systematic review (SR) and meta-analysis of randomized controlled trials (RCTs) on the effects of KT for balance impairment after stroke. We searched the following databases: (1) English databases: EMBASE (via Ovid), MEDLINE (via Ovid), the Cochrane library, PubMed, and PEDro; (2) Chinese databases: China Biology Medicine (CBM), Wan Fang database, China National Knowledge Infrastructure (CNKI), and VIP. Besides, hand searches of relevant references were also conducted. We systematically searched from the inception to December 2018, using the keywords (Kinesio, Kinesio Tape, tape, or Orthotic Tape) and (stroke, hemiplegia, or hemiplegic paralysis) and (balance or stability). The search strategies were adjusted for each database. The reference lists of included articles were reviewed for relevant trials. For missing data, we contacted the authors to get additional information. Results: 22 RCTs involved 1331 patients, among which 667 patients in the experimental group and 664 patients in the control group were included. Results of meta-analysis showed that, compared with conventional rehabilitation (CR), there was significant difference in Berg Balance Scale (BBS) (MD=4.46, 95%CI 1.72 to 7.19, P=0.001), Time Up and Go Test (TUGT) (MD=-4.62, 95%CI -5.48 to -3.79, P < 0.00001), functional ambulation category scale (FAC) (MD=0.53, 95%CI 0.38 to 0.68, P < 0.00001), Fugl-Meyer assessment (FMA-L) (MD=4.20, 95%CI 3.17 to 5.24, P < 0.00001), and Modified Ashworth Scale (MAS) (MD=-0.38, 95%CI -0.49 to -0.27, P < 0.00001). The results of subgroup analysis showed that there was no significant difference between KT and CR with ≤4 weeks treatment duration (< 4 weeks: MD=5.03, 95%CI -1.80 to 11.85, P=0.15; =4 weeks: MD=4.33, 95%CI -1.50 to 10.15, P=0.15), while there was significant difference with more than 4-week treatment duration (MD=4.77, 95%CI 2.58 to 6.97, P < 0.0001). Conclusions: Based on current evidence, KT was more effective than CR for balance function, lower limb function, and walking function in poststroke patients. Longer treatment duration may be associated with better effects. However, more well-conducted RCTs are required in the future.

20.
Medicine (Baltimore) ; 98(28): e16301, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305415

RESUMO

BACKGROUND: Knee osteoarthritis (KOA), known as severe degenerative arthritis, commonly occurs in middle-aged and elderly people all over the world. Acupuncture as traditional oriental intervention is getting widely used and several systematic reviews (SRs) have reported the effectiveness of acupuncture on pain relief and functional recovery in patients with KOA. OBJECTIVE: Conducting an overview of SRs to provide more reliable evidence-based medical references for clinical practitioners and researchers of the effectiveness and safety of acupuncture for KOA. DATA SOURCES: EMBASE, Medline, Web of science, the Cochrane library, China National Knowledge Infrastructure, the Chinese Science and Technology Periodical Database, China Biology Medicine, Wan Fang Digital Journals, and PROSPERO databases from inception to December 2018, magazines, websites, and unpublished sources. SELECTION CRITERIA: Potential SRs were independently selected by 2 reviewers following a predetermined protocol. DATA EXTRACTION: Data information of included SRs were independently extracted by 2 reviewers following a predetermined standardized data extraction form. REVIEW APPRAISAL: The risk of bias and reporting quality of included SRs were evaluated by the Risk of Bias in Systematic reviews (ROBIS) tool and the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) statement. The quality of evidence of outcomes was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS: A total of 12 SRs were included. All the SRs were published in recent 12 years, ranging from 2006 to 2017. According to ROBIS, 4 SRs were in low risk in domain 1 and 7 in domain 3 of phase 2, and 2 SRs were low risk in phase 3. Among 27 items of PRISMA, 19 items were reported over 70% of compliance. Using GRADE assessment, of 34 outcomes, high quality of evidence was found in 5 outcomes, 17 outcomes were rated moderate quality, and 11 outcomes were low quality. According to high-quality outcomes, acupuncture had more total effective rate, short-term effective rate, and less adverse reactions than western medicine in treating KOA. In terms of Lequesne index and Lysholm knee score scale score, the effectiveness of electroacupuncture was better than that of western medicine. LIMITATIONS: There might be missing information. There may be duplicated clinical trials included by each SR that might have impact on the synthetic findings. CONCLUSIONS: According to the high-quality evidence, we concluded that acupuncture may have some advantages in treating KOA. However, there are some risk of bias and reporting deficiencies still needed to be improved.


Assuntos
Terapia por Acupuntura , Osteoartrite do Joelho/terapia , Terapia por Acupuntura/efeitos adversos , Artralgia/etiologia , Artralgia/terapia , Humanos , Osteoartrite do Joelho/complicações , Segurança do Paciente , Revisões Sistemáticas como Assunto
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