未经授权:约束诱导运动疗法(CIMT)是中风后上肢运动功能障碍的常用治疗方法。然而,是否能有效改善脑卒中患者下肢运动功能仍存在争议。本系统综述综合研究现有证据,评价CIMT治疗脑卒中后下肢运动功能障碍的有效性。
UNASSIGNED:我们在八个电子数据库中全面搜索了与本研究相关的随机对照试验(PubMed,Embase,科克伦图书馆,WebofScience,CBM,CNKI,万方,和VIP)。我们根据平均差异和相应的95%置信区间(95%CI)评估了CIMT对卒中后下肢运动功能障碍的有效性。我们基于Cochrane偏差风险评估工具评估了方法学质量。提取一般信息后,意思是,以及纳入研究的标准偏差,我们使用RevMan5.3和Stata16.0进行了荟萃分析。主要指标是下肢Fugl-Meyer评估量表(FMA-L)。次要指标是伯格平衡量表(BBS),10米步行测试(10MWT),步态速度(GS),6分钟步行试验(6MWT),功能行走类别量表(FAC),定时并进行测试(TUGT),Brunnstrom下肢功能分期,承重,修改后的Barthel指数(MBI),功能独立性度量(FIM),卒中特定生活质量问卷(SSQOL),世界卫生组织生活质量评估(WHOQOL)和美国国立卫生研究院卒中量表(NIHSS)。
未经评估:我们最初确定了343项相关研究。其中,34名(总计2,008名患者)符合纳入标准。我们发现,接受CIMT治疗的患者的主要指标(FMA-L)评分明显优于未接受CIMT治疗的患者。CIMT治疗和常规理疗治疗的患者之间的平均差异为3.46(95%CI2.74-4.17,P<0.01,I2=40%),在接受CIMT加常规理疗治疗的患者和仅接受常规理疗治疗的患者之间有3.83(95%CI2.89-4.77,P<0.01,I2=54%),接受CIMT联合西药治疗的患者与仅接受西药治疗的患者之间的比率为3.50(95%CI1.08-5.92,P<0.01)。次要指标遵循相同的趋势。亚组分析显示,带设备的下肢CIMT似乎比不带设备的下肢CIMT产生更高的FMA-L评分平均差异(4.52,95%CI=3.65-5.38,P<0.01和3.37,95%CI分别=2.95-3.79,P<0.01)。
UNASSIGNED:CIMT可有效改善卒中后患者的下肢运动功能障碍;然而,符合条件的研究具有高度异质性.系统审查注册:https://www。crd.约克。AC.uk/prospro/display_record.php?RecordID=277466。
UNASSIGNED: Constraint-induced movement therapy (CIMT) is a common treatment for upper extremity motor dysfunction after a stroke. However, whether it can effectively improve lower extremity motor function in stroke patients remains controversial. This systematic
review comprehensively studies the current evidence and evaluates the effectiveness of CIMT in the treatment of post-stroke lower extremity motor dysfunction.
UNASSIGNED: We comprehensively searched randomized controlled trials related to this study in eight electronic databases (PubMed, Embase, The Cochrane Library, Web of Science, CBM, CNKI, WAN FANG, and VIP). We evaluated CIMT effectiveness against post-stroke lower extremity motor dysfunction based on the mean difference and corresponding 95% confidence interval (95% CI). We assessed methodological quality based on the Cochrane Bias Risk Assessment Tool. After extracting the general information, mean, and standard deviation of the included studies, we conducted a meta-analysis using RevMan 5.3 and Stata 16.0. The primary indicator was the Fugl-Meyer Assessment scale on lower limbs (FMA-L). The secondary indicators were the Berg balance scale (BBS), 10-meter walk test (10MWT), gait speed (GS), 6-min walk test (6MWT), functional ambulation category scale (FAC), timed up and go test (TUGT), Brunnstrom stage of lower limb function, weight-bearing, modified Barthel index (MBI), functional independence measure (FIM), stroke-specific quality of life questionnaire (SSQOL), World Health Organization quality of life assessment (WHOQOL), and National Institute of Health stroke scale (NIHSS).
UNASSIGNED: We initially identified 343 relevant studies. Among them, 34 (totaling 2,008 patients) met the inclusion criteria. We found that patients treated with CIMT had significantly better primary indicator (FMA-L) scores than those not treated with CIMT. The mean differences were 3.46 (95% CI 2.74-4.17, P < 0.01, I2 = 40%) between CIMT-treated and conventional physiotherapy-treated patients, 3.83 (95% CI 2.89-4.77, P < 0.01, I2 = 54%) between patients treated with CIMT plus conventional physiotherapy and patients treated only with conventional physiotherapy, and 3.50 (95% CI 1.08-5.92, P < 0.01) between patients treated with CIMT plus western medicine therapy and those treated only with western medicine therapy. The secondary indicators followed the same trend. The subgroup analysis showed that lower extremity CIMT with device seemed to yield a higher mean difference in FMA-L scores than lower extremity CIMT without device (4.52, 95% CI = 3.65-5.38, P < 0.01 and 3.37, 95% CI = 2.95-3.79, P < 0.01, respectively).
UNASSIGNED: CIMT effectively improves lower extremity motor dysfunction in post-stroke patients; however, the eligible studies were highly heterogeneous.Systematic
review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=277466.