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Tao T, Shi MP, Tan BY, Zhang XS, Sun FL, Liu BR, Li SJ, Li ZH. Evaluation of traditional Chinese exercise for knee osteoarthritis (KOA): an overview of systematic reviews. Syst Rev 2024; 13:187. [PMID: 39026375 PMCID: PMC11256411 DOI: 10.1186/s13643-024-02606-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 07/07/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) has become a public health issue. Several systematic reviews (SRs) and meta-analyses (MAs) indicate that traditional Chinese exercise (TCE) may be an effective treatment for reducing pain and stiffness and improving physical function in people with knee osteoarthritis (KOA). OBJECTIVES To evaluate the literature quality and evidence for the systematic reviews of TCE for KOA and provide evidence to support the clinical application of TCE for KOA. METHODS Eight databases were searched from their inception to January 3, 2023, to retrieve relevant literature, including China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journal Database (VIP), China Biology Medical literature database (CBM), PubMed, Embase, Web of Science and Cochrane Library, without restrictions on publication date or language. AMSTAR-2 and PRISMA 2020 assessed the methodological and reporting quality of included SRs/MAs. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was utilized to evaluate the quality of evidence. RESULTS A total of 18 SRs/MAs were included. The methodological quality was "very low" based on AMSTAR-2. The overall reporting quality was deficient based on PRISMA 2020. The quality of Chinese and English literature differed, with English literature being superior in methodological and reporting quality. Among 93 pieces of evidence obtained, 46 (49.46%) were of very low quality, 34 (36.56%) were of low quality, 13 (13.98%) were of moderate quality, and none were of high quality. TCE was supported by 76 pieces of evidence (81.72%). CONCLUSION TCE appears beneficial and safe for managing KOA. However, due to the relatively low methodological and evidentiary quality of included SRs/MAs, clinicians should interpret these findings cautiously.
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Affiliation(s)
- Tao Tao
- College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Ming-Peng Shi
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Bo-Yang Tan
- College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Xian-Shuai Zhang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Feng-Ling Sun
- Affiliated Hospital of the Changchun University of Chinese Medicine, Changchun, 130021, China
| | - Bao-Ren Liu
- Taojiatun Town Health Center, Gongzhuling City, Changchun, 136104, China
| | - Shao-Jun Li
- Affiliated Hospital of the Changchun University of Chinese Medicine, Changchun, 130021, China
| | - Zhen-Hua Li
- Affiliated Hospital of the Changchun University of Chinese Medicine, Changchun, 130021, China.
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Qiao H, Hao X, Wang G. Effects of mind-body exercise on knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord 2024; 25:229. [PMID: 38515124 PMCID: PMC10958976 DOI: 10.1186/s12891-024-07278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE To evaluate the effect of mind-body exercise on improving knee osteoarthritis (KOA) and thereby informing osteoarthritis exercise rehabilitation. METHODS The China National Knowledge Infrastructure (CNKI), Wanfang, PubMed/Medline, Cochrane Library, Web of Science, EBSCO, Embase, Scopus, and ProQuest databases were searched to identify randomized controlled trials (RCTs) that involved tai chi, yoga, and baduanjin interventions for KOA. The search period ranged from inception to October 25, 2022. The methodological quality of the included studies was evaluated by the Cochrane risk of bias assessment tool, and the included data were statistically analyzed and plotted using Review Manager 5.3 and Stata 14.0 software. RESULTS We included 17 articles with a total of 1122 patients. Compared with the control group, mind-body exercise significantly improved patient pain (standardized mean difference (SMD) = -0.65, 95% confidence interval (CI) [-0.87, -0.42], p < 0.00001), stiffness (SMD = -0.75, 95% CI [-1.05, -0.45], p < 0.00001), physical function (SMD = -0.82, 95% CI [-1.03, -0.62], p < 0.00001), mental health (SMD = 0.31, 95% CI [0.11, 0.51], p = 0.002), and depression (SMD = -0.32, 95% CI [-0.50, -0.15], p = 0.0003). In terms of motor ability, mind-body exercise significantly increased the 6-min walking distance (SMD = 18.45, 95% CI [5.80, 31.10], p = 0.004) and decreased timed up and go test time (SMD = -1.15, 95% CI [-1.71, -0.59], p < 0.0001). CONCLUSIONS The current study showed that mind-body exercise is safe and effective for KOA patients. However, given the methodological limitations of the included studies, additional high-quality evidence is needed to support the conclusions of this study.
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Affiliation(s)
- Hujun Qiao
- School of Physical Education, Soochow University, Suzhou, 215021, China.
- Changzhi University, Changzhi, 046000, China.
| | - Xin Hao
- Changzhi University, Changzhi, 046000, China
| | - Guoxiang Wang
- School of Physical Education, Soochow University, Suzhou, 215021, China.
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Guo G, Wang Y, Xu X, Lu K, Zhu X, Gu Y, Yang G, Yao F, Fang M. Effectiveness of Yijinjing exercise in the treatment of early-stage knee osteoarthritis: a randomized controlled trial protocol. BMJ Open 2024; 14:e074508. [PMID: 38453194 PMCID: PMC10921529 DOI: 10.1136/bmjopen-2023-074508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/11/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Knee osteoarthritis (KOA) is still a challenging degenerative joint disease with high morbidity and disease burden. Early-stage KOA, the focus of this study, could present a Window of Opportunity to arrest the disease process and reduce the disease burden. Yijinjing exercise is an important part of physical and psychological therapies in Traditional Chinese Exercise and may be an effective treatment. However, there is no clinical efficacy assessment of Yijinjing exercise for patients with early-stage KOA. Therefore, we designed a randomised controlled trial to evaluate the effectiveness of Yijinjing exercise on patients with early-stage KOA. METHODS AND ANALYSIS This is a parallel-design, two-arm, analyst assessor-blinded, randomised controlled trial. In total, 60 patients with early-stage KOA will be recruited and randomly assigned to the Yijinjing exercise group (n=30) and health education group (n=30) at a ratio of 1:1, receiving 12 weeks of Yijinjing exercise or health education accordingly. The primary outcome will be measured with the Western Ontario and McMaster Universities Osteoarthritis Index, and the secondary outcomes will include the Visual Analogue Scale, Short-Form 36 Item Health Survey Questionnaire, Beck Depression Inventory, Perceived Stress Scale, Berg Balance Scale, and Gait Analysis for a comprehensive assessment. Outcome measures are collected at baseline, at 12 week ending intervention and at the 12 week, 24 week and 48 week ending follow-up. The primay time point will be 12 weeks postintervention. Adverse events will be recorded for safety assessment. ETHICS AND DISSEMINATION This study has been approved by the ethical application of the Shanghai Municipal Hospital of Traditional Chinese Medicine Ethics Committee (2021SHL-KY-78). TRIAL REGISTRATION NUMBER ChiCTR2200065178.
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Affiliation(s)
- Guangxin Guo
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yihang Wang
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiruo Xu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Kaiqiu Lu
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuanying Zhu
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yijia Gu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guangpu Yang
- School of Basic Medical Sciences, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fei Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Wang X, Luo H. Effects of traditional Chinese exercise therapy on pain scores, sleep quality, and anxiety-depression symptoms in fibromyalgia patients: a systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:99. [PMID: 38281020 PMCID: PMC10821260 DOI: 10.1186/s12891-024-07194-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/10/2024] [Indexed: 01/29/2024] Open
Abstract
OBJECTIVE This study aims to assess the effectiveness of traditional Chinese exercise therapy in alleviating pain, improving sleep quality, and reducing symptoms of anxiety and depression among fibromyalgia patients. METHODS We conducted a comprehensive search across various databases, including PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge, VIP database, and Wanfang, to identify randomized controlled trials (RCTs) examining the impact of Traditional Chinese Exercise (TCE) interventions on fibromyalgia. Two independent authors extracted data from the selected studies based on predefined inclusion and exclusion criteria. Meta-analyses were performed using RevMan 5.3. RESULTS The analysis encompassed 15 RCTs, comprising 936 participants. The meta-analysis revealed that TCE significantly surpassed the control group in reducing pain scores for fibromyalgia patients, as evidenced by improvements in FIQ [MD = -3.30, 95% CI (- 5.37, - 0.69), z = 2.53, p = 0.01] and VAS [MD = -1.87, 95% CI (- 2.12, - 1.61), z = 6.98, p < 0.00001]. Additionally, TCE demonstrated notable enhancements in sleep quality (PSQI) [MD = -2.23, 95% CI (- 2.86, - 1.61), z = 6.98, p < 0.0001], as well as in alleviating symptoms of anxiety and depression [MD = - 0.59, 95% CI (- 0.80, - 0.39), z = 5.63, p < 0.0001]. CONCLUSION Traditional Chinese Exercise (TCE) exhibits significant efficacy in ameliorating pain, enhancing sleep quality, and alleviating symptoms of anxiety and depression in fibromyalgia patients.
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Affiliation(s)
- Xinzheng Wang
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China
| | - Hongbin Luo
- Department of Physical Education, Zhejiang Chinese Medical University, Province, Zhejiang, 310053, Hangzhou, China.
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Tan B, Yan Y, Zhou Q, Ran Q, Chen H, Sun S, Lu W, Chen W, Wang J. Kinesitherapy for Knee Osteoarthritis Patients Physical and Psychological Health Based on "Traditional Chinese Exercise" Management Modalities: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Orthop Surg 2024; 16:3-16. [PMID: 38018392 PMCID: PMC10782256 DOI: 10.1111/os.13920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 11/30/2023] Open
Abstract
Traditional Chinese exercise ("TCE" management modalities), including but not limited to Tai Chi, Baduanjin, and Yijinjing, has a good effect on improving the physical function of patients with knee osteoarthritis, but less attention has been paid to the impact on the psychological health of patients, and currently there is insufficient evidence to support it. We conducted this study to provide a systematic synthesis of best evidence regarding the physical and mental health of patients with knee osteoarthritis treated by traditional Chinese exercise. Literature on the effectiveness of traditional Chinese exercise (Tai Chi, Baduanjin, Yijinjing, Qigong, etc.) versus conventional therapy (muscle-strength training of the lower extremity and aerobic training, wellness education, quadriceps strengthening exercises, etc.) on Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog scale (VAS), Short Form-36 (SF-36), Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) in knee osteoarthritis (KOA) from Pubmed, Web of Science, Ovid Technologies, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database, and SinoMed were collected from their inception to April 2022. Thirty-three studies with 2621 cases were included in this study. The study's results indicated that compared with conventional therapy, traditional Chinese exercise had more advantages on patients' WOMAC score, significantly reducing patients' overall WOMAC score (SMD = -0.99; 95% CI: -1.38, -0.60; p < 0.00001) and relieving pain (SMD = -0.76; 95% CI: -1.11, -0.40; p < 0.0001) in patients with KOA. It also has advantages over conventional therapy in improving mental component score (MCS) (SMD = 0.32; 95% CI: -0.00, 0.65; p = 0.05) and physical component score (PCS) (SMD = 0.34; 95% CI: 0.05, 0.62; p = 0.02). Compared with conventional therapy, traditional Chinese exercise can significantly reduce the effect on timed up and go test (TUG) score (SMD = -0.30; 95% CI: -0.50, -0.11; p = 0.002), beck depression inventory (DBI) score (SMD = -0.62; 95% CI: -1.03, -0.22; p = 0.002), and increase the impact on Berg Balance Scale (BBS) score (SMD = 0.60; 95% CI: 0.37, 0.83; p < 0.00001). The findings of this study indicated that traditional Chinese exercise improved body function and mental health in patients with knee osteoarthritis significantly. More high-quality clinical evidence-based data was needed to confirm the therapeutic effect of traditional Chinese exercise on the physical and mental health in KOA patients.
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Affiliation(s)
- Biao Tan
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Yan Yan
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Qiujun Zhou
- Department of First Clinical Medical CollegeZhejiang Chinese Medical UniversityHangzhouChina
| | - Qiang Ran
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Hong Chen
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Shiyi Sun
- Department of OrthopaedicsChina Academy of Chinese Medical Sciences, Wangjing HospitalBeijingChina
| | - Weizhong Lu
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Weiheng Chen
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Jiajun Wang
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
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Liu Q, Ni W, Zhang L, Zhao M, Bai X, Zhang S, Ding Y, Yin H, Chen L. Comparative efficacy of various exercise interventions on depression in older adults with mild cognitive impairment: A systematic review and network meta-analysis. Ageing Res Rev 2023; 91:102071. [PMID: 37704052 DOI: 10.1016/j.arr.2023.102071] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Exercise is a promising nonpharmacological treatment for improving depression in older adults with MCI, but it is unclear which exercises are most effective. The objectives of this study were to compare and rank the effectiveness of various exercise interventions for depression in mild cognitive impairment (MCI) and to investigate the effects of exercise on depression. METHODS The PRISMA-NMA guidelines were applied to the development and reporting of review criteria. The Cochrane Library, Web of Science, PsycINFO, PubMed, EMBASE, CINAHL, and Scopus databases were systematically searched by combining search terms for randomized controlled trial studies (RCTs) published in English from individual databases with the earliest available date set to March 10, 2023. Two evaluators independently selected and evaluated eligible studies of changes in depression in older adults with MCI after an exercise intervention. A protocol for this systematic review was registered in PROSPERO (Registration number: CRD42022377052). RESULTS A network meta-analysis was conducted on 15 eligible RCTs consisting of 4271 subjects, including aerobic (n = 6), mind-body (n = 6) and multicomponent (n = 3) exercise trials. Compared to controls, mind-body exercise showed the strongest improvement in depressive symptoms (SMD = -0.63, 95% CI: -1.13, -0.14), followed by aerobic (SMD = -0.57, 95% CI: -0.88, -0.26) and multicomponent exercise (SMD = -0.53, 95% CI: -1.02, -0.03). Notably, there were no statistically significant differences between exercise types: aerobic vs. mind-body (SMD = 0.06, 95% PrI: -0.71, 0.84), multicomponent vs. mind-body (SMD = 0.11, 95% PrI: -0.75, 0.97), or multicomponent vs. aerobic (SMD = 0.04, 95% PrI: -0.771, 0.86). CONCLUSIONS In this review, we found that mind-body exercise was most effective when compared to conventional controls and that multiple exercise modalities (aerobic, mind-body, and multicomponent exercise) had beneficial and comparable effects in reducing depressive states in older adults with MCI. These findings may guide clinical geriatric stakeholders and allied health professionals in providing more scientifically optimal exercise prescriptions for older adults with MCI. In the future, more high-quality, long-term clinical trials are needed to support the exploration of longer-term dynamic effects.
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Affiliation(s)
- Qian Liu
- Jilin University School of Nursing, Changchun, China
| | - Weiguang Ni
- Jilin University Physical Education College, Changchun, China
| | - Lijia Zhang
- The First Hospital of Hebei Medicine University, Shijiazhuang, China
| | - Mingzhu Zhao
- Jilin University School of Nursing, Changchun, China
| | - Xuechun Bai
- Jilin University School of Nursing, Changchun, China
| | - Sitao Zhang
- Jilin University School of Nursing, Changchun, China
| | - Yiwen Ding
- Jilin University School of Nursing, Changchun, China
| | - Huiru Yin
- Jilin University School of Nursing, Changchun, China.
| | - Li Chen
- Jilin University School of Nursing, Changchun, China.
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Niu K, Liu YL, Yang F, Wang Y, Zhou XZ, Qu Q. Efficacy of traditional Chinese exercise for sarcopenia: A systematic review and meta-analysis of randomized controlled trials. Front Neurosci 2022; 16:1094054. [PMID: 36620459 PMCID: PMC9813668 DOI: 10.3389/fnins.2022.1094054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
Objective To conduct a systematic review and meta-analysis to evaluate the effectiveness of Traditional Chinese Exercise (TCE) for sarcopenia. Methods A literature search was conducted in eight online databases from inception until September 2022. Based on the Cochrane risk of bias tool, randomized controlled trials (RCTs) with RoB score ≥ 4 were included for further analyses. The primary outcome was muscle strength and physical function, and the secondary outcomes were adverse events. Data collection and analyses were conducted by RevMan 5.4 Software. GRADE system was used to evaluate the certainty of evidence. Results A total of 13 eligible RCTs with 718 subjects were identified and included in this study. Among them, 10 RCTs involved Yijinjing; 2 involved Tai Chi; and 1 involved Baduanjin. Meta-analyses showed that TCE had better clinical effects than control measures in the chair stand test (P < 0.00001, I2 = 38%; Certainty of evidence: Moderate), squatting-to-standing test (P < 0.00001, I2 = 0%; Certainty of evidence: Moderate), 6-m gait speed (P < 0.00001, I2 = 13%; Certainty of evidence: Moderate), Time Up and Go Test (P = 0.03, I2 = 81%; Certainty of evidence: Low), peak torque of the extensors (P = 0.03, I2 = 0%; Certainty of evidence: Moderate), total work of the extensors (P = 0.03, I2 = 35%; Certainty of evidence: Moderate), peak torque of the flexors (P = 0.03, I2 = 47%; Certainty of evidence: Low), total work of the flexors (P = 0.02, I2 = 42%; Certainty of evidence: Low), the average power of the flexors (P = 0.03, I2 = 30%; Certainty of evidence: Moderate), and balance function (P < 0.00001, I2 = 53%; Certainty of evidence: Low). In additional, no adverse events were reported in participants who receive TCE. Conclusion The findings of the present systematic review, at least to a certain extent, provided supporting evidence for the routine use of TCE for sarcopenia.
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Affiliation(s)
- Kun Niu
- College of Traditional Chinese Medicine, Hainan Medical University, Haikou, China
| | - Ying-Lian Liu
- College of Traditional Chinese Medicine, Hainan Medical University, Haikou, China
| | - Fan Yang
- College of Traditional Chinese Medicine, Hainan Medical University, Haikou, China
| | - Yong Wang
- Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China
| | - Xia-Zhi Zhou
- College of Traditional Chinese Medicine, Hainan Medical University, Haikou, China,Xia-Zhi Zhou,
| | - Qing Qu
- Department of Massage, Hangzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University, Hangzhou, China,*Correspondence: Qing Qu,
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Yang L, Sibbritt D. Factors associated with Chinese herbal medicine use among middle-aged and older women with arthritis: evidence from China. Sci Rep 2022; 12:12566. [PMID: 35869253 PMCID: PMC9307752 DOI: 10.1038/s41598-022-16927-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 07/18/2022] [Indexed: 11/20/2022] Open
Abstract
Chinese herbal medicine (CHM) has been used for arthritis in China and elsewhere across the world. However, knowledge about the prevalence and profile of middle-aged and older women who used CHM for arthritis in China is limited. This study aims to identify potentially important insights into the factors associated with CHM use amongst middle-aged and older women with arthritis in China. Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), a population-based survey of Chinese adults aged 45 years or older, comprising 10,833 Chinese women who completed a questionnaire in 2015. Stepwise multiple logistic regression modeling was conducted to determine the key factors (demographic, health condition, and health services use) predicting the use of CHM for the treatment of arthritis. Results revealed that 17.2% of women with arthritis were taking CHM for their arthritic symptoms. Women with arthritis who used CHM were more likely to experience finger pain (OR = 1.70), had difficulty in stooping, kneeling, crouching (OR = 1.40), visited a Traditional Chinese hospital (OR = 2.22), consulted massage therapists (OR = 2.06) and/or had experienced a fall (OR = 1.41). The prevalence of CHM use is high amongst middle-aged and older Chinese women with arthritis. Given the high risk of functional disability and impaired mental health, further research is needed to explore the potential health benefits of CHM for women with arthritis in order to help facilitate the efficacious and safe use of CHM alongside conventional medical care.
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Zhang R, Song W, Zhu L. Effects of traditional Chinese exercises on insomnia after coronavirus disease 2019: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31709. [PMID: 36451411 PMCID: PMC9704889 DOI: 10.1097/md.0000000000031709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND There is growing evidence that coronavirus disease 2019 (COVID-19) can trigger acute episodes of insomnia. Reports on the treatment of COVID-19-related insomnia are limited. Therefore, our study aims to perform a systematic evaluation and meta-analysis of the effects of traditional Chinese exercises (TCEs) in patients with insomnia due to COVID-19. METHODS We will search the Embase, PubMed, Cochrane Library, Web of Science, MEDLINE, Scopus, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure Database, and Wan Fang Database from December 1, 2019 to October 2, 2022 to identify all articles on treatment of COVID-19-related insomnia using TCEs. Two researchers will screen the articles and extract the relevant information. RESULTS The results will provide a systematic overview of the current evidence on the use of TCE to treat patients with insomnia after COVID-19. CONCLUSIONS The conclusions of this study will help clarify the effects of TCEs on patients with insomnia after COVID-19.
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Affiliation(s)
- Runtong Zhang
- Genertec Medical Corporation Limited, Beijing, China
| | - Wenjing Song
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Luwen Zhu
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
- * Correspondence: Luwen Zhu, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150000, China (e-mail: )
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Wen YR, Shi J, Wang YF, Lin YY, Hu ZY, Lin YT, Wang XQ, Wang YL. Are Mind-Body Exercise Beneficial for Treating Pain, Function, and Quality of Life in Middle-Aged and Old People With Chronic Pain? A Systematic Review and Meta-Analysis. Front Aging Neurosci 2022; 14:921069. [PMID: 35800981 PMCID: PMC9255956 DOI: 10.3389/fnagi.2022.921069] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background Aging is a significant risk factor in chronic pain development with extensive disability and greater health care costs. Mind-body exercise (MBE) has been scientifically proven to affect the pain intensity and physical health. Objectives To assess the effects of MBE modes (Tai Chi, yoga, and qigong) for treating chronic pain among middle-aged and old people, compared with nonactive and active treatment, as well as function, quality of life, and adverse events. Methods We searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Scientific Journals Full-Text Database (VIP) till March 2022. No restrictions were chartered within the year and language of publication. We included randomized controlled trials of MBE treatment in middle-aged and elderly people with chronic pain. The overall certainty of evidence was evaluated by using the GRADE approach. Results A total of 17 studies (n = 1,332) were included in this review. There was low-certainty evidence indicating that MBE had a moderate effect on reducing pain compared with the nonactive and active control group (standard mean difference (SMD): −0.64, 95% confidence interval (CI): −0.86 to −0.42, P < 0.001). Very-low-certainty evidence showed that the pooled SMD for the functional improvement was −0.75 (95% CI: −1.13 to −0.37, P < 0.001). Low-certainty evidence presented that no influence was observed in physical component summary (SMD: 0.23, 95% CI: −0.16 to 0.62, P = 0.24) and mental component summary (SMD: −0.01, 95% CI −0.39 to 0.36, P = 0.95). Conclusion Our results indicated that MBE was an effective treatment for reducing symptoms of middle-aged and elderly people with chronic pain compared with nonactive and active control groups. TC and qigong had obvious benefits for knee osteoarthritis in self-reported function, but the efficacy of chronic low back pain was uncertain. No significant benefit of MBE on quality of life in older adults with chronic pain was found. More high-quality RCTs should be conducted to explore the efficacy and mechanism of MBE on chronic pain in middle-aged and elderly people from various dimensions, such as affective and cognitive dimensions. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=316591, identifier CRD42022316591.
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Affiliation(s)
- Yu-Rong Wen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Shi
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ya-Fei Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang-Yang Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zheng-Yu Hu
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - You-Tian Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- *Correspondence: Xue-Qiang Wang
| | - Yu-Ling Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Yu-Ling Wang
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11
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Fogaça LZ, Portella CFS, Ghelman R, Abdala CVM, Schveitzer MC. Mind-Body Therapies From Traditional Chinese Medicine: Evidence Map. Front Public Health 2022; 9:659075. [PMID: 34988045 PMCID: PMC8722380 DOI: 10.3389/fpubh.2021.659075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 11/08/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The mind-body therapies of traditional Chinese medicine include several intervention types and combine physical poses with conscious relaxation and breathing techniques. The purpose of this Evidence Map is to describe these different interventions and report related health outcomes. Methods: This evidence map is based on the 3iE Evidence Gap Map methodology. We searched seven electronic databases (BVS, PUBMED, EMBASE, PEDro, ScienceDirect, Web of Sciences, and PschyInfo) from inception to November 2019 and included systematic reviews only. Systematic reviews were analyzed based on AMSTAR 2. We used Tableau to graphically display quality assessment, the number of reviews, outcomes, and effects. Results: The map is based on 116 systematic reviews and 44 meta-analyses. Most of the reviews were published in the last 5 years. The most researched interventions were Tai Chi and Qi Gong. The reviews presented the following quality assessment: 80 high, 43 moderate, 23 low, and 14 critically low. Every 680 distinct outcome effect was classified: 421 as potential positive; 237 as positive; 21 as inconclusive/mixed; one potential negative and none no effect. Positive effects were related to chronic diseases; mental indicators and disorders; vitality, well-being, and quality of life. Potential positive effects were related to balance, mobility, Parkinson's disease, hypertension, joint pain, cognitive performance, and sleep quality. Inconclusive/mixed-effects justify further research, especially in the following areas: Acupressure as Shiatsu and Tuiná for nausea and vomiting; Tai Chi and Qi Gong for acute diseases, prevention of stroke, stroke risk factors, and schizophrenia. Conclusions: The mind-body therapies from traditional Chinese medicine have been applied in different areas and this Evidence Map provides a visualization of valuable information for patients, professionals, and policymakers, to promote evidence-based complementary therapies.
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Affiliation(s)
| | | | - Ricardo Ghelman
- Brazilian Academic Consortium for Integrative Health (CABSIn), São Paulo, Brazil
| | - Carmen Verônica Mendes Abdala
- BIREME (Latin American and Caribbean Center on Health Sciences Information) - Pan American Health Organization/World Health Organization (PAHO/WHO), São Paulo, Brazil
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12
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Zhang W, Roster K, Hays RD, Wang C. Analysis of Movement-Based Mind-Body Interventions to Guide the Implementation of Osteoarthritis Exercise Programs: A Descriptive Review of Randomized Controlled Trials. J Altern Complement Med 2021; 27:442-457. [PMID: 33902322 DOI: 10.1089/acm.2020.0420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Clear and complete reporting of the components of complex interventions is required in clinical trials to ensure that research can be reliably replicated and successfully translated into clinical practice. Movement-based mind-body exercises, such as Tai Chi, qigong, and Yoga (TQY), are considered complex interventions and recommended for individuals with osteoarthritis in the latest guidelines of the American College of Rheumatology. This review analyzes the intervention reporting of randomized controlled trials of TQY to guide the implementation in osteoarthritis exercise programs. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, and EMBASE for TQY exercise trials in osteoarthritis between 2000 and 2020. Pairs of researchers independently screened the records, extracted study characteristics, and assessed 19 items on the Consensus on Exercise Reporting Template (CERT) checklist. For each of these items, the numbers of studies that clearly reported the item were calculated. We then identified the items in the studies that are key to delivering home-based exercises for further analysis. Results: We included 27 publications reporting 22 TQY interventions in the analysis. None of the studies reported sufficient details on all the 19 CERT items. The median completeness of reporting score was 11 and ranged from 6 to 15 of 19. The most frequently incompletely reported items (number reporting and percentage of studies) were "starting level rule" (n = 1, 5%) and "progression rule" (n = 1, 5%). Other incompletely reported items included "fidelity or adherence (planned)" (n = 9, 41%), "motivations" (n = 9, 41%), and "progression description" (n = 5, 23%). Conclusions: The content analysis highlights motivational strategies for long-term adherence to home-based exercises, which may help clinicians develop interventions for their patients. Details of TQY exercises interventions for osteoarthritis are incompletely reported in the included studies. The study suggests that improvements in content reporting are especially needed on items related to exercise intensity and program progression decisions, and motivational strategies in future implementation.
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Affiliation(s)
- Weijun Zhang
- Center for East-West Medicine, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Ron D Hays
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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Effectiveness of Traditional Chinese Exercise for Symptoms of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217873. [PMID: 33121082 PMCID: PMC7662219 DOI: 10.3390/ijerph17217873] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/22/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
Background: Growing evidences have advocated the potential benefits of traditional Chinese exercise (TCE) on symptomatic improvement of knee osteoarthritis (KOA). However, most of them have been derived from cross-sectional studies or case reports; the effectiveness of TCE therapies has not been fully assessed with a randomized control trial (RCT). In order to evaluate the combined clinical effectiveness of TCE for KOA, we conducted a systematic review and meta-analysis on the existing RCTs on KOA. Methods: A systematic search was performed in four electronic databases: PubMed, Web of Science, Cochrane Library, and EMBASE from the time of their inception to February 2020. All eligible RCTs were included in which TCE was utilized for treating KOA as compared to a control group. Two reviewers independently extracted the data and evaluated the risk of bias following the Cochrane Risk of Bias Tool for RCT. The symptoms of KOA evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were regarded as the primary outcomes in this study. Each outcome measure was pooled by a standardized mean difference (SMD) with 95% confidence intervals (CI). A meta-analysis was applied with a random or fixed effect model for the collected data to calculate the summary SMD with 95% CI based on different statistical heterogeneity. In addition, subgroup analyses were used to investigate heterogeneity and sensitivity analysis was carried out for the results of the meta-analysis. Egger’s test and the funnel plots were used to examine the potential bias in the RCTs. Results: A total of 14 RCTs involving 815 patients with KOA were included. Compared with a control group; the synthesized data of TCE showed a significant improvement in WOMAC/KOOS pain score (SMD = −0.61; 95% CI: −0.86 to −0.37; p < 0.001), stiffness score (SMD = −0.75; 95% CI: −1.09 to −0.41; p < 0.001), and physical function score (SMD = −0.67; 95% CI: −0.82 to −0.53; p < 0.001). Conclusions: Our meta-analysis suggested that TCE may be effective in alleviating pain; relieving stiffness and improving the physical function for patients with KOA. Yet; given the methodological limitations of included RCTs in this meta-analysis; more high-quality RCTs with large sample size and long-term intervention are required to further confirm the effectiveness and underlying mechanisms of TCE for treating KOA.
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Yu DD, You LZ, Huang WQ, Cao H, Wang FJ, Tang XQ, Fang ZH, Shen GM, Guan YX. Effects of traditional Chinese exercises on blood glucose and hemoglobin A1c levels in patients with prediabetes: A systematic review and meta-analysis. JOURNAL OF INTEGRATIVE MEDICINE 2020; 18:292-302. [PMID: 32534937 DOI: 10.1016/j.joim.2020.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 01/06/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Traditional Chinese exercises (TCEs) have a positive effect on glycemic control and hemoglobin A1c (HbA1c), but there is no consensus on the benefits of TCEs for patients with prediabetes. OBJECTIVE The objective of this study was to systematically investigate the effects of TCEs on blood glucose control in patients with prediabetes. SEARCH STRATEGY Comprehensive retrieval of randomized controlled trials (RCTs) was carried out using PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Wanfang Data Knowledge Service Platform, China Biology Medicine disc, Google Scholar and Baidu academic databases. The retrieval window ranged from the establishment of the database to December 2018, and references related to the included trials were searched without language restrictions. INCLUSION CRITERIA The study included RCTs with a clinical diagnosis of prediabetes that was also treated with TCEs. DATA EXTRACTION AND ANALYSIS Literature screening, data extraction and literature quality assessment were performed independently by two researchers. In the case of disagreement, a third party was invited to negotiate and make a decision. Standardized mean difference (SMD) was used to estimate the therapeutic effect. Meta-analysis was performed using Review Manager 5.3.5 and Stata 15.0. Heterogeneity was assessed using Q test and I2, and the source of heterogeneity was determined using Galbraith diagram and sensitivity analysis. A Q test resulting in P < 0.1 and I2 > 50% indicated significant difference and random effect model analysis was performed. Otherwise, a fixed effect model was applied. Begg's and Egger's tests were used to assess publication bias. RESULTS Nine RCTs involving 485 participants were included in this study. The results showed that TCEs could reduce fasting blood glucose (FBG), 2 h blood glucose (2hPBG) and HbA1c in patients with prediabetes. The treatment subgroup showed that an intervention of 6 months had better results, while the Gongfa subgroup showed that the TCE Baduanjin yielded better results. (1) FBG: SMD = -0.73, 95% confidence interval (CI) [-0.97, -0.50], P < 0.00001; Baduanjin: SMD = -0.83, 95% CI [-1.13, -0.53], P < 0.00001; 6 month treatment: SMD = -0.73, 95% CI [-1.20, -0.26], P = 0.002. (2) 2hPBG: SMD = -0.75, 95% CI [-0.94, -0.57], P < 0.00001; Baduanjin: SMD = -0.62, 95% CI [-0.91, -0.32], P < 0.00001; 6 month treatment: SMD = -0.91, 95% CI [-1.39, -0.44], P = 0.0002. (3) HbA1c: SMD = -0.56, 95% CI [-0.89, -0.23], P = 0.00008; Baduanjin: SMD = -0.46, 95% CI [-0.83, -0.08], P = 0.02; 6 month treatment: SMD = -0.77, 95% CI [-1.24, -0.29], P = 0.002. CONCLUSION TCEs had positive effects in improving blood glucose levels in patients with prediabetes. Hence, TCEs may be of potential therapeutic value for patients with prediabetes, as an adjuvant therapy along with other treatments. Although the evidence suggests that the intervention is effective for 6 months, the mechanism of TCEs on glycemic control, the minimum exercise dose and their safety remain to be further studied.
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Affiliation(s)
- Dong-Dong Yu
- Graduate School, Anhui University of Chinese Medicine, Hefei 230038, Anhui Province, China
| | - Liang-Zhen You
- Graduate School, Anhui University of Chinese Medicine, Hefei 230038, Anhui Province, China
| | - Wan-Qiu Huang
- Graduate School, Anhui University of Chinese Medicine, Hefei 230038, Anhui Province, China
| | - Hui Cao
- Graduate School, Anhui University of Chinese Medicine, Hefei 230038, Anhui Province, China
| | - Fan-Jing Wang
- Graduate School, Anhui University of Chinese Medicine, Hefei 230038, Anhui Province, China
| | - Xiu-Qin Tang
- Graduate School, Anhui University of Chinese Medicine, Hefei 230038, Anhui Province, China
| | - Zhao-Hui Fang
- Endocrinology Department, the First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei 230031, Anhui Province, China
| | - Guo-Ming Shen
- Graduate School, Anhui University of Chinese Medicine, Hefei 230038, Anhui Province, China.
| | - Yu-Xiang Guan
- Endocrinology Department, the First Affiliated Hospital, Anhui University of Chinese Medicine, Hefei 230031, Anhui Province, China.
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Hsieh CK, Chang CJ, Liu ZW, Tai TW. Extracorporeal shockwave therapy for the treatment of knee osteoarthritis: a meta-analysis. INTERNATIONAL ORTHOPAEDICS 2020; 44:877-884. [PMID: 31993710 DOI: 10.1007/s00264-020-04489-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/17/2020] [Indexed: 01/13/2023]
Abstract
PURPOSE Extracorporeal shockwave therapy (ESWT) has become a common practice for treating knee osteoarthritis (OA). However, the effectiveness and safety of this treatment are still questionable. This meta-analysis is aimed at determining the degree of pain reduction and functional outcome after ESWT for knee OA. METHODS We systematically searched MEDLINE, EMBASE, and other online databases. The articles comparing the outcomes between ESWT and controls were included in the analysis. RESULTS Nine studies with 705 patients were included. The pooled data revealed significantly lower pain scores in the ESWT groups than in the control groups within two weeks of treatment and six months after treatment (visual analogue scale, - 1.59, p = 0.0003, 95% confidence interval (CI) - 2.45 to - 0.72 at 2 weeks; - 1.12, p = 0.005, 95% CI - 1.89 to - 0.34 at 6 months). The ESWT group also had better functional outcomes four to six weeks post treatment (Western Ontario and McMaster Universities Osteoarthritis Index, - 11.96, p = 0.003, 95% CI - 19.76 to - 4.15). No rebound pain was noted for up to 12 months. CONCLUSION Using ESWT to treat knee OA may reduce pain and improve functional outcomes. The effect may last six months to one year. More prospective studies are needed to investigate the settings for ESWT to optimize treatment results.
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Affiliation(s)
- Chi-Kun Hsieh
- Departments of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - Chao-Jui Chang
- Departments of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan
| | - Zhao-Wei Liu
- Physical Therapy Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ta-Wei Tai
- Departments of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, 70428, Taiwan. .,Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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16
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Ye J, Simpson MW, Liu Y, Lin W, Zhong W, Cai S, Zou L. The Effects of Baduanjin Qigong on Postural Stability, Proprioception, and Symptoms of Patients With Knee Osteoarthritis: A Randomized Controlled Trial. Front Med (Lausanne) 2020; 6:307. [PMID: 31998728 PMCID: PMC6966958 DOI: 10.3389/fmed.2019.00307] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 12/05/2019] [Indexed: 11/26/2022] Open
Abstract
Background: Knee osteoarthritis is a common disease affecting a large number of old individuals worldwide. This study aimed to explore the effects of Baduanjin Qigong in patients with knee osteoarthritis. Methods: Fifty participants with knee osteoarthritis were randomly assigned to either an experimental group (n = 25) or a control group (n = 25). Participants in the experimental group received Baduanjin Qigong training for 12 weeks, with three sessions per week lasting 40 min per session. Participants in the control group did not receive any additional physical training. All of participants completed outcome (proprioception, postural stability, and functional ability) assessments at three time points (baseline, Week 8, 12). Results: Proprioception and Western Ontario and McMaster Universities Osteoarthritis Index function were statistically improved at eighth and 12th week of the intervention in the Baduanjin Qigong group (p < 0.05), while the control group did not have any significant changes. For postural stability at the anterior-posterior direction with eyes closed, Baduanjin Qigong group showed significant improvement compared to controls after the 12 weeks of intervention (p < 0.05). Conclusions: Regular Baduanjin Qigong practice helped the improvement of knee joint proprioception and postural stability, and reduction of pain, stiffness, and functional impairments of old adults with knee osteoarthritis. Well-designed randomized controlled trials with long-term assessment are needed. The trial was registered in Chinese Clinical Trial Registry (ChiCTR-IOR-16010042). URL: http://www.chictr.org.cn/hvshowproject.aspx?id=10550.
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Affiliation(s)
- Jiajia Ye
- Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Michael William Simpson
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Yang Liu
- Department of Kinesiology and Program in Neuroscience, Indiana University Bloomington, Bloomington, IN, United States
| | - Wei Lin
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Weihong Zhong
- Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shuhe Cai
- Department of Orthopaedic Rehabilitation, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Provincial Rehabilitation Industrial Institution, Fuzhou, China
| | - Liye Zou
- Exercise and Mental Health Laboratory, Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China
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17
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Borisovskaya A, Chmelik E, Karnik A. Exercise and Chronic Pain. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:233-253. [PMID: 32342462 DOI: 10.1007/978-981-15-1792-1_16] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this chapter, we describe the impact and etiology of chronic pain, the associated changes in the nervous system, and the mechanisms by which exercise may be able to affect and reverse these changes. Evidence for efficacy of exercise in different conditions associated with chronic pain is presented, with focus on chronic low back pain, fibromyalgia, osteoarthritis, rheumatoid arthritis, and migraines. While the efficacy of exercise and level of evidence supporting it vary in different diseases, exercise has direct and indirect benefits for most patients suffering from chronic pain. Effective exercise regimens include education and cognitive restructuring to promote behavioral activation and reconceptualization of what pain means, with the goal of gradually reversing the vicious cycle of pain, inertia, sedentary behavior, and worsening disability. Long-term, consistent, individualized exercise-based treatment approaches are most likely to result in improvements in pain and function.
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Affiliation(s)
- Anna Borisovskaya
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
- Veterans Administration Medical Center, Seattle, WA, USA.
| | - Elizabeth Chmelik
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- Veterans Administration Medical Center, Seattle, WA, USA
| | - Ashwin Karnik
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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Kraus VB, Sprow K, Powell KE, Buchner D, Bloodgood B, Piercy K, George SM, Kraus WE. Effects of Physical Activity in Knee and Hip Osteoarthritis: A Systematic Umbrella Review. Med Sci Sports Exerc 2019; 51:1324-1339. [PMID: 31095089 DOI: 10.1249/mss.0000000000001944] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION We conducted a systematic umbrella review to evaluate the literature relating to effects of physical activity on pain, physical function, health-related quality of life, comorbid conditions and osteoarthritis (OA) structural disease progression in individuals with lower-extremity OA. METHODS Our primary search encompassed 2011 to February 2018 for existing systematic reviews (SR), meta-analyses (MA) and pooled analyses dealing with physical activity including exercise (not mixed with any other intervention and compared to a no-activity control group). A supplementary search encompassed 2006 to February 2018 for original research related to physical activity (including exercise) and lower limb OA progression. Study characteristics were abstracted, and risk of bias was assessed. RESULTS Physical activity decreased pain and improved physical function (strong evidence) and improved health-related quality of life (moderate evidence) among people with hip or knee OA relative to less active adults with OA. There was no evidence to suggest accelerated OA progression for physical activity below 10,000 steps per day. Both physical activity equivalent to the 2008 Physical Activity Guidelines for Americans (150 min·wk of moderate-intensity exercise in bouts ≥10 min) and lower levels of physical activity (at least 45 total minutes per week of moderate-intensity) were associated with improved or sustained high function. No SR/MA addressing comorbid conditions in OA were found. Measurable benefits of physical activity appeared to persist for periods of up to 6 months following cessation of a defined program. CONCLUSIONS People with lower-extremity OA should be encouraged to engage in achievable amounts of physical activity, of even modest intensities. They can choose to accrue minutes of physical activity throughout the entire day, irrespective of bout duration, and be confident in gaining some health and arthritis-related benefits.
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Affiliation(s)
- Virginia B Kraus
- Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Kyle Sprow
- National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD
| | - Kenneth E Powell
- Georgia Department of Human Resources, Centers for Disease Control and Prevention (Retired), Atlanta, GA
| | - David Buchner
- Department of Kinesiology and Community Health University of Illinois at Urbana-Champaign, Champaign, IL
| | | | - Katrina Piercy
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Rockville, MD
| | - Stephanie M George
- Office of Disease Prevention, National Institutes of Health, U.S Department of Health and Human Services, Rockville, MD
| | - William E Kraus
- Duke Molecular Physiology Institute, Department of Medicine, Duke University School of Medicine, Durham, NC
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Zeng ZP, Liu YB, Fang J, Liu Y, Luo J, Yang M. Effects of Baduanjin exercise for knee osteoarthritis: A systematic review and meta-analysis. Complement Ther Med 2019; 48:102279. [PMID: 31987253 DOI: 10.1016/j.ctim.2019.102279] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 10/30/2019] [Accepted: 12/11/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES Baduanjin is a Chinese form of low-intensity aerobic exercise that consists of eight movements. It is one of the most common forms of Chinese Qigong exercise, which originated during the Song dynasty and has a history of more than 1000 years. The aim of this research was to assess the efficacy of Baduanjin exercise for knee osteoarthritis (KOA). METHODS A literature search was conducted of 10 databases (Web of Science, AMED, Scopus, CINAHL, MEDLINE, EMBASE, KoreaMed Synapse, Oriental Medicine Advanced Searching Integrated System, Chinese Wan Fang and China National Knowledge Infrastructure) from their inception to June 2019. We included eligible randomised controlled trials (RCTs) in which Baduanjin was employed either alone or as an adjuvant treatment for baseline interventions in patients with KOA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC), Visual Analogue Scale (VAS) and response rate were used as important outcomes in this research. Risk of bias was assessed using the Cochrane Collaboration tool. Two reviewers independently selected studies, extracted data and assessed risk of bias. Meta-analysis was applied to quantitative data. RESULTS Seven RCTs totalling 424 participants were included. Overall, only three studies (43 %) reported adequate random sequence generation, allocation concealment, blinding of outcome assessment and accounting for incomplete outcome data. The results showed a statistically significant mean difference (MD) between Baduanjin exercise and waiting list control on three domains of WOMAC scores [MD=-4.40 (95 % CI: -7.16, -1.64), p < 0.01 in pain; MD=-1.34 (95 % CI: -1.64, -1.04), p < 0.01 in stiffness; MD=-2.44 (95 % CI: -4.33,-0.55), p < 0.01 in physical function] and the response rate [RR = 1.18 (95 % CI: 1.01, 1.37), p = 0.04]. Moreover, when used alone, Baduanjin exercise demonstrated a statistically significant improvement on three domains of WOMAC scores [MD=-1.69 (95 % CI: -2.03, -1.35), p < 0.01 in pain; MD=-0.86 (95 % CI: -1.13, -0.58), p < 0.01 in stiffness; MD=-2.23 (95 % CI: -3.65,-0.82), p < 0.01 in physical function] compared to health education. Furthermore, Baduanjin exercise plus NSAID therapies significantly improved total WOMAC score [MD=-10.26 (95 % CI: -13.41, -7.11), p < 0.01] and reduced VAS [MD=-1.65 (95 % CI: -1.83,-1.48), p < 0.01] compared to NSAID therapies alone. CONCLUSION The existing weak evidence suggests that Baduanjin exercise may have favourable effects for KOA patients. However, further rigorously designed RCTs are warranted before it can be recommended.
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Affiliation(s)
- Zhi-Peng Zeng
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Ya-Bin Liu
- 2nd Department of Limb Orthopedic and Reconstructive Surgery, Tianjin Hospital, Tianjin, 300211 China
| | - Jinju Fang
- Department of Dermatology, The Third Affiliated Hospital of Guangxi Medical University, 13 Dancun Road, Nanning, 530031, Guangxi, China
| | - Yue Liu
- School of Health and Biomedical Sciences, Royal Melbourne Institute of Technology University, WHO Collaborating Centre for Traditional Medicine, Bundoora, Vic., Australia
| | - Jun Luo
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, 330006, China.
| | - Meng Yang
- Department of Dermatology, The Third Affiliated Hospital of Guangxi Medical University, 13 Dancun Road, Nanning, 530031, Guangxi, China; Department of Dermatology, The Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, Yunnan, China.
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Zhang Q, Hu J, Wei L, Cao R, Ma R, Song H, Jin Y. Effects of traditional Chinese exercise on cognitive and psychological outcomes in older adults with mild cognitive impairment: A systematic review and meta-analysis. Medicine (Baltimore) 2019; 98:e14581. [PMID: 30762810 PMCID: PMC6408103 DOI: 10.1097/md.0000000000014581] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/28/2018] [Accepted: 01/24/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) can be a stage of pre-dementia. Although the traditional Chinese exercise (TCE) has benefits associated with cognitive functions, the effects of the TCE on cognitive functions of older patients with MCI remain controversial. This study performs a meta-analysis to quantify the efficiency of TCE for older individuals on cognitive and psychological outcomes. METHODS A comprehensive database search was conducted on PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL (EBSCO), Web of Science, and four Chinese medical databases. We included trials published up to April 22, 2018, that fulfilled our inclusion and exclusion criteria. The literature was screened, the data were extracted and the methodological quality of the included trials was assessed. Meta-analyses were performed on the included data. RESULTS A total of 803 patients from 5 trials were included in our meta-analysis. Overall, there were no significant differences in global cognitive functions (P = .06), memory (P = .11), executive function (P = .74), Verbal fluency (P = .45) and depression (P = .89) between the TCE and the control groups. However, the TCE significantly improved the visuospatial function (SMD = 0.38, 95% CI = 0.22 to 0.54; P < .001) for individuals with MCI. CONCLUSIONS The findings of this study suggested that the TCE was associated with significant improvement in visuospatial function but did not affect the global cognitive functions, depression and other specific cognitive domains. There is a lack of clear evidence for effects of TCE; further large, rigorously designed studies are needed.
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Affiliation(s)
- Qi Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Jianan Hu
- The Department of Nursing, Children's Hospital of Shanxi/Woman Health Center of Shanxi, Taiyuan, Shanxi
| | - Lijiao Wei
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Ri Cao
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Ruishu Ma
- School of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine
| | - Huimin Song
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Yi Jin
- The Department of Nursing, Tianjin Huanhu Hospital, Tianjin, China
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Jin X, Pan B, Wu H, Xu D. The effects of traditional Chinese exercise on hypertension: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2019; 98:e14049. [PMID: 30653112 PMCID: PMC6370134 DOI: 10.1097/md.0000000000014049] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2018] [Revised: 11/23/2018] [Accepted: 12/15/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Several studies have reported the benefits of traditional Chinese exercises (TCEs) on hypertension; however, a consensus regarding the effectiveness and safety of TCEs for patients with hypertension has not been reached. METHODS AND RESULTS Only randomized controlled trials were included in our study. A total of 16 articles involving 1164 patients with hypertension met the inclusion criteria. The results showed that TCEs can reduce BP, blood lipids (including total cholesterol and triglyceride levels) and endothelin levels and improves quality of life in hypertensive patients, however, the low-quality of the included studies made the results be of questionable significance. CONCLUSIONS The results of this review suggest that there is no firm evidence to support the objective effectiveness and safety of TCEs for hypertension because of the poor quality of the studies. Well-designed, randomized placebo-controlled trial with objective outcome measures should be conducted in the future.
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Affiliation(s)
- Xiao Jin
- Second School of Clinical Medicine, Guangzhou Univ Chinese Med
| | - BiQi Pan
- Department of Traditional Chinese Medicine, GuangDong Women and Children Hospital
| | - Huanlin Wu
- Beijing University of Chinese Medicine, Beijing
| | - Danping Xu
- Department of Cardiology, Second Affiliated Hospital of Guangzhou Univ Chinese Med (Guangdong Provincial Hospital of Chinese Medicine), China
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Innes KE, Selfe TK, Kandati S, Wen S, Huysmans Z. Effects of Mantra Meditation versus Music Listening on Knee Pain, Function, and Related Outcomes in Older Adults with Knee Osteoarthritis: An Exploratory Randomized Clinical Trial (RCT). EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:7683897. [PMID: 30245732 PMCID: PMC6136530 DOI: 10.1155/2018/7683897] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/31/2018] [Accepted: 08/08/2018] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Disease-modifying treatments for OA remain elusive, and commonly used medications can have serious side effects. Although meditation and music listening (ML) have been shown to improve outcomes in certain chronic pain populations, research in OA is sparse. In this pilot RCT, we explore the effects of two mind-body practices, mantra meditation (MM) and ML, on knee pain, function, and related outcomes in adults with knee OA. METHODS Twenty-two older ambulatory adults diagnosed with knee OA were randomized to a MM (N=11) or ML program (N=11) and asked to practice 15-20 minutes, twice daily for 8 weeks. Core outcomes included knee pain (Knee Injury and Osteoarthritis Outcome Score [KOOS] and Numeric Rating Scale), knee function (KOOS), and perceived OA severity (Patient Global Assessment). Additional outcomes included perceived stress (Perceived Stress Scale), mood (Profile of Mood States), sleep (Pittsburgh Sleep Quality Index), and health-related quality of life (QOL, SF-36). Participants were assessed at baseline and following completion of the program. RESULTS Twenty participants (91%) completed the study (9 MM, 11 ML). Compliance was excellent; participants completed an average of 12.1±0.83 sessions/week. Relative to baseline, participants in both groups demonstrated improvement post-intervention in all core outcomes, including knee pain, function, and perceived OA severity, as well as improvement in mood, perceived stress, and QOL (Physical Health) (p's≤0.05). Relative to ML, the MM group showed greater improvements in overall mood and sleep (p's≤0.04), QOL-Mental Health (p<0.07), kinesiophobia (p=0.09), and two domains of the KOOS (p's<0.09). CONCLUSIONS Findings of this exploratory RCT suggest that a simple MM and, possibly, ML program may be effective in reducing knee pain and dysfunction, decreasing stress, and improving mood, sleep, and QOL in adults with knee OA.
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Affiliation(s)
- Kim E. Innes
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Terry Kit Selfe
- Department of Biomedical and Health Information Services, Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Sahiti Kandati
- Department of Epidemiology, School of Public Health, West Virginia University, Morgantown, WV, USA
- School of Dentistry, SUNY-Buffalo, Buffalo, NY, USA
| | - Sijin Wen
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Zenzi Huysmans
- College of Physical Activity and Sport Sciences, West Virginia University, Morgantown, WV, USA
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Li W, Pan Y, Yang Q, Guo ZG, Yue Q, Meng QG. Extracorporeal shockwave therapy for the treatment of knee osteoarthritis: A retrospective study. Medicine (Baltimore) 2018; 97:e11418. [PMID: 29979441 PMCID: PMC6076154 DOI: 10.1097/md.0000000000011418] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This retrospective study investigated the effect and safety of extracorporeal shockwave therapy (ESWT) for treatment of knee osteoarthritis (KOA).In this retrospective study, 105 patients with KOA were included. Of those, 60 patients underwent ESWT, whereas 45 patients received laser therapy. Effect was measured by the Numeric Rating Scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). In addition, adverse events (AEs) were also recorded in this study. All outcome measurements were evaluated at the end of weeks 1, 6, and 12.Compared with the laser therapy, ESWT showed greater effect in KOA symptoms relief with regard to NRS, WOMAC total, and its subscores at week 6 (P < .05) and week 12 (P < .01) after treatment. No AE, however, occurred in both groups.The results of this retrospective study found that ESWT may be efficacious and safe for the treatment of patients with KOA. It, however, had an intrinsic limitation as a retrospective study. Prospective study with larger sample size is still needed to warrant the result of this study in the future.
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Affiliation(s)
- Wei Li
- Department of Medical Science, Institute of Harbin, The First Hospital of Harbin City, Harbin Medical University
| | - Yu Pan
- Department of Study Center, The First Affiliated Hospital of Harbin Medical University
| | - Qi Yang
- Department of Medical Science, Institute of Harbin, The First Hospital of Harbin City, Harbin Medical University
| | - Zheng-gui Guo
- Department of Medical Science, Institute of Harbin, The First Hospital of Harbin City, Harbin Medical University
| | - Qi Yue
- Department of Study Center, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Qing-Gang Meng
- Department of Medical Science, Institute of Harbin, The First Hospital of Harbin City, Harbin Medical University
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Schiphof D, van den Driest JJ, Runhaar J. Osteoarthritis year in review 2017: rehabilitation and outcomes. Osteoarthritis Cartilage 2018; 26:326-340. [PMID: 29330103 DOI: 10.1016/j.joca.2018.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 12/14/2017] [Accepted: 01/02/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this systematic review was to describe studies examining rehabilitation for people with osteoarthritis (OA) and to summarize findings from selected key systematic reviews (SRs) and randomized controlled trials (RCTs). DESIGN A systematic search was performed using Pubmed, Embase and Cochrane databases from April 1st 2016 to May 15th 2017 using the terms 'osteoarthritis', 'randomized controlled trial', and 'systematic review'. Inclusion criteria were: clinically or radiologically diagnosed patients with OA, rehabilitation treatment, RCT or SRs. A selection of the included studies is discussed based on study quality and perceived importance to the field; including those that are innovative, inform the direction of the field or generate controversy. Methodological quality of the included studies was assessed using the PEDro-scale for RCTs and the Amstar guideline for SRs. RESULTS From 1211 articles, 80 articles met the eligibility criteria including 21 SRs and 61 RCTs. The median of the methodological quality of the SRs and RCTs was 7 (2-9) and 6 (3-10), respectively. The studies were grouped into several themes, covering the most important rehabilitation fields. CONCLUSIONS Striking is the small number of studies investigating another joint (18%) than the knee (82%). Exercise is the most common treatment evaluated and should be accompanied with education to effectuate a behavioural change in physical activity of people with OA. No new insights in the field of braces (or orthoses) and in the field of acupuncture were found.
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Affiliation(s)
- D Schiphof
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - J J van den Driest
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
| | - J Runhaar
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
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Ge L, Zheng QX, Liao YT, Tan JY, Xie QL, Rask M. Effects of traditional Chinese exercises on the rehabilitation of limb function among stroke patients: A systematic review and meta-analysis. Complement Ther Clin Pract 2017; 29:35-47. [PMID: 29122267 DOI: 10.1016/j.ctcp.2017.08.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 08/20/2017] [Accepted: 08/22/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVE To systematically review literature about the rehabilitative effects of traditional Chinese exercises (TCEs) on limb function among patients with stroke. METHODS Systematic review and meta-analysis of randomized controlled trials (RCTs). Twelve electronic databases were searched from their inceptions to February 2017, including PudMed, The Cochrane Library, Web of Science, EMBase, Science Direct, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Chinese Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang Data. RCTs were located to examine the rehabilitative effects of TCEs on limb function among stroke patients. Two authors independently screened the literature, extracted data and assessed the risk bias of the included studies. Methodological quality evaluation and meta-analysis of included studies was performed by using Cochrane Collaboration's tool (RevMan 5.3). RESULTS A total of 31 RCTs with 2349 participants were included. Results of meta-analysis showed that TCEs produced positive effects on limb motor function (random effects model, standardized mean difference [SMD] = 1.21, 95% confidence interval [CI] = 0.66 to 1.77, P < 0.01), balance function{Berg balance scale: (random effects model, SMD = 2.07, 95%CI = 1.52 to 2.62, P < 0.01), timed-up-and-go test: (fixed effects model, mean difference [MD] = -1.77, 95%CI = -2.87 to -0.67, P < 0.01)}, activities of daily living (ADL) ability {Barthel Index scale: (random effects model, MD = 15.60, 95%CI = 7.57 to 23.63, P < 0.01), Modified Barthel Index scale: (random effects model, MD = 12.30, 95%CI = 7.48 to 17.12, P < 0.01)}, and neurological impairment (fixed effects model, MD = -2.57, 95%CI = -3.14 to -2.00, P < 0.01). After subgroup analysis and sensitivity analysis, the positive effects did not be affected by different types of TCEs and different lengths of intervention time. However, TCEs were no benefit to physical function on Short Physical Performance Battery and 2-min Step Test among stroke patients. CONCLUSION Current evidence showed that TCEs produced positive effects on limb motor function, balance function, ADL ability and neurological impairment among stroke patients. More large-scale, high-quality, multiple center RCTs are required to further verify above conclusions in the future.
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Affiliation(s)
- Li Ge
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
| | - Qing-Xiang Zheng
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yan-Tan Liao
- Rehabilitative Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jing-Yu Tan
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Qiu-Lin Xie
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Mikael Rask
- Department of Health and Caring Sciences, Linnaeus University, S-35195, Växjö, Sweden
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