Hu Yijuan, Zhong Dongling, Xiao Qiwei, Chen Qiang, Li Juan, Jin Rongjiang
Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China.
Huili County People's Hospital, Sichuan Province, China.
Evid Based Complement Alternat Med. 2019 Jul 16;2019:8470235. doi: 10.1155/2019/8470235. eCollection 2019.
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.
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.
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, =0.001), Time Up and Go Test (TUGT) (MD=-4.62, 95%CI -5.48 to -3.79, < 0.00001), functional ambulation category scale (FAC) (MD=0.53, 95%CI 0.38 to 0.68, < 0.00001), Fugl-Meyer assessment (FMA-L) (MD=4.20, 95%CI 3.17 to 5.24, < 0.00001), and Modified Ashworth Scale (MAS) (MD=-0.38, 95%CI -0.49 to -0.27, < 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, =0.15; =4 weeks: MD=4.33, 95%CI -1.50 to 10.15, =0.15), while there was significant difference with more than 4-week treatment duration (MD=4.77, 95%CI 2.58 to 6.97, < 0.0001).
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.
随着中风后平衡功能障碍所带来的社会和经济负担日益加重，中风后平衡功能障碍的治疗成为全球主要的公共卫生问题。肌内效贴扎（KT）作为临床实践的一部分，已广泛应用于中风后平衡功能障碍的治疗。然而，KT对平衡功能的临床疗效尚未得到证实。本研究的目的是探讨KT对中风后平衡功能障碍的疗效和安全性。
我们对关于KT治疗中风后平衡功能障碍的随机对照试验（RCT）进行了系统评价（SR）和荟萃分析。我们检索了以下数据库：（1）英文数据库：EMBASE（通过Ovid）、MEDLINE（通过Ovid）、Cochrane图书馆、PubMed和PEDro；（2）中文数据库：中国生物医学文献数据库（CBM）、万方数据库、中国知网（CNKI）和维普资讯。此外，还对手头检索相关参考文献。我们从数据库建库至2018年12月进行系统检索，使用关键词（肌内效、肌内效贴布、贴布或矫形贴布）和（中风、偏瘫或偏瘫性麻痹）以及（平衡或稳定性）。针对每个数据库调整检索策略。对纳入文章的参考文献列表进行审查以查找相关试验。对于缺失数据，我们联系作者以获取更多信息。
22项RCT涉及1331例患者，其中实验组667例患者，对照组664例患者。荟萃分析结果显示，与传统康复（CR）相比，Berg平衡量表（BBS）（MD = 4.46，95%CI 1.72至7.19，P = 0.001）、起立行走试验（TUGT）（MD = -4.62，95%CI -5.48至-3.79，P < 0.00001）、功能性步行分类量表（FAC）（MD = 0.53，95%CI 0.38至0.68，P < 0.00001）、Fugl - Meyer评估（FMA - L）（MD = 4.20，95%CI 3.17至5.24，P < 0.00001）和改良Ashworth量表（MAS）（MD = -0.38，95%CI -0.49至-0.27，P < 0.00001）存在显著差异。亚组分析结果显示，治疗持续时间≤4周时，KT与CR之间无显著差异（< 4周：MD = 5.03，95%CI -1.80至11.85，P = 0.15；= 4周：MD = 4.33，95%CI -1.50至10.15，P = 0.15），而治疗持续时间超过4周时存在显著差异（MD = 4.77，95%CI 2.58至6.97，P < 0.0001）。
基于现有证据，对于中风后患者的平衡功能、下肢功能和步行功能，KT比CR更有效。更长的治疗持续时间可能与更好的效果相关。然而，未来需要更多设计良好的RCT。
