体外冲击波干预对脑卒中后痉挛患者的疗效及最佳时机：一项系统评价和Meta分析
Effect and Optimal Timing of Extracorporeal Shock-Wave Intervention to Patients With Spasticity After Stroke: A Systematic Review and Meta-analysis.
作者信息
Ou-Yang Liang-Jun, Chen Po-Huang, Lee Cho-Hao, Li Tsung-Ying, Wu Yung-Tsan, Jhou Hong-Jie, Yu Tung-Yang
机构信息
From the Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan (L-JO-Y, T-YY); Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (P-HC); Division of Hematology and Oncology Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (C-HL); Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (T-YL, Y-TW); Department of Research and Development, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Y-TW); Integrated Pain Management Center, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan (Y-TW); Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan (H-JJ); School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (H-JJ); and College of Medicine, Chang Gung University, Taoyuan City, Taiwan (T-YY).
出版信息
Am J Phys Med Rehabil. 2023 Jan 1;102(1):43-51. doi: 10.1097/PHM.0000000000002019. Epub 2022 Apr 5.
OBJECTIVE
This study investigated the efficacy of extracorporeal shock wave therapy as well as the optimal intervention timing for extracorporeal shock wave therapy for patients with spasticity after stroke.
DESIGN
A search of randomized controlled trials was conducted in different electronic databases. We performed a meta-analysis to measure the effect of extracorporeal shock wave therapy versus sham interventions on spasticity and limb functionality. The meta-regression analysis was performed to determine the adequate intervention timing of extracorporeal shock wave therapy. The follow-up period of the outcomes was divided into the short (<2 wks), mid (>2 wks and ≤4 wks), and long (>4 wks and ≤3 mos) terms.
RESULTS
Thirteen studies with 677 participants were evaluated. Spasticity significantly improved throughout the follow-up duration. Limb functionality significantly improved in the short-term follow-up period. The meta-regression analysis showed that patients with stroke duration less than 45 mos may be benefited from extracorporeal shock wave therapy in improving limb function in all follow-up periods.
CONCLUSIONS
Extracorporeal shock wave therapy is an effective method for reducing spasticity in patients with stroke, and the effect could be maintained for up to 3 mos. Its effects on limb functionality could persist for at least 2 wks. Patients who had stroke for less than 45 mos may have significant benefit from extracorporeal shock wave therapy in all follow-up periods.
目的
本研究调查了体外冲击波疗法对中风后痉挛患者的疗效以及体外冲击波疗法的最佳干预时机。
设计
在不同电子数据库中检索随机对照试验。我们进行了一项荟萃分析，以衡量体外冲击波疗法与假干预对痉挛和肢体功能的影响。进行荟萃回归分析以确定体外冲击波疗法的适当干预时机。结果的随访期分为短期（<2周）、中期（>2周且≤4周）和长期（>4周且≤3个月）。
结果
评估了13项研究，共677名参与者。在整个随访期间，痉挛明显改善。在短期随访期，肢体功能明显改善。荟萃回归分析表明，中风持续时间少于45个月的患者在所有随访期接受体外冲击波疗法可能有助于改善肢体功能。
结论
体外冲击波疗法是减轻中风患者痉挛的有效方法，其效果可持续长达3个月。其对肢体功能的影响至少可持续2周。中风少于45个月的患者在所有随访期接受体外冲击波疗法可能有显著益处。
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