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一项系统评价研究了维生素 D 补充剂对中风后功能结局的影响。

A systematic review examining the effect of vitamin D supplementation on functional outcomes post-stroke.

机构信息

Department of Physical Medicine and Rehabilitation, Western University, London, Canada.

St. Joseph's Health Care London, London, Canada.

出版信息

Clin Rehabil. 2023 Nov;37(11):1451-1466. doi: 10.1177/02692155231174599. Epub 2023 May 11.

Abstract

OBJECTIVE

The objective of this systematic review was to explore the effect of vitamin D supplementation on functional outcomes (motor function, mobility, activities of daily living and stroke impairment) among individuals post-stroke (PROSPERO CRD42022296462).

DATA SOURCES

MEDLINE, PsycINFO, EMBASE, and CINAHL were searched for all articles published up to March 5, 2023.

METHODS

Only interventional studies assessing vitamin D supplementation compared to placebo or usual care in adult stroke patients were selected. After duplicate removal, 2912 studies were screened by two independent reviewers. A total of 43 studies underwent full text review; 10 studies met inclusion criteria (8 randomized controlled trials and 2 non-randomized studies of intervention). Data were extracted by two independent reviewers using Covidence software. Motor function (Brunnstrom Recovery Stage, Berg Balance Score), mobility (Functional Ambulation Category), activities of daily living (Barthel Index, Functional Independence Measure) and stroke impairment (modified Rankin Scale, National Institutes for Health Stroke Severity, Scandinavian Stroke Severity) were the outcome measures of interest reported in the included studies.

RESULTS

In total, 691 patients were studied for which 11 of 13 outcome measures showed improvement with vitamin D supplementation.

CONCLUSIONS

The majority of studies showed a statistical improvement in motor function, mobility, and stroke impairment with vitamin D supplementation; however, the evidence did not support an improvement in activities of daily living with treatment. Despite this, there may not be clinical significance. Strong, methodologically sound, randomized controlled trials are required to verify these findings.

摘要

目的

本系统评价的目的是探讨维生素 D 补充剂对脑卒中后个体(PROSPERO CRD42022296462)的功能结局(运动功能、移动能力、日常生活活动和卒中损伤)的影响。

数据来源

检索了 MEDLINE、PsycINFO、EMBASE 和 CINAHL 数据库,以获取截至 2023 年 3 月 5 日发表的所有文章。

方法

仅选择评估维生素 D 补充剂与安慰剂或常规护理相比在成年脑卒中患者中的干预研究。在重复去除后,由两名独立评审员筛选 2912 篇研究。共有 43 项研究进行了全文审查;10 项研究符合纳入标准(8 项随机对照试验和 2 项干预性非随机研究)。使用 Covidence 软件由两名独立评审员提取数据。运动功能(Brunnstrom 恢复阶段、伯格平衡量表)、移动能力(功能性步行类别)、日常生活活动(巴氏指数、功能独立性测量)和卒中损伤(改良 Rankin 量表、国立卫生研究院卒中严重程度量表、斯堪的纳维亚卒中严重程度量表)是纳入研究报告的感兴趣的结局指标。

结果

共有 691 名患者接受了研究,其中 13 项结局指标中的 11 项显示维生素 D 补充剂治疗后有所改善。

结论

大多数研究显示,维生素 D 补充剂治疗可在运动功能、移动能力和卒中损伤方面显著改善;然而,治疗并未支持日常生活活动的改善。尽管如此,可能没有临床意义。需要进行严格、方法学合理的随机对照试验来验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1aba/10492437/dcd0ce9911d7/10.1177_02692155231174599-fig1.jpg

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