Chinese Journal of Tissue Engineering Research ›› 2022, Vol. 26 ›› Issue (29): 4742-4748.doi: 10.12307/2022.899
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Zhang Tiantian1, Li Jiamin1, Ou Liang2, Shang Yan1, Xu Yaqian3, Hu Guoheng1, 3
Received:
2021-09-10
Accepted:
2021-10-28
Online:
2022-10-18
Published:
2022-03-28
Contact:
Hu Guoheng, MD, Professor, Chief physician, Graduate School, Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China; Department of Neurology, the First Hospital of Hunan University of Chinese Medicine, Changsha 410007, Hunan Province, China
About author:
Zhang Tiantian, MD candidate, Physician, Graduate School, Hunan University of Chinese Medicine, Changsha 410208, Hunan Province, China
Supported by:
CLC Number:
Zhang Tiantian, Li Jiamin, Ou Liang, Shang Yan, Xu Yaqian, Hu Guoheng. Electromyographic biofeedback for post-stroke limb spasticity: a Meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(29): 4742-4748.
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2.2 纳入研究的方法学质量评价 纳入的15项研究均报道了组间基线资料的可比性。有14项研究提及了“随机”分配[19-22,24-33],并有7项研究提及了随机数字表法产生随机序列[26,28-33];研究均未具体描述分配序列隐藏方案;因操作限制,受试者盲法难以完成,故实施过程偏倚均判定为高风险,3项研究提及测量过程盲法[22,24,29];6项研究通过了伦理委员会伦理审查[19,28,30-33],10项研究提及签署了知情同意书[19,21,25-26,28-33],纳入研究均未发现存在研究结果数据不完整、选择性报告研究结局及其他偏倚来源的情况。Jadad评分高质量文献9篇[22,24,26,28-33],低质量文献6篇[19-21,23,25,27]。具体的风险偏倚评估结果见表1,图3和4。"
2.3 Meta分析结果 2.3.1 痉挛程度评定 在纳入的15项研究中,报道了2种痉挛评定量表,分别是MAS量表及临床痉挛指数。其中,12项研究报道了MAS评分[19-22,24-27,29-30,32-33],1项研究因原始数据为区间数值无法计算故未纳入定量分析[21]。其中,7项研究报道了肌电生物反馈治疗时间≤4周的MAS[20,22,26-27,29-30,32],提示试验组MAS评分优于对照组,具有统计学意义(MD=-0.32,95%CI:-0.45至-0.19,P < 0.000 01),如图5所示。由于研究结果间存在显著异质性(I2=51%,P=0.05),经逐一剔除研究进行敏感性分析后,提示剔除DO?AN-ASLAN等[22]研究后研究间异质性明显降低(I2=20%,P=0.28),且试验组MAS评分仍优于对照组,具有统计学意义(MD=-0.26,95%CI:-0.40至-0.13,P=0.000 2)。5项研究报道了肌电生物反馈治疗时间在4周以上的MAS[19,24-25,32-33],结果显示试验组MAS评分优于对照组,具有统计学意义(MD=-0.27,95%CI:-0.37至-0.17,P < 0.000 01),研究间异质性在可接受范围内,见图5。"
2.3.2 FMA运动功能评分 5项研究报道了肌电生物反馈治疗时间≤4周的上肢FMA评分[20,22,27,29,32],提示试验组对上肢运动功能改善优于对照组,具有统计学意义(MD=3.39,95%CI:2.02-4.77,P < 0.000 01),研究间同质性较好(I2=0%,P=0.45)。3项研究报道了肌电生物反馈治疗时间在4周以上的上肢FMA评分[27,31-32],试验组对上肢运动功能改善优于对照组,具有统计学意义(MD=2.53,95% CI:2.04-3.02,P < 0.000 01),研究间异质性在可接受范围内(I2=47%,P=0.15)。见图7。2项研究报道肌电生物反馈治疗4周以上的下肢FMA评分[28,31],试验组对下肢运动功能改善优于对照组,具有统计学意义(MD=3.36,95% CI:2.90-3.83),P < 0.000 01),研究间同质性较好(I2=0%,P=0.66)。见图8。"
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