Motor dysfunction is a common and severe complication of stroke that affects the quality of life of these patients. Currently, motor function rehabilitation predominantly focuses on active movement training; nevertheless, the role of sensory input is usually overlooked. Sensory input is very important to motor function. Voluntary functional movement necessitates preparation, execution, and monitoring functions of the central nervous system, while the monitoring needs the participation of the sensory system. Sensory signals affect motor functions by inputting external environment information and intrinsic physiological status as well as by guiding initiation of the motor system. Recent studies focusing on sensory input-based rehabilitation training for post-stroke dyskinesia have demonstrated that sensory function has significant effects on voluntary functional movements. In conclusion, sensory input plays a crucial role in motor function rehabilitation, and the combined sensorimotor training modality is more effective than conventional motor-oriented approaches.
Purpose: There are few studies compares surgery with proximal femoral nail antirotation (PFNA) in lateral decubitus with that in supine position about their advantages and disadvantages for patients with intertrochanteric femoral fractures. Previous studies reported conflicting findings. This meta-analysis was to compare the efficacy and safety of surgery with PFNA in different surgical positions.Methods: Relevant randomized controlled trials comparing surgery with PFNA in lateral decubitus with surgery in supine position for intertrochanteric fractures patients were included into this meta-analysis. Inclusion criteria of this meta-analysis were: randomized controlled trials comparing lateral decubitus with supine position for surgery for intertrochanteric fractures and reporting at least one of the main outcomes, including blood loss, operating time, hospital stay, and length of incision, Harris values and union time.Results: Six randomized controlled trials were finally included into this meta-analysis. Pooled results showed that there were less blood loss, less operation time, smaller incision and higher Harris values score in lateral decubitus group. Sensitivity analysis by sequential omission of individual studies showed the significance of weighted mean difference was robust, which suggested this outcome was credible.Conclusions: Surgery with PFNA in lateral decubitus can benefit intertrochanteric fractures patients with less blood loss, less operation time, shorter incision and high Harris values scores compared with surgery in supine position according to our research.
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