BackgroundRepetitive transcranial magnetic stimulation (rTMS) applied to the mylohyoid cortical region has positive clinical effects on post-stroke. Therefore, we conducted a meta-analysis to investigate the efficacy of rTMS for patients with post-stroke dysphagia.MethodsAccording to PRISMA guidelines, we searched the databases of MEDLINE (PubMed), Cochrane Library, Embase, Web of Science, CNKI, Wangfang. We searched for studies of randomized controlled trials (RCTs) of rTMS to treat dysphagia after stroke and screened by inclusion and exclusion criteria. Features of RCTs were extracted. The heterogeneity of the trials was measured by I2 statistic.ResultsIn total, 11 RCTs with 463 dysphagia patients fulfilled our inclusion criteria. In our analysis, rTMS demonstrated a great beneficial effect for post-stroke dysphagia when combined with traditional swallowing exercises. Moreover, a greatly significant difference (P = 0.008) was noted based on stimulation frequency (high frequency vs. low frequency). Additionally, no significant difference (P = 0.53) was observed based on stimulation site (affected vs. unaffected hemisphere).ConclusionsOverall, rTMS can effectively accelerate the improvement of swallowing function in patients with post-stroke swallowing disorders.
ObjectiveThis study aimed to examine the effectiveness and safety of the Brain-computer interface (BCI) in treatment of upper limb dysfunction after stroke.MethodsEnglish and Chinese electronic databases were searched up to July 2021. Randomized controlled trials (RCTs) were eligible. The methodological quality was assessed using Cochrane’s risk-of-bias tool. Meta-analysis was performed using RevMan 5.4.ResultsA total of 488 patients from 16 RCTs were included. The results showed that (1) the meta-analysis of BCI-combined treatment on the improvement of the upper limb function showed statistical significance [standardized mean difference (SMD): 0.53, 95% CI: 0.26–0.80, P < 0.05]; (2) BCI treatment can improve the abilities of daily living of patients after stroke, and the analysis results are statistically significant (SMD: 1.67, 95% CI: 0.61–2.74, P < 0.05); and (3) the BCI-combined therapy was not statistically significant for the analysis of the Modified Ashworth Scale (MAS) (SMD: −0.10, 95% CI: −0.50 to 0.30, P = 0.61).ConclusionThe meta-analysis indicates that the BCI therapy or BCI combined with other therapies such as conventional rehabilitation training and motor imagery training can improve upper limb dysfunction after stroke and enhance the quality of daily life.
Background: Parkinson's disease is a common neurodegenerative disorder with motor and non-motor symptoms. Recently, as adjuvant therapy, transcranial direct current stimulation (tDCS) has been shown to improve the motor and non-motor function of patients with Parkinson's disease (PD). This systematic review aimed to evaluate the existing evidence for the efficacy of tDCS for PD. We included English databases (PubMed, the Cochrane Library, Embase, and Web of Science) and Chinese databases [Wanfang database, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), and China Biology Medicine (CBM)] without restricting the year of publication. Twenty-one tDCS studies, with a total of 736 participants, were included in the analysis. Two independent researchers extracted the data and characteristics of each study. There was a significant pooled effect size (−1.29; 95% CI = −1.60, −0.98; p < 0.00001; I2 = 0%) in the Unified PD Rating Scale (UPDRS) I and the Montreal cognitive assessment (SMD = 0.87, 95% CI = 0.50 to 1.24; p < 0.00001; I2 = 0%). The poor effect size was observed in the UPDRS III scores (SMD = −0.13; 95% CI = −0.64, 0.38; p = 0.61; I2 = 77%), and similar results were observed for the timed up and go (TUG) test, Berg balance scale, and gait assessment. The results of this meta-analysis showed that there was insufficient evidence that tDCS improves the motor function of patients with PD. However, tDCS seemed to improve their cognitive performance. Further multicenter research with a larger sample size is needed. In addition, future research should focus on determining the tDCS parameters that are most beneficial to the functional recovery of patients with PD.
Background Although patient accessible electronic health records (PAEHRs) offer great potential in enhancing the provision of patient-centered care and improving satisfaction, the adoption rate is still low. Currently, few studies are there for researchers and health organization leaders to understand patients’ thoughts and related factors of PAEHRs adoption in developing countries. China adopted more limited practices of PAEHRs, among which we selected Yuebei People's Hospital as an example. Objective The study aimed to research patient attitudes toward PAEHRs use and the associated factors of patients’ adoption of PAEHRs in China, which is achieved by both qualitative and quantitative studies. Methods This study employed sequential mixed-methods. The DeLone & McLean information systems (D&M IS) success model, Unified Theory of Acceptance and Use of Technology (UTAUT) and task-technology fit (TTF) model were used to guide the research. Finally, we collected 28 valid in-depth interview responses, 51 valid semi-structured interview responses and 235 valid questionnaire responses. The research model was tested and validated using data collected. Results The findings of the qualitative study reveal that patients’ rate perceived task productivity and customer satisfaction as benefits, and poor-quality information as flaws. Results of the quantitative study show that the drivers of behavioral intention are performance expectance, effort expectancy and social influence; the predictors of use behavior are TTF and behavioral intention. Conclusion It is necessary to consider PAEHRs’ task-tool role in patients’ adoption behavior. Hospitalized patients value PAEHRs’ practical attributes and attach much importance to the information content and application design.
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