Effects of traditional Chinese exercises on the rehabilitation of limb function among stroke patients

A systematic review and meta-analysis

Li Ge, Qing Xiang Zheng, Yan Tan Liao, Jing Yu Tan, Qiu Lin Xie, Mikael Rask

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Objective: To systematically review literature about the rehabilitative effects of traditional Chinese exercises (TCEs) on limb function among patients with stroke. 

Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs). Twelve electronic databases were searched from their inceptions to February 2017, including PudMed, The Cochrane Library, Web of Science, EMBase, Science Direct, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Chinese Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang Data. RCTs were located to examine the rehabilitative effects of TCEs on limb function among stroke patients. Two authors independently screened the literature, extracted data and assessed the risk bias of the included studies. Methodological quality evaluation and meta-analysis of included studies was performed by using Cochrane Collaboration's tool (RevMan 5.3). 

Results: A total of 31 RCTs with 2349 participants were included. Results of meta-analysis showed that TCEs produced positive effects on limb motor function (random effects model, standardized mean difference [SMD] = 1.21, 95% confidence interval [CI] = 0.66 to 1.77, P < 0.01), balance function{Berg balance scale: (random effects model, SMD = 2.07, 95%CI = 1.52 to 2.62, P < 0.01), timed-up-and-go test: (fixed effects model, mean difference [MD] = −1.77, 95%CI = −2.87 to −0.67, P < 0.01)}, activities of daily living (ADL) ability {Barthel Index scale: (random effects model, MD = 15.60, 95%CI = 7.57 to 23.63, P < 0.01), Modified Barthel Index scale: (random effects model, MD = 12.30, 95%CI = 7.48 to 17.12, P < 0.01)}, and neurological impairment (fixed effects model, MD = −2.57, 95%CI = −3.14 to −2.00, P < 0.01). After subgroup analysis and sensitivity analysis, the positive effects did not be affected by different types of TCEs and different lengths of intervention time. However, TCEs were no benefit to physical function on Short Physical Performance Battery and 2-min Step Test among stroke patients. 

Conclusion: Current evidence showed that TCEs produced positive effects on limb motor function, balance function, ADL ability and neurological impairment among stroke patients. More large-scale, high-quality, multiple center RCTs are required to further verify above conclusions in the future.

Original languageEnglish
Pages (from-to)35-47
Number of pages13
JournalComplementary Therapies in Clinical Practice
Volume29
DOIs
Publication statusPublished - Nov 2017
Externally publishedYes

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Exercise Therapy
Meta-Analysis
Extremities
Stroke
Confidence Intervals
Exercise
Randomized Controlled Trials
Databases
Activities of Daily Living
Library Science
Complementary Therapies
Exercise Test
China
Nursing
Health

Cite this

@article{bae4f4991e4f4da7adcc685456a490fe,
title = "Effects of traditional Chinese exercises on the rehabilitation of limb function among stroke patients: A systematic review and meta-analysis",
abstract = "Objective: To systematically review literature about the rehabilitative effects of traditional Chinese exercises (TCEs) on limb function among patients with stroke. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs). Twelve electronic databases were searched from their inceptions to February 2017, including PudMed, The Cochrane Library, Web of Science, EMBase, Science Direct, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Chinese Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang Data. RCTs were located to examine the rehabilitative effects of TCEs on limb function among stroke patients. Two authors independently screened the literature, extracted data and assessed the risk bias of the included studies. Methodological quality evaluation and meta-analysis of included studies was performed by using Cochrane Collaboration's tool (RevMan 5.3). Results: A total of 31 RCTs with 2349 participants were included. Results of meta-analysis showed that TCEs produced positive effects on limb motor function (random effects model, standardized mean difference [SMD] = 1.21, 95{\%} confidence interval [CI] = 0.66 to 1.77, P < 0.01), balance function{Berg balance scale: (random effects model, SMD = 2.07, 95{\%}CI = 1.52 to 2.62, P < 0.01), timed-up-and-go test: (fixed effects model, mean difference [MD] = −1.77, 95{\%}CI = −2.87 to −0.67, P < 0.01)}, activities of daily living (ADL) ability {Barthel Index scale: (random effects model, MD = 15.60, 95{\%}CI = 7.57 to 23.63, P < 0.01), Modified Barthel Index scale: (random effects model, MD = 12.30, 95{\%}CI = 7.48 to 17.12, P < 0.01)}, and neurological impairment (fixed effects model, MD = −2.57, 95{\%}CI = −3.14 to −2.00, P < 0.01). After subgroup analysis and sensitivity analysis, the positive effects did not be affected by different types of TCEs and different lengths of intervention time. However, TCEs were no benefit to physical function on Short Physical Performance Battery and 2-min Step Test among stroke patients. Conclusion: Current evidence showed that TCEs produced positive effects on limb motor function, balance function, ADL ability and neurological impairment among stroke patients. More large-scale, high-quality, multiple center RCTs are required to further verify above conclusions in the future.",
keywords = "Limb function, Meta-analysis, Randomized controlled trial, Stroke, Systematic review, Traditional Chinese exercises",
author = "Li Ge and Zheng, {Qing Xiang} and Liao, {Yan Tan} and Tan, {Jing Yu} and Xie, {Qiu Lin} and Mikael Rask",
year = "2017",
month = "11",
doi = "10.1016/j.ctcp.2017.08.005",
language = "English",
volume = "29",
pages = "35--47",
journal = "Complementary Therapies in Clinical Practice",
issn = "1744-3881",
publisher = "Churchill Livingstone",

}

Effects of traditional Chinese exercises on the rehabilitation of limb function among stroke patients : A systematic review and meta-analysis. / Ge, Li; Zheng, Qing Xiang; Liao, Yan Tan; Tan, Jing Yu; Xie, Qiu Lin; Rask, Mikael.

In: Complementary Therapies in Clinical Practice, Vol. 29, 11.2017, p. 35-47.

Research output: Contribution to journalReview articleResearchpeer-review

TY - JOUR

T1 - Effects of traditional Chinese exercises on the rehabilitation of limb function among stroke patients

T2 - A systematic review and meta-analysis

AU - Ge, Li

AU - Zheng, Qing Xiang

AU - Liao, Yan Tan

AU - Tan, Jing Yu

AU - Xie, Qiu Lin

AU - Rask, Mikael

PY - 2017/11

Y1 - 2017/11

N2 - Objective: To systematically review literature about the rehabilitative effects of traditional Chinese exercises (TCEs) on limb function among patients with stroke. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs). Twelve electronic databases were searched from their inceptions to February 2017, including PudMed, The Cochrane Library, Web of Science, EMBase, Science Direct, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Chinese Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang Data. RCTs were located to examine the rehabilitative effects of TCEs on limb function among stroke patients. Two authors independently screened the literature, extracted data and assessed the risk bias of the included studies. Methodological quality evaluation and meta-analysis of included studies was performed by using Cochrane Collaboration's tool (RevMan 5.3). Results: A total of 31 RCTs with 2349 participants were included. Results of meta-analysis showed that TCEs produced positive effects on limb motor function (random effects model, standardized mean difference [SMD] = 1.21, 95% confidence interval [CI] = 0.66 to 1.77, P < 0.01), balance function{Berg balance scale: (random effects model, SMD = 2.07, 95%CI = 1.52 to 2.62, P < 0.01), timed-up-and-go test: (fixed effects model, mean difference [MD] = −1.77, 95%CI = −2.87 to −0.67, P < 0.01)}, activities of daily living (ADL) ability {Barthel Index scale: (random effects model, MD = 15.60, 95%CI = 7.57 to 23.63, P < 0.01), Modified Barthel Index scale: (random effects model, MD = 12.30, 95%CI = 7.48 to 17.12, P < 0.01)}, and neurological impairment (fixed effects model, MD = −2.57, 95%CI = −3.14 to −2.00, P < 0.01). After subgroup analysis and sensitivity analysis, the positive effects did not be affected by different types of TCEs and different lengths of intervention time. However, TCEs were no benefit to physical function on Short Physical Performance Battery and 2-min Step Test among stroke patients. Conclusion: Current evidence showed that TCEs produced positive effects on limb motor function, balance function, ADL ability and neurological impairment among stroke patients. More large-scale, high-quality, multiple center RCTs are required to further verify above conclusions in the future.

AB - Objective: To systematically review literature about the rehabilitative effects of traditional Chinese exercises (TCEs) on limb function among patients with stroke. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs). Twelve electronic databases were searched from their inceptions to February 2017, including PudMed, The Cochrane Library, Web of Science, EMBase, Science Direct, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Chinese Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database and WanFang Data. RCTs were located to examine the rehabilitative effects of TCEs on limb function among stroke patients. Two authors independently screened the literature, extracted data and assessed the risk bias of the included studies. Methodological quality evaluation and meta-analysis of included studies was performed by using Cochrane Collaboration's tool (RevMan 5.3). Results: A total of 31 RCTs with 2349 participants were included. Results of meta-analysis showed that TCEs produced positive effects on limb motor function (random effects model, standardized mean difference [SMD] = 1.21, 95% confidence interval [CI] = 0.66 to 1.77, P < 0.01), balance function{Berg balance scale: (random effects model, SMD = 2.07, 95%CI = 1.52 to 2.62, P < 0.01), timed-up-and-go test: (fixed effects model, mean difference [MD] = −1.77, 95%CI = −2.87 to −0.67, P < 0.01)}, activities of daily living (ADL) ability {Barthel Index scale: (random effects model, MD = 15.60, 95%CI = 7.57 to 23.63, P < 0.01), Modified Barthel Index scale: (random effects model, MD = 12.30, 95%CI = 7.48 to 17.12, P < 0.01)}, and neurological impairment (fixed effects model, MD = −2.57, 95%CI = −3.14 to −2.00, P < 0.01). After subgroup analysis and sensitivity analysis, the positive effects did not be affected by different types of TCEs and different lengths of intervention time. However, TCEs were no benefit to physical function on Short Physical Performance Battery and 2-min Step Test among stroke patients. Conclusion: Current evidence showed that TCEs produced positive effects on limb motor function, balance function, ADL ability and neurological impairment among stroke patients. More large-scale, high-quality, multiple center RCTs are required to further verify above conclusions in the future.

KW - Limb function

KW - Meta-analysis

KW - Randomized controlled trial

KW - Stroke

KW - Systematic review

KW - Traditional Chinese exercises

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U2 - 10.1016/j.ctcp.2017.08.005

DO - 10.1016/j.ctcp.2017.08.005

M3 - Review article

VL - 29

SP - 35

EP - 47

JO - Complementary Therapies in Clinical Practice

JF - Complementary Therapies in Clinical Practice

SN - 1744-3881

ER -