The effectiveness of five-element music therapy for post-stroke depression: A systematic review and meta-analysis
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SUBMITTER: Zhong K
PROVIDER: S-EPMC10912230 | biostudies-literature | 2024 Feb
REPOSITORIES: biostudies-literature
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| S-EPMC10855257 | biostudies-literature
Project description:IntroductionAcupuncture is widely used on the rehabilitation of stroke survivors, including hemiplegia, constipation, emotional disorders and so on. Although the effectiveness of manual acupuncture therapy on post-stroke depression (PSD) has been confirmed by multiple randomised controlled trials, there were few meta-analyses focused on the connection between different techniques, durations or other detailed operations of manual acupuncture and their effectiveness of improving the depression severity and quality of life for patients with PSD.Methods and analysisA systematic search will be performed on English databases (PubMed, the Cochrane Library, Medline and Embase), Chinese databases (China National Knowledge Infrastructure, WanFang Data, VIP and Chinese biomedical databases) and Japanese databases (Japan Science and Technology Agency and CiNii). The retrieval time limit will be from the establishment of the database to November 2020. Two researchers will independently screen the literature works, extract data and evaluate the quality of the included studies. Meta-analysis will be conducted by using STATA V.14.0 and Review Manager V.5.3.Ethics and disseminationThe results of this meta-analysis will be disseminated through publication in peer-reviewed journals or conference presentations. The data used in this meta-analysis will not contain individual patient data; therefore, ethical approval is not required.Prospero registration numberCRD42020222825.
| S-EPMC8666868 | biostudies-literature
Project description:BackgroundAcupuncture for post-stroke depression (PSD) has been evolving, but uncertainty remains. To assess the existing evidence from randomized clinical trials (RCTs) of acupuncture for PSD, we sought to draw conclusions by synthesizing RCTs.MethodsAn exhaustive literature search was conducted in seven electronic databases from their inception dates to April 19, 2020, to identify systematic reviews (SRs) and meta-analyses (MAs) on this topic. The primary RCTs included in the SRs/MAs were identified. We also conducted a supplementary search for RCTs published from January 1, 2015, to May 12, 2020. Two reviewers extracted data separately and pooled data using RevMan 5.3 software. The quality of evidence was critically appraised with the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system.ResultsA total of 17 RCTs involving 1402 patients were included. Meta-analysis showed that participants who received a combination of acupuncture and conventional treatments exhibited significantly lower scores on the HAM-D17, HAM-D24 and HAM-D (MD, - 5.08 [95% CI, - 6.48 to - 3.67], I2 = 0%), (MD, - 9.72 [95% CI, - 14.54 to - 4.91], I2 = 65%) and (MD, - 2.72 [95% CI, - 3.61 to - 1.82], respectively) than those who received conventional treatment. However, there was no significant difference in acupuncture versus antidepressants in terms of the 17-item, 24-item and HAM-D scales (MD, - 0.43 [95% CI, - 1.61 to 0.75], I2 = 51%), (MD, - 3.09 [95% CI, - 10.81 to 4.63], I2 = 90%) and (MD, - 1.55 [95% CI, - 4.36 to 1.26], I2 = 95%, respectively). For adverse events, acupuncture was associated with fewer adverse events than antidepressants (RR, 0.16 [95% CI, 0.07 to 0.39], I2 = 35%), but there was no significant difference in the occurrence of adverse events between the combination of acupuncture and conventional treatments versus conventional treatments (RR, 0.63 [95% CI, 0.21 to 1.83], I2 = 38%). The quality of evidence was low to very low due to the substantial heterogeneity among the included studies.ConclusionsThe current review indicates that acupuncture has greater effect on PSD and better safety profile than antidepressants, but high-quality evidence evaluating acupuncture for PSD is still needed.
| S-EPMC8017746 | biostudies-literature
Project description:Patients with post-stroke depression (PSD) usually experience anxiety, hopelessness, and insomnia, which have a negative impact on their daily activities and post-stroke rehabilitation. Acupuncture (AC), as a minimally invasive technique, has become a popular choice for improving depression symptoms. However, it is still unclear which therapy is associated with the best outcomes for PSD. In this review, we aimed to explore the impact of AC in alleviating symptoms of PSD and to evaluate the difference in effectiveness between AC combined with pharmacotherapies and various non-pharmacotherapies. Six databases and three clinical trials registration platforms were searched from inception to March 2023. Randomized clinical trial comparing needle-based AC with pharmacotherapy, and other non-pharmacotherapy or invalid group were included. Two independent reviewers identified eligible studies, and collected data using a pre-made form. A Bayesian network meta-analysis was conducted to assess and compare different techniques using RStudio 3.6.0 with the package 'GEMTC' V.0.8.1. The primary outcome was the efficacy for PSD assessed by scales measuring depressive symptoms. The secondary outcomes were effectiveness for neurological function and the quality of life. The ranking probabilities for all treatment interventions was performed using the Surface Under the Cumulative Ranking curve (SUCRA). The risk of bias was assessed by using the Revised Cochrane Risk of Bias tool 2. Sixty-two studies, involving 5308 participants published from 2003 to 2022, were included. The results showed that compared with western medicine (WM) (defined as pharmacotherapy for PSD), AC alone or with repetitive transcranial magnetic stimulation (RTMS), Traditional Chinese medicine (TCM) alone or with WM, were superior for alleviating depression symptoms. Compared to Usual Care, AC alone or plus other therapies could significantly decrease scores on the Hamilton Depression Rating scale. According to result of SUCRA, AC plus RTMS had the highest probability of improving depressive symptoms with a probability of 49.43%. The results of this study indicate that AC alone or combined with other therapies appears to be effective in improving depression symptoms of stroke survivors. Moreover, in comparison to WM, AC alone or plus RTMS, TCM, TCM with WM, or WM, were more effective in improving depression symptoms of PSD. Also, AC with RTMS seems to be the most effective with the highest probability. This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database in November 2020 and updated in July 2021. The registration number is CRD42020218752.
| S-EPMC10161596 | biostudies-literature
Project description:To assess the effect of therapeutic massage for improving sequelae in stroke survivors. A systematic review of the nine medical databases from January 1961 to December 2020 was carried out. The bibliography was screened to identify randomized controlled clinical trials (RCTs). Two reviewers independently screened references, selected relevant studies, extracted data and assessed the risk of bias using the PEDro scale. The primary outcome was upper and lower limb motor function and spasticity. A total of 3196 studies were identified and 18 RCT were finally included (1989 individuals). A meta-analysis of RCTs in the comparison of Chinese massage (Tuina) plus conventional physiotherapy versus conventional physiotherapy was performed. The mean difference (MD) in the subacute stage on upper limb motor-function using the Fugl Meyer Assessment was 2.75; (95% confidence interval (CI) from 0.97 to 4.53, p = 0.002, I2 = 36%). The MD on upper limb spasticity using modified Ashworth scale was -0.15; (95% CI from -0.24 to -0.06, p < 0.02, I2 = 0%).The MD on lower limb spasticity was -0.59; (95% CI from -0.78 to -0.40, p < 0.001, I2 = 0%) in the endpoint. Therapeutic massage, especially Tuina, in addition to conventional therapy is effective for improving motor function and for reducing spasticity in stroke survivors.
| S-EPMC8122530 | biostudies-literature
Project description:BackgroundMusic therapy (MT) aims at maintaining, restoring and furthering physical/emotional/mental health. This review assesses effectiveness of MT and its methods for autism spectrum disorder (ASD), dementia, depression, insomnia and schizophrenia.MethodsA search for systematic reviews and health technology assessment reports was conducted and yielded 139 hits. Given the large amount, we focused on five frequent diagnostic groups with available Cochrane reviews. A second search was conducted in four databases. Two authors independently performed study selection, data extraction and assessed methodological quality. Only trials with moderate/low risk of bias (RoB) were selected.ResultsTen randomized controlled trials (1.248 participants) met inclusion criteria. For schizophrenia, no studies with low/moderate RoB were found; therefore, updating was not possible. The Cochrane authors stated that quality of life (QoL), social functioning, global/mental state improved for schizophrenia, but not global functioning. For ASD, MT improved behaviour, social communication, brain connectivity and parent-child relationship. For depression, mood was enhanced, and for insomnia, sleep quality, stress, anxiety, total sleep time, disease severity and psychological QoL improved. MT positively affected mood, neuropsychiatric behaviour, apathy, communication and physical functions for dementia; behavioural/psychological symptoms improved only in severe, and memory and verbal fluency only in mild Alzheimer's disease. Cognition improved for dementia in one of four studies. Both active (playing music) and receptive (listening to music) methods were used for dementia, whereas for ASD and depression, active methods were applied. For insomnia, only receptive methods were used.ConclusionThese findings provide evidence that MT helps patients improving their physical/psychosocial health. More research investigating long-term effects is needed.
| S-EPMC8846327 | biostudies-literature
Project description:To conduct a meta-analysis of clinical trials that examined the effect of music-supported therapy on stroke-induced motor dysfunction, comprehensive literature searches of PubMed, Embase and the Cochrane Library from their inception to April 2016 were performed. A total of 10 studies (13 analyses, 358 subjects) were included; all had acceptable quality according to PEDro scale score. The baseline differences between the two groups were confirmed to be comparable. Compared with the control group, the standardized mean difference of 9-Hole Peg Test was 0.28 (-0.01, 0.57), 0.64 (0.31, 0.97) in Box and Block Test, 0.47 (0.08, 0.87) in Arm Paresis Score and 0.35 (-0.04, 0.75) in Action Research Arm Test for upper-limb motor function, 0.11 (-0.24, 0.46) in Berg Balance Scale score, 0.09 (-0.36, 0.54) in Fugl-Meyer Assessment score, 0.30 (-0.15, 0.74) in Wolf Motor Function Test, 0.30 (-0.15, 0.74) in Wolf Motor Function time, 0.65 (0.14, 1.16) in Stride length and 0.62 (0.01, 1.24) in Gait Velocity for total motor function, and 1.75 (0.94, 2.56) in Frontal Assessment Battery score for executive function. There was evidence of a positive effect of music-supported therapy, supporting its use for the treatment of stroke-induced motor dysfunction. This study was registered at PRESPERO (CRD42016037106).
| S-EPMC5137001 | biostudies-literature
Project description:IntroductionPost-stroke depression (PSD) can lead to poorer functional outcomes and prognosis. Brain inflammation is a risk factor for PSD. Statins might be beneficial due to their anti-inflammatory properties. Different studies have yielded varying results regarding the effects of statins. Therefore, this meta-analysis aims to clarify the effect of statins on PSD.MethodsObjectives: To evaluate the relationship between PSD and the use of statins. Data Sources: Databases including PubMed, Web of Science, Embase, and Cochrane Library. Eligibility Criteria: Original observational cohort studies. Participants: Patients with ischemic stroke. Interventions: Use of statins. Appraisal and Synthesis Methods: Forest plot to display pooled results; I 2 test to evaluate heterogeneity.ResultsOf the 37 studies selected, four were eligible. The four studies included 93,893 patients (with statins: 45,598) and more than 17,470 PSD patients. The mean age ranged from 62.1 to 70.8 years. The percentage of female participants ranged from 42.1% to 57.9%. For PSD in different regions, the pooled OR for all regions using random-effects methods was 1.21 (95% CI: 0.44-3.33). The pooled OR for Asian populations was 1.42 (95% CI: 0.37-5.40), and for European populations, it was 0.76 (95% CI: 0.73-0.78). The pooled OR for all regions using fixed-effects methods was 0.84 (95% CI: 0.81-0.86). The pooled OR for Asian populations was 2.62 (95% CI: 2.34-2.93).ConclusionDepending on the pooling method used, statin use in Asia either increased or had no relationship with PSD. For European patients, statin use reduced the incidence of PSD.
| S-EPMC11746108 | biostudies-literature
Project description:Several brain imaging markers have been studied in the development of post-stroke depression (PSD) and post-stroke apathy (PSA), but inconsistent associations have been reported. This systematic review and meta-analysis aims to provide a comprehensive and up-to-date evaluation of imaging markers associated with PSD and PSA. Databases (Medline, Embase, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews) were searched from inception to July 21, 2016. Observational studies describing imaging markers of PSD and PSA were included. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated to examine the association between PSD or PSA and stroke lesion laterality, type, and location, also stratified by study phase (acute, post-acute, chronic). Other imaging markers were reviewed qualitatively. The search retrieved 4502 studies, of which 149 studies were included in the review and 86 studies in the meta-analyses. PSD in the post-acute stroke phase was significantly associated with frontal (OR 1.72, 95% CI 1.34-2.19) and basal ganglia lesions (OR 2.25, 95% CI 1.33-3.84). Hemorrhagic stroke related to higher odds for PSA in the acute phase (OR 2.58, 95% CI 1.18-5.65), whereas ischemic stroke related to higher odds for PSA in the post-acute phase (OR 0.20, 95% CI 0.06-0.69). Frequency of PSD and PSA is modestly associated with stroke type and location and is dependent on stroke phase. These findings have to be taken into consideration for stroke rehabilitation programs, as this could prevent stroke patients from developing PSD and PSA, resulting in better clinical outcome.
| S-EPMC5613051 | biostudies-literature
Project description:BackgroundPrevious research showed that behavioural activation is as effective as cognitive-behavioural therapy for general depression. However, it remains unclear if it leads to greater improvement in depressive symptoms when compared with standard treatment for post-stroke depression.AimsTo compare the effectiveness of behavioural activation against control conditions in reducing depression symptoms in individuals with post-stroke depression.MethodThis review searched five databases from inception until 13 July 2021 (updated 15 September 2023) for randomised controlled trials comparing behavioural activation and any control conditions for post-stroke depression. Risk of bias was assessed with the Cochrane Collaboration's Risk-of-Bias 2 tool. The primary outcome was improvement in depressive symptoms in individuals with post-stroke depression. We calculated a random-effects, inverse variance weighting meta-analysis.ResultsOf 922 initial studies, five randomised controlled trials with 425 participants met the inclusion criteria. Meta-analysis showed that behavioural activation was associated with reduced depressive symptoms in individuals with post-stroke depression at 6-month follow-up (Hedges' g -0.39; 95% CI -0.64 to -0.14). The risk of bias was low for two (40%) of five trials, and the remaining three (60%) trials were rated as having a high risk of bias. Heterogeneity was low, with no indication of inconsistency.ConclusionsEvidence from this review was too little to confirm the effectiveness of behavioural activation as a useful treatment for post-stroke depression when compared with control conditions. Further high-quality studies are needed to conclusively establish the efficacy of behavioural activation as a treatment option for post-stroke depression.
| S-EPMC11698145 | biostudies-literature