ObjectiveThis study used network Meta-analysis to compare the effects of different transcranial magnetic stimulation (TMS) modalities on the effectiveness and long-term validity of improving cognitive function in Parkinson’s patients.MethodsComputer searches of the Cochrane Library, PubMed, Web of Science, Embass, CNKI and Wanfang Data were conducted to collect randomized controlled clinical studies on TMS to improve cognitive function in Parkinson’s patients published from the time of library construction to December 2023.ResultsA total of 22 studies and 1,473 patients were included, comprising 5 interventions: high frequency repetitive transcranial magnetic stimulation (HF-rTMS), low frequency repetitive transcranial magnetic stimulation (LF-rTMS), intermittent theta burst stimulation (iTBS), sham stimulation and conventional rehabilitation therapy (CRT). Network Meta-analysis showed that the ranking results of different TMS intervention modalities in terms of MoCA scores were: HF-rTMS > LF-rTMS > iTBS > sham > CRT, the ranking results of different TMS intervention modalities in terms of MMSE scores were: HF-rTMS > LF-rTMS > sham > CRT. The effect of TMS on improving Parkinsonian cognitive function lasted for 1 month compared to the no-stimulation group.ConclusionTMS has some long-term sustained effects on improving cognitive function in Parkinson’s patients. HF-rTMS is more effective in improving cognitive function in Parkinson’s patients.Systematic review registration: https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42023463958.

目的 分析近10年国内外产后康复的研究热点和发展趋势. 方法 采用CiteSpace 6.2.R2对近10年中国知网和Web of Science(WOS)中产后康复领域的相关文献进行关键词共现、关键词聚类和关键词突现分析. 结果 共纳入中文文献2 686篇,英文文献1 247篇.两数据库产后康复领域相关文献的发文量均呈上升趋势,但中国知网总体发文量增长速度更快,总发文量高于WOS.对中国知网纳入文献关键词进行共现分析,得到455个节点,1 102条连线,密度为0.010 7.在关键词共现分析的基础上进行聚类分析,得到9个聚类.关键词突现结果显示,近10年国内产后康复领域关注的疾病逐渐由乳房胀痛转变为盆底疾病,治疗方法的热点逐渐由中医疗法到电刺激、生物反馈,再到盆底训练.对WOS纳入文献关键词进行共现分析,共得到463个节点,1 633条连线,密度为0.015 3.在关键词共现分析的基础上进行聚类分析,共得到14个聚类.关键词突现结果显示,近10年国外产后康复领域关注的疾病热点逐渐由肛门脱垂、产后出血转变为器官脱垂,治疗方法的热点逐渐由止痛药转变为运动,研究方法的关注点由试验转变为定性研究和Meta分析. 结论 国内产后康复相较于国外起步晚,虽然已取得一定的研究成果,但相比国外产后康复的发展还有一定的差距.

Objective:The article investigates the clinical effectiveness of extracorporeal shock wave treatment for non-specific low back pain through Meta-analysis, with a view to providing evidence-based evidence for clinical treatment.Methods:Computer searches of PubMed, Web of science, Embase, Cochrane Library and China Knowledge Network, Vipshop and Wanfang databases were conducted to collect randomized controlled trials of extracorporeal shock wave for low back pain, and the search time frame was from the establishment of each database to March 12, 2023, and the Cochrane Risk of Bias Tool and Jadad were used to The quality of the included literature was evaluated using the Cochrane Risk of Bias Tool and Jadad scale, and Meta-analysis was performed using Revman 5.4 software.Results:14 eligible randomized controlled trials involving 642 patients were included, including 324 in the intervention group and 318 in the control group. Meta-analysis results showed that compared with the control group, extracorporeal shock wave significantly improved pain levels in patients with low back pain (SMD=-0.90, 95% CI: -1.07, -0.74, P<0.001), the Oswestry Dysfunction Index (MD=-6.61, 95% CI: -9.19, -4.03, P<0.001), Beck Depression Scale score (MD=-3.84, 95% CI: -5.37, -1.97, P<0.001) and 36-item Brief Health Survey scale score (MD=8.51, 95% CI: 7.82, 9.20, P<0.001), but did not significantly improve patients' finger-ground distance (MD= -2.65, 95% CI: -7.57, 2.26, P=0.29).Conclusions:Extracorporeal shock waves can improve the level of pain, dysfunction, depression and quality of life in patients with low back pain, but further studies are needed to prove the improvement effect on low back flexibility.

The average life expectancy of older people is increasing, and most seniors desire to age at home and are capable of living independently. Occupational therapy (OT) is client-centered and uses patients’ meaningful activities, or occupations, as treatment methods, thus playing an important role in later adulthood. Telemedicine removes the constraints of time and space, and the combination of OT and telemedicine can greatly improve medical efficiency and clinical effectiveness. The purpose of this scoping review was to examine the scope and effectiveness of telehealth OT for older people. This scoping review was conducted following the methodological framework proposed by Arksey and O’Malley. We searched the literature in five databases following the PICOS (Population, Intervention, Comparison, Outcome, Study design) guideline, from inception to April 2022. Two trained reviewers independently retrieved, screened, and extracted data, and used a descriptive synthesizing approach to summarize the results. The initial search yielded 1249 studies from databases and manual searches, of which 20 were eligible and were included in the final review. A thematic analysis revealed five main themes related to telehealth OT: occupational assessment, occupational intervention, rehabilitation counseling, caregiver support, and activity monitoring. Telehealth OT has been used widely for older people, focusing primarily on occupational assessment and intervention provided conveniently for occupational therapists and older clients. In addition, telehealth OT can monitor patients’ activities and provide rehabilitation counseling and health education for the elderly and their caregivers, thus improving the security of their home life and the efficacy of OT. During the COVID-19 pandemic, telehealth will be an effective alternative to face-to-face modalities.