Prognosis of survival among older adults with COVID-19: A systematic review and meta-analysis

Older adults hospitalized due to COVID-19 infection are at high risk of fatality. Additional fatalities such as obesity and comorbidity tend to rapidly develop into progressive clinical deterioration. Therefore, a complex survival prognosis is urgently needed to save more older adults. This study aims to systematically examine obesity and comorbidity as a prognosis of survival in older adults with COVID-19. A Systematic review was conducted using five databases; CINAHL; EMBASE; MEDLINE; PubMed, and Web of Science. Selected papers were published between 2019 and 2020 based on a computerized search. Three reviewers reviewed the quality of the included studies using the JBI (Joanna Briggs Institute) tool for cohort study. The data were compiled using the random-effect models while heterogeneity between studies was assessed using the Cochran Q and I2 statistics. A total of 40,154 data were retrieved from 8 included studies, older adults ranging from 65 to 74-year-olds, with basal metabolism index (BMI) 30-35 kg/m2, diabetes mellitus, hypertension, chronic kidney disease (CKD), and malignancy. Predictors of survival in older adults with COVID-19 include comorbidity (61.3%), obesity (7.1%), mortality (17.3%), female (6.0%), and male (8.3%)

The beneficial effects of transitional care for patients with stroke: A meta-analysis

Introduction Transitional care interventions have emerged as a promising method of ensuring treatment continuity and health care coordination when patients are discharged from hospital to home. However, few studies have investigated the frequency and duration of interventions and the effects of interventions on physical function. Therefore, this study aimed to determine the efficacy of transitional care for patients with stroke. Methods Six databases and the grey literature were searched to obtain relevant articles from October 1, 2022 to March 10, 2023. The primary outcomes studied were motor performance, walking speed, activities of daily living (ADLs) and caregiver burden following hospital-to-home transitional care. The quality of the studies was assessed with Cochrane risk of bias version 2. The quality and sensitivity of the evidence were assessed to ensure rigour of the findings. Meta-analyses were performed using stata 17.0. Results A total of 2966 patients were identified from 23 studies. Transitional care improved post-stroke motor performance, walking speed and ADLs, and reduced caregiver burden. Conclusion The findings suggest that provision of transitional care model implementation in patients with stroke is important because it reduces disability in stroke patients and helps to decrease caregivers' burden. Impact The findings of the study emphasize the importance of transitional care programmes for stroke patients after they are discharged from the hospital and returned to their homes. To meet the needs of patients, all levels of health professionals including nurses should be aware of the discharge process and care plan

Robotic arm use for upper limb rehabilitation after stroke: A systematic review and meta‐analysis

Abstract Several studies have reported the effects of robotic arms on improving upper limb function in patients with stroke. However, previous studies have reported inconsistent findings that may lead to incorrect applications of robotic arm use. Six databases were searched for relevant randomized controlled trials. Meta‐analyses were performed for upper limb performance measures, including subgroup analysis of pooled upper limb rehabilitation data such as stroke stage and intervention delivery dose. Furthermore, the Cochrane risk‐of‐bias tool for randomized trials version 2 (RoB 2) and sensitivity analysis were used to assess methodology and determine publication bias. The final analysis included 18 studies. Robotic arms improved upper limb and hand function in patients with stroke. Subgroup analysis revealed that robotic arm interventions lasting 30–60 min per session significantly improved upper limb function. However, no significant improvement was observed in shoulder and elbow or wrist and hand movements. This review may help develop applicable rehabilitation robots and collaboration between clinicians

Efficacy of Robots-Assisted Therapy in Patients With Stroke - A Meta-analysis Update

Abstract Background Robot-assisted therapy (RAT) could address an unmet need to relieve the strain on healthcare providers and intensify treatment in the context of an increasing stroke incidence. A comprehensive meta-analysis could provide firmer data about the topic by considering methodology limitations discovered in previous reviews and providing more rigorous evidence. Objective This meta-analysis study identifies RAT's efficacy for patients with stroke. Methods A systematic search of the 7 databases from January 10 to February 1, 2022, located relevant publications. We used the updated Cochrane risk-of-bias checklist for 52 trials to assess the methodologic quality of the included studies. The efficacy of RAT for patients with stroke was estimated using a pooled random-effects model in the Stata 16 software application. Results The final analysis included 2774 patients with stroke from 52 trials. In those patients, RAT was proven to improve quality of movement (mean difference, 0.15; 95% confidence interval, 0.03–0.28) and to reduce balance disturbances (mean difference, −1.28; 95% confidence interval, −2.48 to −0.09) and pain (standardized mean difference, −0.34; 95% confidence interval, −0.58 to −0.09). Conclusions Robot-assisted therapy seems to improve the quality of mobility and reduce balance disturbances and pain for patients with stroke. These findings will help develop advanced rehabilitation robots and could improve health outcomes by facilitating health services for healthcare providers and patients with stroke

Vagus nerve stimulation to improve post-stroke motor function and activity

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of vagus nerve stimulation as an add‐on treatment to rehabilitate people with post‐stroke motor function impairments and activity limitations

Vagus nerve stimulation to improve post-stroke motor function and activity (Protocol)

This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the effectiveness and safety of VNS as an add-on treatment to rehabilitate poststroke motor function and activity