Network Meta-analysis of the effects of different methods of remote ischemic conditioning in stroke patients

WU Lin; CHENG Gang; TIAN Yuhong; LIU Rongrong; NIE Xingxing; SUN Junzhao; PI Hongying

Abstract：Objective To evaluate the effect of different methods of remote ischemic conditioning(RIC)therapy in stroke patients by using network Meta-analysis.Methods A comprehensive search was conducted on Chinese and English databases,including CNKI,VIP Journal official website,Wanfang Database,Chinese Biomedical Literature Database,PubMed,EMbase,Web of Science Core Collection,The Cochrane Library,and others.Randomized controlled trial(RCT)with different methods of RIC therapy in stroke patients were collected,with the retrieval time limit from the establishment of the database to January 2024.Literature screening and data extraction were performed by two independent researchers.After the risk of bias was assessed for the included studies,Stata 16.0 and RevMan 5.4 software were used for network Meta-analysis.Results After rigorous screening,a total of 37 RCTs were finally undertaken on 5 984 patients with stroke and in 3 methods of RIC:upper limb treatment,once a day;upper limb treatment,twice a day;lower limb treatment,once a day.The results of network Meta-analysis showed that in terms of improving the neurological function of stroke patients(based on the US National Institute of Health stroke scale,NHISS score),all of the five treatment sub-modes of upper limb treatment once a day for 7 days,upper limb treatment once a day for 14 days,upper limb treatment once a day for 6 months,upper limb treatment twice a day for 7 days,and upper limb treatment twice a day for 14 days had better therapeutic effects than the conventional treatment mode(P<0.05).Upper limb treatment once a day for 14 days intervention effect ranked the best.Conclusions Current evidence suggests that upper limb therapy once a day for 14 days may be more advantageous in improving neurological function in patients with stroke(based on US NHISS score).The above conclusions are limited by the number and quality of included studies,and need to be verified by future studies with more samples and higher quality.