BACKGROUND People living with human immunodeficiency virus(HIV)are aging as a result the benefits of combination antiretroviral therapy.AIM To provide descriptions of eligible existing studies on demographics,methodol...BACKGROUND People living with human immunodeficiency virus(HIV)are aging as a result the benefits of combination antiretroviral therapy.AIM To provide descriptions of eligible existing studies on demographics,methodologies,and outcome measures related to health-related quality of life(HRQoL)in the context of HIV and aging.METHODS The MEDLINE,CINAHL,Scopus,and PsycINFO databases were systematically searched using the terms HIV,age,and HRQoL to find studies published between January 1995 and June 2022.Key variables of the eligible studies were identified and categorized into demographics(e.g.,study sites,study year),methodologies(e.g.,use of conceptual frameworks,measures used),and outcome measures[e.g.,HRQoL,quality of life(QoL)].The PRISMA 2009 checklist was followed.RESULTS A total of 68 published studies involving 53504 participants were included.The majority of the studies(55.88%)were conducted in North America,with relatively few studies conducted in Africa.The median age of participants was 51.0 years(IQR=11.0).Over one-third(32.56%)of all participants were older people living with HIV aged 50 years and older Four studies included only older female participants,and six studies included only men who have sex with men.Outcome mea-sures were assessed as HRQoL(26.47%)or QoL(36.76%).Overall,data from African studies,older women living with HIV,socioeconomic status(e.g.,employment,income,education),sexual behavioral risks,theoretical frameworks used,and follow-up studies were limited.CONCLUSION This narrative review highlights imbalances and gaps in research on HRQoL in the context of HIV and aging,providing direction for future studies in this area.展开更多
Diabetes mellitus has become a global health problem,and the number of patients with diabetic foot ulcers(DFU)is rapidly increasing.Currently,DFU still poses great challenges to physicians,as the treatment is complex,...Diabetes mellitus has become a global health problem,and the number of patients with diabetic foot ulcers(DFU)is rapidly increasing.Currently,DFU still poses great challenges to physicians,as the treatment is complex,with high risks of infection,recurrence,limb amputation,and even death.Therefore,a comprehensive understanding of DFU pathogenesis is of great importance.In this review,we summarized recent findings regarding the DFU development from the perspective of single-nucleotide variations(SNVs).Studies have shown that SNVs located in the genes encoding C-reactive protein,interleukin-6,tumor necrosis factor-alpha,stromal cell-derived factor-1,vascular endothelial growth factor,nuclear factor erythroid-2-related factor 2,sirtuin 1,intercellular adhesion molecule 1,monocyte chemoattractant protein-1,endothelial nitric oxide synthase,heat shock protein 70,hypoxia inducible factor 1 alpha,lysyl oxidase,intelectin 1,mitogen-activated protein kinase 14,toll-like receptors,osteoprotegerin,vitamin D receptor,and fibrinogen may be associated with the development of DFU.However,considering the limitations of the present investigations,future multi-center studies with larger sample sizes,as well as in-depth mechanistic research are warranted.展开更多
Hypertriglyceridemia(HTG)is the third most common cause of acute pancreatitis(AP),and the incidence of HTG-induced AP(HTG-AP)is rising worldwide as a result of changes in lifestyle and dietary habits.In China,HTG acco...Hypertriglyceridemia(HTG)is the third most common cause of acute pancreatitis(AP),and the incidence of HTG-induced AP(HTG-AP)is rising worldwide as a result of changes in lifestyle and dietary habits.In China,HTG accounts for 10%to 20%of the causes of AP,even becoming the second leading cause of AP.The presentation and diagnosis of HTG-AP is similar to that of AP from other causes,however,the complication rates and severe AP are significantly higher in patients with HTG-AP than in patients with other etiologies.Regarding the management of HTG-AP,the initial management is similar to that of AP from other causes and mainly includes fluid resuscitation,pain control,and nutritional support.In addition to supportive care,it is necessary to take appropriate measures to decrease serum TG levels,in order to alleviate the progression of AP and prevent recurrence.This review aims to summarize existing clinical and basic research evidence of HTG-AP and seeks to highlight the epidemiology,definition,pathogenesis,clinical course,diagnosis,management,prevention of recurrence,and specific clinical scenarios,such as HTG-AP during pregnancy,HTG-AP with diabetic ketoacidosis.展开更多
Purpose:This paper attempts to review and conceptualize how different scholars approach research on teacher identity through the lens of three human interests defined by Jurgen Habermas.Design/Approach/Methods:This li...Purpose:This paper attempts to review and conceptualize how different scholars approach research on teacher identity through the lens of three human interests defined by Jurgen Habermas.Design/Approach/Methods:This literature review,guided by Habermas's three human interests,illustrates the characteristics of three different approaches to the inquiry into teacher identity.Findings:This paper summarizes three approaches to researching teacher identity and their characteristics,namely the technical approach,the practical approach,and the critical approach.The implications for future research and teacher development are also discussed.Originality/Value:By incorporating Habermas's three human interests into teacher identity inquiries,this article offers a theoretical narrative review of the approaches to investigating teacher identity.Strengths and weaknesses of each approach as well as the possibility of a combined application of different approaches provide an original discussion of teacher identity research.展开更多
Visceral hypersensitivity(VH),one of themajor symptoms of functional gastrointestinal disorders(FGIDs),impacts the social life and quality of life of the patients.Because of the complex pathological mechanism,the drug...Visceral hypersensitivity(VH),one of themajor symptoms of functional gastrointestinal disorders(FGIDs),impacts the social life and quality of life of the patients.Because of the complex pathological mechanism,the drug therapy for VH has unsatisfactory clinical efficacy and induces side effects.Alternative strategies acting on the central nervous system with few side effects are urgently needed.We summarize the centralmechanisms of acupuncture in relieving VH to provide theoretical support for the clinical application of acupuncture in the treatment of VH in FGIDs.In this study,we retrieved the related articles from PubMed and Web of Science with the key words of“acupuncture,”“electroacupuncture,”and“visceral hypersensitivity.”According to the sensory conduction,perception,and emotion-related pathways involved in VH,we summarize the central mechanism of acupuncture in relieving VH from the perspectives of molecular biology and neuroimaging.The pathogenesis of VH in FGIDs involves the peripheral and central nervous systems,which are responsible for the transmission and perception of visceral sensations as well as the regulation of emotion.The widespread nature of VH indicates the involvement of the central nervous system.Acupuncture mediates the signaling pathways between the gastrointestinal tract and the brain to regulate gastrointestinal function and relieve VH.Acupuncture relieves VH by integrating multiple pathways and targets.The available studies in this field mainly focus on the regulation of a specific target or chemical transmitter by acupuncture,while the exact connection among these targets remains to be clarified by multilevel and multitarget studies.展开更多
Exosomes have gained recognition as potential diagnostic and prognostic markers due to their stability and disease-specific cargos.Exosomes,once dismissed as cellular debris,are now acknowledged as crucial mediators o...Exosomes have gained recognition as potential diagnostic and prognostic markers due to their stability and disease-specific cargos.Exosomes,once dismissed as cellular debris,are now acknowledged as crucial mediators of intercellular communications and disease.These nanosized vesicles transport dynamic cargos consisting of bioactive molecules,including proteins,lipids,and nucleic acids,enabling cells to exchange information and influence each other’s behavior.This review delves into the multifaceted roles of exosomes,particularly their emergence as biomarkers for various diseases.To conduct research for this review,a comprehensive literature search strategy was employed across various databases using keywords related to exosomes,biomarkers,cellular communication,disease diagnosis,and more.Selected articles were evaluated based on their relevance,and data were extracted,synthesized,and categorized according to thematic content.Quality assessment was performed on different types of articles,ensuring robust findings.In cancer,exosomes act as liquid biopsy samples,revealing genetic mutations,and protein markers.The misfolded proteins characteristic of neurodegenerative diseases such as Alzheimer disease and Parkinson disease are carried by exosomes.Moreover,exosomes have been studied as biomarkers for cardiovascular,infectious,and autoimmune diseases.In addition to their functions as biomarkers,exosomes influence the tumor microenvironment,immune response,synaptic plasticity,and tissue regeneration.Challenges remain to fill research gaps and standardize exosome analyses.Exosomes are pivotal in intercellular communication and for disease diagnosis,offering insights into cellular processes,immunity,and regeneration.Future research may reshape our understanding of cellular communication and drive therapeutic interventions.Although challenges must be addressed,exosomes hold undeniable potential for use in personalized medicine and biomedical research.展开更多
Economic inequality is a persistent global issue with profound implications for mental health,particularly among older adults.Previous studies have largely focused on objective economic well-being indicators such as i...Economic inequality is a persistent global issue with profound implications for mental health,particularly among older adults.Previous studies have largely focused on objective economic well-being indicators such as income,employment status,and poverty.While these factors are crucial,emerging evidence suggests that welfare benefits and subjective economic well-being components of what can be deemed augmented economic well-being,may play equally significant roles in shaping psychological health among aging populations.This research explores how disparities in these aspects contribute to psychological distress in older adults.We highlight the role of financial security,government assistance pro-grams,and personal economic satisfaction.We propose policy interventions to mitigate adverse effects and emphasize the need for a holistic approach to econo-mic well-being to improve mental health outcomes in older adults.This study reveals that subjective financial security and access to welfare benefits often surpass income as predictors of mental health.These insights underscore the importance of broadening economic frameworks in aging research and deve-loping integrated policies to enhance financial and psychological well-being.展开更多
Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that often co-occurs with depression and anxiety,worsening disease progression and reducing quality of life.A thorough review of the existing...Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that often co-occurs with depression and anxiety,worsening disease progression and reducing quality of life.A thorough review of the existing literature was conducted,including searches in PubMed,Embase,PsycINFO,and Cochrane Library databases up to 2024.This review encompasses a critical analysis of studies reporting on the prevalence,impact,and management of depression and anxiety in COPD patients.We found a high prevalence of psychological comorbidities in COPD patients,which were associated with worse disease outcomes,including increased exacerbations,hospitalizations,and reduced health-related quality of life.Diagnosing and managing these conditions is complex due to overlapping symptoms,necessitating a comprehensive patient care approach.While there has been progress in understanding COPD comorbidities,there is a need for more personalized and integrated treatments.This review emphasizes the need for increased awareness,tailored treatment plans,and further research for effective interventions.展开更多
In addition to higher risks of various obstetric and gynaecological illnesses among women with obesity or who are overweight, maternal adiposity threatens the lifetime health of their offspring. Diverse treatments are...In addition to higher risks of various obstetric and gynaecological illnesses among women with obesity or who are overweight, maternal adiposity threatens the lifetime health of their offspring. Diverse treatments are provided, including complementary and alternative medicine such as Chinese medical practices. Acupuncture, a traditional Chinese medicinal method, is increasingly being applied to this health problem. This literature review analyses 25 clinical studies, involving 2407 participants aged 13-65 in Africa, Asia, the Middle East and North America. This illustrates the use of acupuncture alone or with other approaches to control body weight, obesity-induced diseases, and gynaecological health. Although positive indicators are presented, this study offers recommendations for enhancing reliability and validity in further research. It therefore suggests the use of acupuncture in dealing with obesity due to its efficacy, and economic and safety benefits.展开更多
Being overweight and obese impacts health due to adiposity itself and illnesses it incurs,which produces individual and societal financial burdens.This urges effective interventions,including adjunct therapies.Acupunc...Being overweight and obese impacts health due to adiposity itself and illnesses it incurs,which produces individual and societal financial burdens.This urges effective interventions,including adjunct therapies.Acupuncture,a traditional Chinese medical practice,indicates positive signs for tackling these problems.Investigating 101 empirical human-based projects,this narrative review analyses their outcomes and then provides an overview of the effects of acupuncture in body weight reduction and obesity-induced diseases,either performed alone or with other approaches.It involves 15941 participants from 9-80 years old in China's Mainland,Taiwan,Turkey,Brazil,Egypt,Iran,Greece,Korea,Sudan,Thailand,and the USA.It also reveals practical implications and future research directions,benefiting the development of acupuncture in the modern medical arena for both patients and practitioners.展开更多
Background and objectives In many patients after stroke, spasticity develops over time, resulting in a decrease in the patient′s independence, pain, worsening mood, and, consequently, lower quality of life. In the la...Background and objectives In many patients after stroke, spasticity develops over time, resulting in a decrease in the patient′s independence, pain, worsening mood, and, consequently, lower quality of life. In the last ten years, a rich arsenal of physical agents to reduce muscle tone such as extracorporeal shock therapy (ESWT) wave has come through. The aim of this narrative review article is to present the current state of knowledge on the use of ESWT as a supplement to the comprehensive rehabilitation of people after stroke suffering from spasticity.Methods The PubMed and PEDro databases were searched for papers published in English from January 2000 to December 2020, 22 of which met inclusion criteria for clinical studies related to post-stroke spasticity management with ESWT.Results A total of 22 studies including 468 post-stroke patients-11 reports with the upper limb (267 patients) and 10 reports within the lower limb (201 patients), as well as one report including both upper and lower limb. We focused our attention on clinical and methodological aspects. Therefore, we performed the assessment of enrolled studies in terms of methodological quality using the PEDro and level of evidence using the National Institute for Health and Clinical Excellence (NICE) guidelines. Furthermore, we indicated implications for clinical practice in using ESWT for post-stroke spasticity management. Moreover, we discussed a suggestion for future research directions.Conclusions In conclusion, an ESWT effectively reduces muscle tone in people with spastic limb after stroke. Further, ESWT is safe and free of undesirable side effects.The mechanism of action of ESWT on muscles affected by spasticity is still unknown.To date, no standard parameters of ESWT in post-stroke spasticity regarding intensity, frequency, location, and the number of sessions has been established. Further research, meeting the highest standards, is needed to establish uniform muscle stimulation parameters using ESWT.展开更多
文摘BACKGROUND People living with human immunodeficiency virus(HIV)are aging as a result the benefits of combination antiretroviral therapy.AIM To provide descriptions of eligible existing studies on demographics,methodologies,and outcome measures related to health-related quality of life(HRQoL)in the context of HIV and aging.METHODS The MEDLINE,CINAHL,Scopus,and PsycINFO databases were systematically searched using the terms HIV,age,and HRQoL to find studies published between January 1995 and June 2022.Key variables of the eligible studies were identified and categorized into demographics(e.g.,study sites,study year),methodologies(e.g.,use of conceptual frameworks,measures used),and outcome measures[e.g.,HRQoL,quality of life(QoL)].The PRISMA 2009 checklist was followed.RESULTS A total of 68 published studies involving 53504 participants were included.The majority of the studies(55.88%)were conducted in North America,with relatively few studies conducted in Africa.The median age of participants was 51.0 years(IQR=11.0).Over one-third(32.56%)of all participants were older people living with HIV aged 50 years and older Four studies included only older female participants,and six studies included only men who have sex with men.Outcome mea-sures were assessed as HRQoL(26.47%)or QoL(36.76%).Overall,data from African studies,older women living with HIV,socioeconomic status(e.g.,employment,income,education),sexual behavioral risks,theoretical frameworks used,and follow-up studies were limited.CONCLUSION This narrative review highlights imbalances and gaps in research on HRQoL in the context of HIV and aging,providing direction for future studies in this area.
基金Supported by National Natural Science Foundation of China,No.82172197Guangdong Basic and Applied Basic Research Foundation,No.2022A1515012385Guangdong Provincial Science and Technology Project,No.2020A0505100039.
文摘Diabetes mellitus has become a global health problem,and the number of patients with diabetic foot ulcers(DFU)is rapidly increasing.Currently,DFU still poses great challenges to physicians,as the treatment is complex,with high risks of infection,recurrence,limb amputation,and even death.Therefore,a comprehensive understanding of DFU pathogenesis is of great importance.In this review,we summarized recent findings regarding the DFU development from the perspective of single-nucleotide variations(SNVs).Studies have shown that SNVs located in the genes encoding C-reactive protein,interleukin-6,tumor necrosis factor-alpha,stromal cell-derived factor-1,vascular endothelial growth factor,nuclear factor erythroid-2-related factor 2,sirtuin 1,intercellular adhesion molecule 1,monocyte chemoattractant protein-1,endothelial nitric oxide synthase,heat shock protein 70,hypoxia inducible factor 1 alpha,lysyl oxidase,intelectin 1,mitogen-activated protein kinase 14,toll-like receptors,osteoprotegerin,vitamin D receptor,and fibrinogen may be associated with the development of DFU.However,considering the limitations of the present investigations,future multi-center studies with larger sample sizes,as well as in-depth mechanistic research are warranted.
文摘Hypertriglyceridemia(HTG)is the third most common cause of acute pancreatitis(AP),and the incidence of HTG-induced AP(HTG-AP)is rising worldwide as a result of changes in lifestyle and dietary habits.In China,HTG accounts for 10%to 20%of the causes of AP,even becoming the second leading cause of AP.The presentation and diagnosis of HTG-AP is similar to that of AP from other causes,however,the complication rates and severe AP are significantly higher in patients with HTG-AP than in patients with other etiologies.Regarding the management of HTG-AP,the initial management is similar to that of AP from other causes and mainly includes fluid resuscitation,pain control,and nutritional support.In addition to supportive care,it is necessary to take appropriate measures to decrease serum TG levels,in order to alleviate the progression of AP and prevent recurrence.This review aims to summarize existing clinical and basic research evidence of HTG-AP and seeks to highlight the epidemiology,definition,pathogenesis,clinical course,diagnosis,management,prevention of recurrence,and specific clinical scenarios,such as HTG-AP during pregnancy,HTG-AP with diabetic ketoacidosis.
文摘Purpose:This paper attempts to review and conceptualize how different scholars approach research on teacher identity through the lens of three human interests defined by Jurgen Habermas.Design/Approach/Methods:This literature review,guided by Habermas's three human interests,illustrates the characteristics of three different approaches to the inquiry into teacher identity.Findings:This paper summarizes three approaches to researching teacher identity and their characteristics,namely the technical approach,the practical approach,and the critical approach.The implications for future research and teacher development are also discussed.Originality/Value:By incorporating Habermas's three human interests into teacher identity inquiries,this article offers a theoretical narrative review of the approaches to investigating teacher identity.Strengths and weaknesses of each approach as well as the possibility of a combined application of different approaches provide an original discussion of teacher identity research.
基金This research supported by National Key R&D Program of China(2022YFC3500500)National Natural Science Foundation of China(8217153454).
文摘Visceral hypersensitivity(VH),one of themajor symptoms of functional gastrointestinal disorders(FGIDs),impacts the social life and quality of life of the patients.Because of the complex pathological mechanism,the drug therapy for VH has unsatisfactory clinical efficacy and induces side effects.Alternative strategies acting on the central nervous system with few side effects are urgently needed.We summarize the centralmechanisms of acupuncture in relieving VH to provide theoretical support for the clinical application of acupuncture in the treatment of VH in FGIDs.In this study,we retrieved the related articles from PubMed and Web of Science with the key words of“acupuncture,”“electroacupuncture,”and“visceral hypersensitivity.”According to the sensory conduction,perception,and emotion-related pathways involved in VH,we summarize the central mechanism of acupuncture in relieving VH from the perspectives of molecular biology and neuroimaging.The pathogenesis of VH in FGIDs involves the peripheral and central nervous systems,which are responsible for the transmission and perception of visceral sensations as well as the regulation of emotion.The widespread nature of VH indicates the involvement of the central nervous system.Acupuncture mediates the signaling pathways between the gastrointestinal tract and the brain to regulate gastrointestinal function and relieve VH.Acupuncture relieves VH by integrating multiple pathways and targets.The available studies in this field mainly focus on the regulation of a specific target or chemical transmitter by acupuncture,while the exact connection among these targets remains to be clarified by multilevel and multitarget studies.
文摘Exosomes have gained recognition as potential diagnostic and prognostic markers due to their stability and disease-specific cargos.Exosomes,once dismissed as cellular debris,are now acknowledged as crucial mediators of intercellular communications and disease.These nanosized vesicles transport dynamic cargos consisting of bioactive molecules,including proteins,lipids,and nucleic acids,enabling cells to exchange information and influence each other’s behavior.This review delves into the multifaceted roles of exosomes,particularly their emergence as biomarkers for various diseases.To conduct research for this review,a comprehensive literature search strategy was employed across various databases using keywords related to exosomes,biomarkers,cellular communication,disease diagnosis,and more.Selected articles were evaluated based on their relevance,and data were extracted,synthesized,and categorized according to thematic content.Quality assessment was performed on different types of articles,ensuring robust findings.In cancer,exosomes act as liquid biopsy samples,revealing genetic mutations,and protein markers.The misfolded proteins characteristic of neurodegenerative diseases such as Alzheimer disease and Parkinson disease are carried by exosomes.Moreover,exosomes have been studied as biomarkers for cardiovascular,infectious,and autoimmune diseases.In addition to their functions as biomarkers,exosomes influence the tumor microenvironment,immune response,synaptic plasticity,and tissue regeneration.Challenges remain to fill research gaps and standardize exosome analyses.Exosomes are pivotal in intercellular communication and for disease diagnosis,offering insights into cellular processes,immunity,and regeneration.Future research may reshape our understanding of cellular communication and drive therapeutic interventions.Although challenges must be addressed,exosomes hold undeniable potential for use in personalized medicine and biomedical research.
文摘Economic inequality is a persistent global issue with profound implications for mental health,particularly among older adults.Previous studies have largely focused on objective economic well-being indicators such as income,employment status,and poverty.While these factors are crucial,emerging evidence suggests that welfare benefits and subjective economic well-being components of what can be deemed augmented economic well-being,may play equally significant roles in shaping psychological health among aging populations.This research explores how disparities in these aspects contribute to psychological distress in older adults.We highlight the role of financial security,government assistance pro-grams,and personal economic satisfaction.We propose policy interventions to mitigate adverse effects and emphasize the need for a holistic approach to econo-mic well-being to improve mental health outcomes in older adults.This study reveals that subjective financial security and access to welfare benefits often surpass income as predictors of mental health.These insights underscore the importance of broadening economic frameworks in aging research and deve-loping integrated policies to enhance financial and psychological well-being.
文摘Chronic obstructive pulmonary disease(COPD)is a common respiratory disorder that often co-occurs with depression and anxiety,worsening disease progression and reducing quality of life.A thorough review of the existing literature was conducted,including searches in PubMed,Embase,PsycINFO,and Cochrane Library databases up to 2024.This review encompasses a critical analysis of studies reporting on the prevalence,impact,and management of depression and anxiety in COPD patients.We found a high prevalence of psychological comorbidities in COPD patients,which were associated with worse disease outcomes,including increased exacerbations,hospitalizations,and reduced health-related quality of life.Diagnosing and managing these conditions is complex due to overlapping symptoms,necessitating a comprehensive patient care approach.While there has been progress in understanding COPD comorbidities,there is a need for more personalized and integrated treatments.This review emphasizes the need for increased awareness,tailored treatment plans,and further research for effective interventions.
文摘In addition to higher risks of various obstetric and gynaecological illnesses among women with obesity or who are overweight, maternal adiposity threatens the lifetime health of their offspring. Diverse treatments are provided, including complementary and alternative medicine such as Chinese medical practices. Acupuncture, a traditional Chinese medicinal method, is increasingly being applied to this health problem. This literature review analyses 25 clinical studies, involving 2407 participants aged 13-65 in Africa, Asia, the Middle East and North America. This illustrates the use of acupuncture alone or with other approaches to control body weight, obesity-induced diseases, and gynaecological health. Although positive indicators are presented, this study offers recommendations for enhancing reliability and validity in further research. It therefore suggests the use of acupuncture in dealing with obesity due to its efficacy, and economic and safety benefits.
文摘Being overweight and obese impacts health due to adiposity itself and illnesses it incurs,which produces individual and societal financial burdens.This urges effective interventions,including adjunct therapies.Acupuncture,a traditional Chinese medical practice,indicates positive signs for tackling these problems.Investigating 101 empirical human-based projects,this narrative review analyses their outcomes and then provides an overview of the effects of acupuncture in body weight reduction and obesity-induced diseases,either performed alone or with other approaches.It involves 15941 participants from 9-80 years old in China's Mainland,Taiwan,Turkey,Brazil,Egypt,Iran,Greece,Korea,Sudan,Thailand,and the USA.It also reveals practical implications and future research directions,benefiting the development of acupuncture in the modern medical arena for both patients and practitioners.
文摘Background and objectives In many patients after stroke, spasticity develops over time, resulting in a decrease in the patient′s independence, pain, worsening mood, and, consequently, lower quality of life. In the last ten years, a rich arsenal of physical agents to reduce muscle tone such as extracorporeal shock therapy (ESWT) wave has come through. The aim of this narrative review article is to present the current state of knowledge on the use of ESWT as a supplement to the comprehensive rehabilitation of people after stroke suffering from spasticity.Methods The PubMed and PEDro databases were searched for papers published in English from January 2000 to December 2020, 22 of which met inclusion criteria for clinical studies related to post-stroke spasticity management with ESWT.Results A total of 22 studies including 468 post-stroke patients-11 reports with the upper limb (267 patients) and 10 reports within the lower limb (201 patients), as well as one report including both upper and lower limb. We focused our attention on clinical and methodological aspects. Therefore, we performed the assessment of enrolled studies in terms of methodological quality using the PEDro and level of evidence using the National Institute for Health and Clinical Excellence (NICE) guidelines. Furthermore, we indicated implications for clinical practice in using ESWT for post-stroke spasticity management. Moreover, we discussed a suggestion for future research directions.Conclusions In conclusion, an ESWT effectively reduces muscle tone in people with spastic limb after stroke. Further, ESWT is safe and free of undesirable side effects.The mechanism of action of ESWT on muscles affected by spasticity is still unknown.To date, no standard parameters of ESWT in post-stroke spasticity regarding intensity, frequency, location, and the number of sessions has been established. Further research, meeting the highest standards, is needed to establish uniform muscle stimulation parameters using ESWT.
