Data were extracted by 2 reviewers (XZ and DL) independently using a pre-constructed data extraction form. The data extraction form included the publication information (title, authors, year, etc), participant characteristics (age, gender, etc), intervention details (intervention of experimental group and intervention of control group, frequency, intensity, duration, follow-up), outcomes (primary outcome and secondary outcome, outcome instruments), and study design (randomized, blinded, etc). For continuous data, standard deviation (SD) or standard error (SE) values were extracted. For categorical data, the number of events was extracted.

Review Manager 5.3 (RevMan 5.3) was used for statistical analysis. For all dichotomous variables, relative risks or odds ratios with 95% confidence intervals (CI) were presented. For all continuous variables, mean differences (MDs) or standard MDs with 95% CIs were calculated. Two-sided P value of <.05 was defined as statistical significance. The fixed-effect model was used if data were available and there was no significant heterogeneity. If heterogeneity was high (I2 > 75%), the pooled analysis was not considered and a sensitivity analysis was performed. The χ2 test and Higgins I2 value were used to assess statistical heterogeneity, with I2 > 75% suggesting high statistical heterogeneity.[13] In some evaluations, studies were excluded on the basis of clinical heterogeneity to determine the study's influence on the pooled effect size.

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