Scalp Acupuncture for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials

Wang, Yan; Shen, Jiangang; Wang, Xiumin; Fu, Deng-lei; Chen, Chaoyang; Lu, Ling-yan; Lü, Lin; Xie, Chenglong; Fang, Jianqiao; 鄭, 国慶

doi:10.1155/2012/480950

Cited by 58 publications

(56 citation statements)

References 31 publications

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“…The 24 reviews included 366 RCTs and quasi-RCTs, with each systematic review comprising 3-72 RCTs. Three reviews (12.5%) analyzed acupuncture as an acute stroke intervention [18,19,20], 6 (25%) analyzed it as an approach to stroke rehabilitation [21,22,23,24,25,26], and the remaining 15 (62.5%) analyzed it as an intervention to treat various stroke-related disorders. Of these 15 reviews, 4 focused on poststroke motor dysfunction [27,28,29,30], 4 on poststroke dysphagia [31,32,33,34], 2 on poststroke depression [35,36], and 1 review on each of poststroke hiccup [37], poststroke urinary incontinence [38], shoulder-hand syndrome [29], shoulder pain [39] and apoplectic aphasia [40].…”

Section: Resultsmentioning

confidence: 99%

“…Three reviews [18,19,20], comprising 27 RCTs and quasi-RCTs, examined the efficacy of acupuncture therapy as an intervention for acute stroke. All 3 reviews conducted meta-analyses.…”

Section: Resultsmentioning

confidence: 99%

“…In the third review, Wang et al [18] meta-analyzed 8 RCTs and compared the efficacy of scalp acupuncture with conventional medication. Acupuncture was associated with significantly greater improvement in neurological deficit scores (WMD 3.89, 95% CI 2.43-5.36) as well as significantly higher rates of clinical efficacy (RR 1.23, 95% CI 1.11-1.37).…”

Section: Resultsmentioning

confidence: 99%

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Overview of Systematic Reviews and Meta-Analyses of Acupuncture for Stroke

Zhang

Wang

Liu³

2013

Neuroepidemiology

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Background: We aimed to systematically overview published systematic reviews and meta-analyses in order to identify whether and when acupuncture is an effective treatment for stroke and stroke-related disorders. We also hoped to identify the best directions for future research in this area. Methods: Systematic reviews and meta-analyses of randomized controlled trials (RCTs) and quasi-RCTs evaluating the efficacy of acupuncture to treat stroke or stroke-related conditions were included. Electronic searches were conducted in the Cochrane Database of Systematic Reviews, Ovid MEDLINE, CINAHL, Ovid EMBASE, EBSCO Allied and Complementary Medicine (AMED) database, Chinese Biological Medicine Database, and Chinese National Knowledge Infrastructure Database. Two authors independently assessed the compliance of studies with eligibility criteria, and extracted data from included studies. The quality of systematic reviews was assessed according to the Overview Quality Assessment Questionnaire. Results: A total of 24 systematic reviews were included, of which 4 (16.7%) were Cochrane systematic reviews and 20 (83.3%) were non-Cochrane reviews. Acupuncture was analyzed as an acute stroke intervention in 3 reviews (12.5%), as an approach to stroke rehabilitation in 6 (25%), and as an intervention to treat various stroke-related disorders in the remaining 15 (62.5%). Reviews analyzing death or dependency/disability as the primary outcome reported no statistically significant difference between acupuncture and nonacupuncture control treatments. In contrast, reviews in which the outcome was improvement in global neurological deficit scores or performance on the video-fluoroscopic swallowing study test or water-swallowing test often reported that acupuncture was superior to control treatment. The quality of 10 reviews was ‘poor', 6 reviews were ‘moderate' and 8 were ‘good'. Conclusions: The available evidence suggests that acupuncture may be effective for treating poststroke neurological impairment and dysfunction such as dysphagia, although these reported benefits should be verified in large, well-controlled studies. On the other hand, the available evidence does not clearly indicate that acupuncture can help prevent poststroke death or disability, or ameliorate other aspects of stroke recovery, such as poststroke motor dysfunction. These findings suggest that researchers should focus on the potential application of acupuncture to treat poststroke neurological impairment and dysfunction and on the development of more precise tools to assess these improvements after stroke.

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Section: Resultsmentioning

confidence: 99%

“…Three reviews [18,19,20], comprising 27 RCTs and quasi-RCTs, examined the efficacy of acupuncture therapy as an intervention for acute stroke. All 3 reviews conducted meta-analyses.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Overview of Systematic Reviews and Meta-Analyses of Acupuncture for Stroke

Zhang

Wang

Liu³

2013

Neuroepidemiology

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“…The criteria drafted by the authors were used in 10 reviews, (10,24,26,27,29,31,41,(46)(47)(48) which usually contained randomization, concealment, blinded, dropout, and ITT analysis. Fourteen reviews used Cochrane risk of bias tool, (11,20,22,23,25,28,30,33,36,37,(42)(43)(44)(45) and 2 reviews also used PEDro. (28,43) Jadad scale was used in 8 reviews.…”

Section: Methodological Quality Of Systematic Reviewsmentioning

confidence: 99%

Methological quality of systematic reviews and meta-analyses on acupuncture for stroke: A review of review

Chen

et al. 2017

Chin. J. Integr. Med.

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-T. (2017) Methological quality of systematic reviews and meta-analyses on acupuncture for stroke: a review of review. Chinese Journal of Integrative Medicine, 23(11), pp. 871-877.(doi:10.1007Medicine, 23(11), pp. 871-877.(doi:10. /s11655-017-2764 This is the author's final accepted version.There may be differences between this version and the published version. You are advised to consult the publisher's version if you wish to cite from it.http://eprints.gla.ac.uk/148733/ Database to identify systematic reviews and meta-analyses about acupuncture for stroke published from the inception to December 2016. Review characteristics and the criteria for assessing the primary studies within reviews were extracted. The methodological quality of the reviews was assessed using adapted Oxman and Guyatt Scale. The methodological quality of primary studies was also assessed.Results: Thirty-two eligible reviews were identified, 15 in English and 17 in Chinese.The English reviews were scored higher than the Chinese reviews (P=0.025), especially in criteria for avoiding bias and the scope of search. All reviews used the quality criteria to evaluate the methodological quality of primary studies, but some criteria were not comprehensive. The primary studies, in particular the Chinese reviews, had problems with randomization, allocation concealment, blinding, dropouts and withdrawals, intent to treat analysis and adverse events.Conclusions: Important methodological flaws were found in Chinese systematic reviews and primary studies. It was necessary to improve the methodological quality and reporting quality of both the systematic reviews published in China and primary studies on acupuncture for stroke. KEYWORDSsystematic review, meta-analyses, stroke, acupuncture, review of review, methodological quality 3

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“…5 Acupuncture is often used as an adjunct to standardized rehabilitation treatments after stroke, but its mode of action in the rehabilitation of these patients is yet to be discovered. [6][7][8][9] Acupuncture influences cerebral blood flow in healthy persons [10][11][12] and patients with stroke. 13,14 However, few studies on cerebral blood flow in patients after stroke have used sham acupuncture.…”

mentioning

confidence: 99%

The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial

Ratmansky

Levy

Messinger

et al. 2016

The Journal of Alternative and Complementary Medicine

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Background/Objective: Stroke is a major cause of disability and death in the Western world. Studies have shown a direct relationship between specific mental and motor activity and changes in cerebral blood flow. Acupuncture is often used in post-stroke patients, but there is a lack of sham-controlled studies evaluating the effects of acupuncture on cerebral blood flow following a stroke. This pilot concept-assessment study sought to evaluate the effects of true acupuncture on cerebral blood flow velocity compared with sham acupuncture and lay a foundation for future work in this field. Methods: Seventeen inpatients (age range, 44-79 years) 1-3 months post-stroke were allocated to acupuncture at true acupuncture (TA) points or at sham acupuncture (SA) points. The treatment was 20 minutes long. Transcranial Doppler ultrasonography was used to measure mean flow velocity (MFV) and peak flow velocity (PFV) at both healthy and damaged hemispheres before (T0), in the middle of (T15), and 5 minutes after (T25) treatment. Blood pressure was measured at T0 and T25. Results: A statistically significant ( p < 0.04) MFV increase in both hemispheres was found during and after TA; this increase was higher than that seen with SA ( p < 0.035). Acupuncture had no significant effect on PFV. Systolic blood pressure significantly decreased after acupuncture ( p < 0.005) in a similar manner for both TA and SA. National Institutes of Health Stroke Scale score was negatively correlated with MFV at T15 (r = -0.825; p < 0.05). Conclusion: This pilot study showed a significant influence on cerebral blood flow velocity by TA. This study lays a foundation for larger-scale studies that may prove acupuncture to be a useful tool for cerebral blood flow enhancement during post-stroke rehabilitation.

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Scalp Acupuncture for Acute Ischemic Stroke: A Meta-Analysis of Randomized Controlled Trials

Cited by 58 publications

References 31 publications

Overview of Systematic Reviews and Meta-Analyses of Acupuncture for Stroke

Overview of Systematic Reviews and Meta-Analyses of Acupuncture for Stroke

Methological quality of systematic reviews and meta-analyses on acupuncture for stroke: A review of review

The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial

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