Evaluating the efficacy of acupuncture in defined aspects of stroke recovery

Hopwood, Val; Lewith, George; Prescott, P.; Campbell, Mike

doi:10.1007/s00415-008-0790-1

Cited by 39 publications

(56 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Key data are summarized in Table 1. [13][14][15][16][17][18][19][20][21][22] Seven trials included patients in the acute or subacute stage of stroke, and three included patients in the chronic stage. Eight trials were from Western countries and published in English.…”

Section: Study Descriptionmentioning

confidence: 99%

“…Eight trials were from Western countries and published in English. [13][14][15]17,18,[20][21][22] Two trials were from China and published in Chinese. 16,19 Details of the treatment regimens are summarized in Appendix 4 (available at www .cmaj .ca /cgi /content /full /cmaj.091113/DC1).…”

Section: Study Descriptionmentioning

confidence: 99%

“…Only four studies reported appropriate sequence generation. 13,15,18,20 Five trials used blinding of participants and assessors, 17,18,[20][21][22] three used blinding of participants only, 14,16,19 and two used blinding of assessors only. 13,15 Six trials assessed the outcome of more than 85% of the allocated participants at the last followup.…”

Section: Study Qualitymentioning

confidence: 99%

“…13,15,18,20 Five trials used blinding of participants and assessors, 17,18,[20][21][22] three used blinding of participants only, 14,16,19 and two used blinding of assessors only. 13,15 Six trials assessed the outcome of more than 85% of the allocated participants at the last followup. 13,15,[17][18][19]21 Five trials mentioned that the outcomes were analyzed by intention-to-treat analysis.…”

Section: Study Qualitymentioning

confidence: 99%

See 3 more Smart Citations

Acupuncture for functional recovery after stroke: a systematic review of sham-controlled randomized clinical trials

Kong¹,

Lee²,

Shin³

et al. 2010

Canadian Medical Association Journal

View full text Add to dashboard Cite

Background: Acupuncture is frequently advocated as an adjunct treatment during stroke rehabilitation. The aim of this review was to assess its effectiveness in this setting. Methods:We searched 25 databases and 12 major Korean traditional medicine journals from their inception to October 2009. We included randomized controlled trials, with no language restrictions, that compared the effects of acupuncture (with or without electrical stimulation) with sham acupuncture. We assessed the methodologic quality of the trials using the Cochrane risk-of-bias criteria and the PEDro (Physiotherapy Evidence Database) scale.Results: Ten of 664 potentially relevant studies met our inclusion criteria. For acute and subacute stages after stroke, we included seven trials. A meta-analysis of the five studies that assessed functionality did not show a significant difference in favour of acupuncture, with high heterogeneity. A post-hoc sensitivity analysis of three trials with low risk of bias did not show beneficial effects of acupuncture on activities of daily living at the end of the intervention period (n = 244; standard mean difference 0.07, 95% confidence interval [CI] -0.18 to 0.32; I 2 = 0%) or after follow-up (n = 244; standard mean difference 0.10, 95% CI -0.15 to 0.35; I 2 = 0%). For the chronic stage after stroke, three trials tested effects of acupuncture on function according to the Modified Ashworth Scale; all failed to show favourable effects. Interpretation:Our meta-analyses of data from rigorous randomized sham-controlled trials did not show a positive effect of acupuncture as a treatment for functional recovery after stroke. Research Appendix 2, available at www.cmaj.ca /cgi /content /full /cmaj .091113 /DC1). We also searched our own files manually for relevant articles. Hard copies of all articles were obtained and read in full. No language restrictions were imposed. We included dissertations and abstracts, provided they contained sufficient detail for critical evaluation. Abstract

show abstract

Section: Study Descriptionmentioning

confidence: 99%

Section: Study Descriptionmentioning

confidence: 99%

Section: Study Qualitymentioning

confidence: 99%

Section: Study Qualitymentioning

confidence: 99%

See 2 more Smart Citations

Acupuncture for functional recovery after stroke: a systematic review of sham-controlled randomized clinical trials

Kong¹,

Lee²,

Shin³

et al. 2010

Canadian Medical Association Journal

View full text Add to dashboard Cite

show abstract

“…Clinical efficacy of acupuncture in stroke rehabilitation in the chronic phase is yet to be confirmed in a controlled clinical trial using a larger sample size. However, the effectiveness of acupuncture is suggested by the present results, as acupuncture stimulation on well recognized motor-implicated acupoints Hegu LI-4 [13,[26][27][28] and Quchi LI-11 [13,[27][28][29][30] was the sole intervention applied during the study period to our clinically stable chronic stroke patients. Such a setting cannot be applied to studies on stroke patients at acute or subacute phase [13,14,30,31] because of ethical considerations.…”

Section: Discussionmentioning

confidence: 84%

Increased Brain Activation in Motor Cortex After Acupuncture Treatment for Motor Recovery in Chronic Stroke Patients

Chau¹,

Cheung²,

Xian-yong³

et al. 2009

TOREHJ

View full text Add to dashboard Cite

Acupuncture has historically been recommended as adjunctive treatment to patients with stroke, but its effectiveness has yet to be proven. This case series aims to report the results of using functional magnetic resonance imaging (fMRI), together with motor function evaluations, to assess the effect of acupuncture on stable patients after stroke. Eleven chronic stroke patients underwent fMRI and motor function evaluations of their impaired upper limb before and after an 8-week period of acupuncture on two acupoints (Hegu LI-4 and Quchi LI-11), without undergoing simultaneous rehabilitation. Improvements in motor functions of the impaired upper limb were found after acupuncture treatment. Changes in cortical activities were closely related to the finding of improved motor functions. A larger and stronger activation was found in the sensorimotor area of the lesioned hemisphere after receiving the acupuncture intervention. Conjunction analysis demonstrated common regions that were activated during either motor task or acupuncture stimulation. Acupuncture may improve functions of the impaired upper limb in chronic stroke patients via modulating peri-infarct regions that are responsible for plasticity of the motor cortex.

show abstract

Acupuncture for acute stroke

Zhang

2018

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

GRADE Working Group grades of evidence. High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.a Of the 33 included RCTs, the acupuncture treatment type and period were heterogeneous. The acupuncture treatment period ranged from one to three months. The acupoints varied across trials. The needling sensation could be provoked by manual stimulation or electrical stimulation. b Downgraded one level for serious inconsistency: variation in the definition of dependency and acupuncture treatment type and duration. c Downgraded two levels for very serious risk of bias: Among the 11 included trials, eight had risk of performance bias and seven had risk of detection bias; the result was not consistent with the sensitivity analysis using only sham controls. d Downgraded two levels for very serious risk of bias: Among the eight included trials, six had risk of performance bias and four had risk of detection bias; the result was not consistent with the sensitivity analysis using only sham controls. e Downgraded two levels for very serious risk of bias: Among the five included trials, four had risk of performance bias; the result was not consistent with the sensitivity analysis using only sham controls. f Downgraded two levels for very serious inconsistency: considerable statistical heterogeneity (I 2 > 50%) and variation in acupuncture treatment type and duration. g Downgraded two levels for very serious risk of bias: Among the 13 included trials, at least eight trials had risk of allocation bias, performance bias, or detection bias; the result was not consistent with the sensitivity analysis using only sham controls. h Downgraded two levels for very serious risk of bias: Among the 11 included trials, at least six had risk of allocation bias, performance bias, or detection bias; the result was not consistent with the sensitivity analysis using only sham controls. i Downgraded two levels for very serious risk of bias: Among the 18 included trials, at least 10 trials had risk of allocation bias, performance bias, or detection bias; the result was not consistent with the sensitivity analysis using only sham controls. j Downgraded two levels for very serious risk of bias: Among the 22 included trials, at least 11 trials had risk of allocation bias, performance bias, or detection bias; the result was not consistent with the sensitivity analysis using only sham controls. k Downgraded two levels for very serious inconsistency: variation between trials in reporting of adverse events and in acupuncture treatment type and duration. Summary of findings 2. Acupuncture compared with sham control for patients with acute stroke Acupuncture com...

show abstract

Evaluating the efficacy of acupuncture in defined aspects of stroke recovery

Abstract: Acupuncture did not demonstrate specific efficacy over placebo and both groups did as well as normally expected with this condition.

Cited by 39 publications

References 28 publications

Acupuncture for functional recovery after stroke: a systematic review of sham-controlled randomized clinical trials

Acupuncture for functional recovery after stroke: a systematic review of sham-controlled randomized clinical trials

Increased Brain Activation in Motor Cortex After Acupuncture Treatment for Motor Recovery in Chronic Stroke Patients

Acupuncture for acute stroke

Contact Info

Product

Resources

About