Manual Acupuncture or Combination of Rehabilitation Therapy to Treat Poststroke Dysphagia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Backgroundand Objective. Poststroke dysphagia is one of the most common stroke complications with high morbidity and long course, while acupuncture treatment is easily accepted by patients due to its reliability, feasibility, simple operation, low price, and quick effect. Our objective was to evaluate the efficacy of manual acupuncture in poststroke dysphagia patients. Methods. Databases including Medline, Web of Science, PubMed, Cochrane Library databases, EMBASE, CNKI (China National Knowledge Infrastructure), WanFang (WanFang Database), and VIP (Chongqing VIP) were searched from inception until Aug 19, 2022. Data were analyzed using Revman 5.3, Stata 14.0, and TSA 0.9.5.10 Beta software. Evidence quality evaluation was performed by using GRADE profiler 3.6. Results. A total of 33 randomized control trials (RCTs) enrolled 2680 patients. Meta-analysis results revealed that compared to rehabilitation, acupuncture decreased water swallow test (WST) and standard swallowing assessment (SSA) scores. Meanwhile, in contrast to rehabilitation alone, integration of acupuncture with rehabilitation effectively decreased WST and SSA scores; improved swallowing scores of videofluoroscopic swallowing study (VFSS), swallowing scores of Fujishima Ichiro, Barthel index (BI), and swallowing quality of life questionnaire (SWAL-QOL); reduced the aspiration rates as well as aspiration pneumonia; and shortened the duration of empty swallowing and the duration of 5 mL water swallowing. Pooled analysis did not reveal any significant differences in dysphagia outcome severity scores (DOSS) ( p = 0.15 > 0.05 p) between the acupuncture group combined with rehabilitation group and the rehabilitation group alone. After the risk-of-bias assessment, these studies were not of low quality, except in terms of allocation concealment and blindness. Evidence quality evaluation showed that allocation concealment and blindness led to a downgrade and primary outcomes’ evaluation of acupuncture combined with rehabilitation were ranked as moderate-quality evidence while acupuncture alone was ranked as low-quality. Conclusion. This meta-analysis provided positive pieces of evidences that acupuncture and acupuncture combined with rehabilitation were better than using rehabilitation alone in the treatment of poststroke dysphagia.

Dynamic Prognostic Score to Predict Survival in East Asian Elderly Populations with Dysphagia

“…However, this treatment was predominantly considered appropriate for patients with cricopharyngeal achalasia and cricopharyngeal tumors. Moreover, there is evidence that neuromuscular electrical stimulation, peripheral magnetic stimulation, and acupuncture are valuable adjuncts in patients with dysphagia and vocal fold paresis [28][29][30]. However, the efficacy remains to be determined, and more research is consequently required.…”

Swallowing dysfunctions in patients with disorders of consciousness: Evidence from neuroimaging data, assessment, and management

“…Acupuncture combined with rehabilitation is another potential method to treat neurogenic dysphagia. In a recently published meta-analysis aimed at assessing the efficacy of manual acupuncture in poststroke dysphagia, it appears that the integration of this method during the rehabilitation improved swallowing efficacy and reduced the aspiration rate as well as the incidence of aspiration pneumonia (Jiang et al, 2022). Another treatment for dysphagia is the pharyngeal electrical stimulation.…”

Research hotspot and frontiers in post‐stroke dysphagia: A bibliometric study and visualisation analysis

“…Typical clinical manifestations of dysphagia include sialorrhea, coughing, and choking while drinking or eating, and it is one of the most common sequelae of stroke. 1 Studies suggest that the incidence of dysphagia after stroke ranges from 8.1% to 80%. 2,3 Post-stroke dysphagia (PSD) can lead to complications such as pneumonia, malnutrition, and dehydration.…”

“…It helps researchers gain insight into the current research landscape, trends, and collaborations within a particular field. 13 Therefore, this study aimed to (1) visually analyse the research on PSD using CiteSpace and VOSViewer software, and (2) dynamically identify and explore the research hotspots and trends in the field.…”

“…Dysphagia is the feeling that food or liquid is getting stuck in the throat or elsewhere before entering the stomach. Typical clinical manifestations of dysphagia include sialorrhea, coughing, and choking while drinking or eating, and it is one of the most common sequelae of stroke 1 . Studies suggest that the incidence of dysphagia after stroke ranges from 8.1% to 80% 2,3 .…”