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

Abstract

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.

The quality of reporting of randomized controlled trials of electroacupuncture for stroke

“…Up to now, at least 24 systematic reviews have been published, the available evidence suggests that acupuncture is effective for improving some aspects of poststroke neurological impairment and dysfunction, although there was insufficient evidence for stroke in preventing poststroke death [3]. Especially, electroacupuncture (EA) is an extension technique of acupuncture based on traditional acupuncture combined with modern electrotherapy [4].…”

Efficacy and safety of acupuncture in children: an overview of systematic reviews

“…There are nearly 400 acupuncture points (acupoints) on the body surface, which linked through the 14 meridians to various organs or viscera (13). By stimulating various meridian points, acupuncture is thought to correct the imbalance of energy in the body and restore natural internal homeostasis (10,(14)(15)(16).…”

Acupuncture Mechanism and Redox Equilibrium

“…VD-induced damage of neural tissues has been proved to produce excessive ROS [10]. It has been reported that acupuncture could improve memory impairment in VD patient [11]. The cognitive enhancing effect of acupuncture is likely to be at least partially attributable to decreased oxidative stress [12].…”