Insights & Discussion
Acupuncture may have beneficial effects on improving dependency, global neurological deficiency, and some specific neurological impairments for people with stroke in the convalescent stage, with no obvious serious adverse events.
Although acupuncture may have positive effects in stroke rehabilitation and there were no reported serious adverse events, the small number of low quality studies and the probability of publication bias means that there was insufficient evidence to support the routine use of acupuncture for people with subacute or chronic stroke.
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Meta-analysis has strong implications of the effectiveness of tongue acupuncture, especially when combined with conventional therapies, in treating poststroke aphasia. This holistic approach demonstrates significant improvements in patient outcomes.
2022 Evidence-Based Complementary and Alternative Medicine Tongue Acupuncture for the Treatment of Poststroke Aphasia: A Systematic Review and Meta-Analysis Yang S, Li L, Jiang R, Ding H, Xu F, Ge L, et al.
Systematic Review Aphasia Post-Stroke Aphasia Tongue Acupuncture
Meta-analysis showed significant heterogeneity in ABC scores, with tongue acupuncture combined with conventional therapies proving more effective. Clinical efficacy also favored tongue acupuncture combined with conventional therapies. CFCP scores showed significant improvement with tongue acupuncture, especially when combined with conventional therapies.
Acupuncture added to conventional rehabilitation has been found more effective in reducing post-stroke spasticity than conventional rehabilitation alone.
2022 Frontiers in Neurology Effectiveness and safety of acupuncture for post-stroke spasticity: A systematic review and meta-analysis Xue C, Jiang C, Zhu Y, Liu X, Zhong D, Li Y, et al.
Systematic Review Acupuncture Spasticity
In this systematic review and meta-analysis, a charge was led to determine the effectiveness and safety of acupuncture for post-stroke spasticity. A comprehensive search across nine electronic databases was carried out up to June 2022. Identification was focused on randomized-controlled trials that scrutinized the potency and safety garnered from acupuncture for post-stroke spasticity. An independent screening of studies was initiated by two reviewers who also took charge of data extraction and bias risk assessment. Software tools were employed for statistical analysis of data.
Out of the search, 88 studies deemed eligible were included amounting to a total of 6,431 participants. Pooled data illustrated that there was a beneficial effect when combining acupuncture and conventional rehabilitation, surpassing the results obtained from conventional rehabilitation alone. Subgroup analysis underscored that acquiring acupuncture either once or twice a day had superior results than conventional rehabilitation. The antispasmodic effect seemed to improve with more treatment sessions. A small number of studies explicitly pointed out slight adverse events related to acupuncture.
Acupuncture combined with rehabilitation was more effective in improving the motor function and the ability of daily living.
2021 Evidence-Based Complementary and Alternative Medicine Acupuncture plus Rehabilitation for Unilateral Neglect after Stroke: A Systematic Review and Meta-Analysis Hou, Y., Liu, Y., Li, M., et al.
Systematic Review
The mechanism for the effects of acupuncture in the improvement of motor function and activity of daily life may be explained by two reasons. First, acupuncture can directly enhance the motor function and daily life of stroke patients. Acupuncture has been shown to lead to a higher improvement in motor function than conventional treatment. Acupuncture when combined with rehabilitation may have a positive effect on motor function, activity of daily life, neurological deficits, and spasticity. Indeed, the meta-analysis concluded that no matter what kind of acupuncture therapy was combined with rehabilitation, it was better than the rehabilitation group when it came to significantly improving the activity of daily life of patients after ischaemic stroke.
Second, acupuncture may indirectly improve the motor function and daily living ability of stroke patients by improving the symptoms of unilateral neglect and making them aware of their limbs. Acupuncture points may be the more intensive parts of the sensory organs that produce needle sensation. Acupuncture sensation is continuously transmitted to the central nervous system through the peripheral receptors of acupuncture point of contact, which facilitates new cognitive neural pathways for effective information, processing, and analysis, which may be one of the mechanisms for improving the perception of an injured hemisphere and alleviating the symptoms of unilateral neglect in patients.
Compared with conventional treatment, acupuncture as an adjuvant therapy can significantly reduce the incidence of post-stroke fatigue.
2021 Acupuncture & Electro-Therapeutics Research Acupuncture for the Adjunctive Therapy of Post-stoke Fatigue: A Systematic Review and Meta-analysis Chen Y, Peng M, Li Y
Systematic Review Acupuncture Fatigue
A total of 6 RCTs were included in this study, including 426 cases (213 cases in the treatment group and 213 cases in the control group).
Our systematic review and meta-analysis suggests that acupuncture combined with conventional rehabilitation therapy is an effective therapy for patients suffering from post-stroke fatigue, which is suitable for clinical promotion and use. However, due to methodological weakness and limited number of RCTs, the results should be interpreted cautiously. Further clinical trials with large sample sizes and a rigorous design are needed.
Acupuncture, when combined with other treatments, is an effective therapy for treating swallowing difficulties experienced after a stroke.
2021 Evidence-Based Complementary and Alternative Medicine The Effectiveness of Acupuncture for Dysphagia after Stroke: A Systematic Review and Meta-Analysis Zhong, L., Wang, J., Li, F., et al.
Systematic Review Dysphagia
In the methodology used for this study, the researchers examined various English and Chinese databases up to March 2020, focusing on randomized controlled trials that used acupuncture or combined acupuncture with other treatments to help stroke patients with dysphagia. Two authors independently assessed and extracted the data. For quality control, the bias risk assessment tool recommended by the Cochrane Collaboration was used to assess each selected study. The researchers then conducted a meta-analysis using RevMan 5.3 software and calculated pooled analyses by the mean difference.
Results showed that when compared to a control group, patients who underwent acupuncture combined with other treatments experienced an improvement in their ability to swallow as measured by different scales and tests. No serious adverse effects were reported in the studies, indicating that acupuncture is not only effective but also safe as a treatment method for dysphagia following stroke.
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