Acupuncture for managing post-stroke spasticity:a systematic review of randomized controlled trial and Meta analysis
10.3969/j.issn.1006-2157.2017.01.011
- VernacularTitle:针刺治疗脑卒中后肌痉挛的系统综述与Meta分析
- Author:
Xiaoyi YAN
1
;
Liyan JIA
;
Yunjiao ZHANG
;
Li ZHOU
;
Jianping LIU
;
Zhaolan LIU
Author Information
1. 北京中医药大学循证医学中心 北京 100029
- Keywords:
stroke;
muscular spasm;
spasticity;
acupuncture;
systematic review
- From:
Journal of Beijing University of Traditional Chinese Medicine
2017;40(1):52-58
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effectiveness and safety of acupuncture in the management of post-stroke spasticity.Methods Six domestic and abroad databases were screened by computer.Randomized controlled trials (RCT)were included if acupuncture treatment was used as the sole intervention or as an adjunction to another conventional treatment on post-stroke spasticity. Two independent reviewers screened the articles,extracted data and assessed the risk of bias.The evaluation of the quality was performed using Cochrane Risk of Bias Tool and the data was analyzed by using RevMan 5.3.Mean difference (MD)and 95% confidence interval (CI)were used to describe quantitative data.Results A total 29 RCT were included,7 of them had high risk of bias and the rest of them had unclear risk of bias. Acupuncture was better than rehabilitation therapy in remission of spasticity (-0.40 [-0.68,-0.12]).The 4 or 8 weeks of treatment in studies of unmentioned spasmodic regions showed that acu-puncture with rehabilitation therapy was better than rehabilitation therapy (-0.31 [-0.50,-0.11],-0.41[-0.54,-0.28]).The studies of 4 weeks of treatment showed superior effect of acupuncture with conventional treatment compared with rehabilitation therapy with conventional treatment (-0.96 [-1.73,-0.19]),and acupuncture with rehabilitation therapy was superior to conventional treatment with rehabilitation therapy (-0.57[-0.80,-0.34]).After 6 months of treatment,acupuncture with nerve block therapy and rehabilitation therapy was better than nerve block therapy with rehabilitation therapy (-0.63[-1.12,-0.14]),and acupuncture with nerve block therapy was better than nerve block therapy (-0.70[-1.08,-0.32]).In improving the physical activity,acupuncture,acupunc-ture with rehabilitation therapy,acupuncture with conventional treatment and rehabilitation therapy 1 or 4 weeks of follow-up,and acupuncture with nerve block therapy was better than that of control group. Conclusion Acupuncture could remiss the spasticity after stroke and improve the ability of daily life and motor function of patient,but the conclusion of subgroups are not the same.The high quality RCT studies with clear spasmodic position and measurement at more time points are needed to confirm the effectiveness and safety of acupuncture in post-stroke patients with spasticity.
