Acupuncture has been used in stroke recovery in Eastern countries from ancient times. There is now a convincing body of research on the beneficial effect of adjunct acupuncture treatment on aspects of poststroke recovery including dysphagia, poststroke pain syndrome and spasticity.
Furthermore, there is emerging evidence in the areas of motor recovery, insomnia, cognitive impairment and depression.
The following insights are obtained from systematic reviews and analysis of clinical trials investigating the efficacy of Acupuncture for Stroke Rehabilitation.
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.
Acupuncture plus Rehabilitation for Unilateral Neglect after Stroke: A Systematic Review and Meta-Analysis Hou, Y., Liu, Y., Li, M., Ning, B., Wen, Z., & Fu, W.
Researchers retrieved 2452 articles in total, after screening, thirty-eight studies with 2628 participants of were included. In this meta-analysis, twenty-seven trials revealed that acupuncture therapy was associated with an increase in FMA scores compared with rehabilitation training (RT).
Acupuncture therapy for poststroke spastic hemiplegia: A systematic review and meta-analysis of randomized controlled trials Fan W, Kuang X, Hu J, Chen X, Yi W, Lu L, Xu N, Wang L.
Our study revealed that, compared with speech rehabilitation training alone, additional acupuncture has a beneficial effect on clinical response rate (when using FDA for evaluation), based on low-quality evidence. Furthermore, no serious adverse events were reported among the studies analyzed.
Acupuncture combined with speech rehabilitation training for post-stroke dysarthria: a systematic review and meta-analysis of randomized controlled trials Xie Q, Chen X, Xiao J, Liu S, Yang L, Chen J, Lai J, Lan R, Chen Y, Yang H, Guo X.
This systematic review shows that adding acupuncture to routine rehabilitation can improve clinical outcomes (pain and motor function) for people with mild post-stroke SHS. However, the evidence was assessed as â€œlowâ€ by GRADE due to the methodological limitations and heterogeneity of included studies, which made our certainty in recommending acupuncture for this condition in clinical practice as â€œlow.â€ Well-designed placebo-controlled RCTs with a long treatment duration and follow up, as well as standardized reporting, are needed to support acupuncture's safe and effective use in the management of post-stroke SHS.
Acupuncture for Post-stroke Shoulder-Hand Syndrome: A Systematic Review and Meta-Analysis Liu, S., Zhang, C. S., Cai, Y., Guo, X., Zhang, A. L., Xue, C. C., & Lu, C
A systematic review was carried out. A search was conducted in March 2014 using PubMed, Medline, the Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI) and Wanfang databases. English and Chinese language articles published within 10â€…years of the search were reviewed for inclusion. Randomised control trials comparing combined treatment with acupuncture and rehabilitation and rehabilitation alone in patients with acute or subacute stroke (onset until 3â€…months after stroke) were included in this review. Three review authors independently checked the titles and abstracts of trials for inclusion based on selection criteria. Studies measuring changes of motor function, activities of daily living, neurological deficit or spasticity/range of motion during the treatment period and at the end of follow-up were included.
17 trials met the inclusion criteria, of which five were of good quality. 14 trials had results favourable to acupuncture combined with rehabilitation, compared with conventional rehabilitation treatment alone.
Effectiveness of Acupuncture Combined with Rehabilitation for Treatment of Acute Or Subacute Stroke: A Systematic Review Vados, L., Ferreira, A., Zhao, S., Vercelino, R., & Wang, S.
A total of 20 studies involving 1918 participants were included in this study. Compared to rehabilitation therapy alone, the combined therapy significantly reduced pain on the visual analogue scale and improved limb movement on the Fuglâ€“Meyer Assessment scale and the performance of activities of daily living (ADL) on the Barthel Index scale or Modified Barthel Index scale. Of these, the visual analogue scale score changes were significantly higher favoring the combined therapy after treatment, with severe heterogeneity.
Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system: a systematic review and meta-analysis Peng, L., Zhang, C., Zhou, L., Zuo, H. X., He, X. K., & Niu, Y. M. (
Twenty-nine RCTs comprising 2,190 patients were included. The included studies had a medium quality grade based on the Consolidated Standards of Reporting Trials (CONSORT) and Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklist. Acupuncture therapy provided a higher effective rate compared with nonacupuncture treatments. Subgroup and meta-regression analyses suggested that acupuncture intensity and measurement method were main sources of heterogeneity and resulted in a significant difference for pooled effect size. No severe adverse events were documented in these RCTs.
Acupuncture Treatment for Post-Stroke Dysphagia: An Update Meta-Analysis of Randomized Controlled Trials Li, Lx., Deng, K. & Qu, Y.
This review suggests that conventional acupuncture and electroacupuncture could be effective treatments for survivors with poststroke shoulder pain, with regard to reducing pain and improving upper extremity function and physical function. However, the results of this review should be interpreted with consideration of its limitations.
Effects of Acupuncture on the Recovery Outcomes of Stroke Survivors with Shoulder Pain: A Systematic Review Chau, J., Lo, S., Yu, X., Choi, K. C., Lau, A., Wu, J., Lee, V., Cheung, W., Ching, J., & Thompson, D. R.
EA combined with conventional routine care has the potential of reducing spasticity in the upper and lower limbs and improving overall and lower extremity motor function and activities of daily living for patients with spasticity, within 180 days poststroke. Further studies of high methodological and reporting quality are needed to confirm the effects and safety of EA, and to explore the adequate and optimal protocol of EA for poststroke spasticity, incorporating a group of comprehensive outcome measures in different populations.
Electroacupuncture for Poststroke Spasticity: A Systematic Review and Meta-Analysis Cai Y, Zhang CS, Liu S, Wen Z, Zhang AL, Guo X, Lu C, Xue CC
A total of 165 studies were identified; 13 RCTs met our inclusion criteria. Meta-analysis showed that acupuncture appeared to be more effective than drugs for treatment of insomnia after stroke, as assessed by the PSQI and by the efficacy standards of Chinese medicine. Intradermal acupuncture had significant effects compared with sham acupuncture, as assessed by the ISI and the AIS.
Acupuncture for insomnia after stroke: a systematic review and meta-analysis. Lee, SH., Lim, S.M.
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.
Acupuncture for stroke rehabilitation Yang A, Wu HM, Tang JL, Xu L, Yang M, Liu GJ.
Our findings indicate that acupuncture ameliorates neurological deficits and reduces brain edema in experimental ischemic stroke and the mechanisms positively correlate with endogenous neurogenesis, in which acupuncture therapy can promote the proliferation, migration and differentiation of NSCs.
Acupuncture for neurogenesis in experimental ischemic stroke: a systematic review and meta-analysis Lu, L., Zhang, Xg., Zhong, L. et al.
The results of this systematic review shows that acupuncture therapy is significantly effective in improving the Clinical Efficacy Rate, Fugl-Meyer Assessment Scores, Barthel Index Scores and Neurological Deficit Scores in ischemic stroke patients when compared with the conventional medication. Further large-scale, well-designed RCTs on this topic are still warranted.
An Updated Meta-Analysis of the Efficacy and Safety of Acupuncture Treatment for Cerebral Infarction Li Li, Hong Zhang , Shu-qing Meng, Hai-zhou Qian
The current evidence suggests that acupuncture is not effective for death or dependency/disability. However, acupuncture may be effective for treating poststroke neurological impairment and dysfunction, particularly poststroke dysphagia, although these findings require verification in rigorous RCTs. Future studies should place more emphasis on the efficacy of acupuncture for treating poststroke neurological impairment and dysfunction and on the development of more precise tools for assessing these outcomes.
Overview of Systematic Reviews and Meta-Analyses of Acupuncture for Stroke Zhang J. Wang D. Liu M.
Twenty-one trials with a total of 1421 patients met inclusion criteria. Pooled random-effects estimates of the change in the Mini-Mental State Examination were calculated for the comparison of acupuncture with no acupuncture in addition to medicine or rehabilitation. Following 4 weeks and 8 weeks of intervention with acupuncture, the merged mean difference was 3.14 (95% confidence interval [CI], 2.06â€“4.21; p<.00001) and 2.03 (95% CI, 0.26â€“3.80; p=0.02), respectively. For the comparison of 3â€“4 weeks of acupuncture with no acupuncture in addition to medicine or rehabilitation groups, the merged MD in Neurobehavioral Cognitive State Examination total scores was 5.63 (95% CI, 3.95â€“7.31; p<.00001). For the comparison of 8â€“12 weeks of acupuncture with no acupuncture in addition to medicine or rehabilitation groups, the P300 latency merged MD was âˆ’12.80 (95% CI, âˆ’21.08 to âˆ’4.51; p<.00001), while the P300 amplitude merged MD was 1.38 (95% CI, 0.93â€“1.82; p<.00001). Overall, the study quality was rated as moderate on the basis of the Cochrane Handbook for Systematic Reviews of Interventions (part 2: 8.5).
A Meta-Analysis of Acupuncture Use in the Treatment of Cognitive Impairment After Stroke Fang Liu, Zhuang-Miao Li, Yi-Jing Jiang, and Li-Dian Chen.
It was found in this review of reported RCTs that acupuncture is an effective treatment for shoulder pain after stroke. Acupuncture can be considered as an adjuvant therapy in combination with exercise for rehabilitation of the stroke patients who are suffering from shoulder pain. Further trials concerning this topic should be conducted according to the highest methodological standards for certainty.
Acupuncture for Shoulder Pain After Stroke: A Systematic Review Jung Ah Lee, Si-Woon Park, Pil Woo Hwang, Sung Min Lim, Sejeong Kook, Kyung In Choi, and Kyoung Sook Kang.
Randomized clinical trials demonstrate that acupuncture may be effective in the treatment of poststroke rehabilitation. Poor study quality and the possibility of publication bias hinder the strength of this recommendation and argue for a large, transparent, well-conducted randomized clinical trial to support this claim and implement changes to clinical practice.
Acupuncture in Poststroke Rehabilitation Ping Wu , Edward Mills , David Moher , and Dugald Seely
Browse our collection of scientific clinical research on Acupuncture for Stroke Rehabilitation. It includes recent and reputable papers published by peer-reviewed journals within the last 10 years.
This academic article showed that acupuncture treatments when combined with rehabilitation have a positive effect on motor function, activity of daily life, neurological deficits, and spasticity. Patients are more aware of their limbs and improved symptoms of unilateral neglect.
Hou, Y., Liu, Y., Li, M., Ning, B., Wen, Z., & Fu, W. Full Article
The study revealed in comparison with speech rehabilitation training alone, acupuncture treatments have a more effective respond rate. Patients also showed improvements with dysarthria (slurred speech) and overall better quality of life.
Xie Q, Chen X, Xiao J, Liu S, Yang L, Chen J, Lai J, Lan R, Chen Y, Yang H, Guo X. Full Article
The study analysed 38 clinical trials with 2628 participants with high efficacy of acupuncture in recovery for post stroke spastic hemiplegia. Patients showed improvements of motor functioning, balance, sensation and joint functions. They also reported to have better performances to activities of life, after including acupuncture treatments with rehabilitation training.
Fan W, Kuang X, Hu J, Chen X, Yi W, Lu L, Xu N, Wang L. Full Article
2019, Apr 26
This research showcase that acupuncture treatments are effective for post-stroke patients with mild Shoulder-Hand Syndrome. The results highlighted improvements on motor function, pain relief with reduction of join inflammation, muscle weakness and limited range of motions. Acupuncture has supported patients towards returning back to daily activities.
Liu, S., Zhang, C. S., Cai, Y., Guo, X., Zhang, A. L., Xue, C. C., & Lu, C Full Article
2018, Dec 12
This clinical systematic review analysed 17 acupuncture trials which demonstrated the treatments to be highly effective. Stroke recovery is higher with acupuncture treatments compared with rehabilitation alone.
Vados, L., Ferreira, A., Zhao, S., Vercelino, R., & Wang, S. Full Article
2018, Jul 18
The meta-analysis evidently supports the efficacy and safety of acupuncture in treatment to post-stroke dysphagia within a short-term. Patients reported to have better recovery rate compared with rehabilitation or medication.
Li, Lx., Deng, K. & Qu, Y. Full Article
This academic journal demonstrated that acupuncture is highly effective in alleviating pain when combined with rehabilitation therapy. Patients increased performance levels on stroke-specific assessments and improved on daily life activities.
Peng, L., Zhang, C., Zhou, L., Zuo, H. X., He, X. K., & Niu, Y. M. ( Full Article
2018, Jan 31
This study showed that acupuncture reduced shoulder pain and improved quality of life post-stroke. Patients experienced better shoulder range of motion, less edema and swelling.
Chau, J., Lo, S., Yu, X., Choi, K. C., Lau, A., Wu, J., Lee, V., Cheung, W., Ching, J., & Thompson, D. R. Full Article
2017, Apr 25
Electro-acupuncture combined with conventional routine care has the potential of reducing spasticity in the upper and lower limbs. The treatments have overall benefits to daily activities especially lower extremity motor function for patients with spasticity, within 180 days poststroke.
Cai Y, Zhang CS, Liu S, Wen Z, Zhang AL, Guo X, Lu C, Xue CC Full Article
2016, Aug 26
This research article showcased that acupuncture treatments have beneficial effects on improving dependency, motor and cognitive functions , with no obvious serious adverse events. The clinical trials also evaluated improvements on reduction of pain and spasticity and increased sleep quality and mental health.
Yang A, Wu HM, Tang JL, Xu L, Yang M, Liu GJ. Full Article
2016, Jul 19
This clinical article showed high efficacy of acupuncture in treating insomnia post-stroke. Patients mainly experienced hyperactivities of sympathetic nervous system which resulted in disturb sleep patterns. Acupuncture reduced other post-stroke insomnia symptoms such as anxiety, depression and side effects from antipsychotic drugs. It was effective improving overall quality of sleep and lifestyle.
Lee, SH., Lim, S.M. Full Article
2016, Jan 20
This systematic review found that acupuncture improved neurological deficits and reduced brain edema in experimental ischemia. Patients under the acupuncture group have enhanced Neurological function score with increased endogenous neurogenesis.
Lu, L., Zhang, Xg., Zhong, L. et al. Full Article
2014, Dec 1
This clinical article demonstrated that acupuncture treatment is effective, compared to controlled group with rehabilitation therapy for cerebral infarction.
Li Li, Hong Zhang , Shu-qing Meng, Hai-zhou Qian Full Article
2014, Jul 8
This meta-analysis suggests that acupuncture had positive effects on cognitive function after stroke and supports the need for additional research on the potential benefits of this therapeutic approach.
Fang Liu, Zhuang-Miao Li, Yi-Jing Jiang, and Li-Dian Chen. Full Article
The journal article suggested that acupuncture may be effective for treating poststroke neurological impairment and dysfunction such as dysphagia (difficulty in swallowing). Patients suffering from dysphagia after stroke reported to have improved symptoms after acupuncture treatments.
Zhang J. Wang D. Liu M. Full Article
This systematic review proved that acupuncture combined with exercise is effective for shoulder pain after stroke. Patients showed improvements with axillary nerve pain, spasticity of shoulder muscles and mobility of rotator cuff muscles.
Jung Ah Lee, Si-Woon Park, Pil Woo Hwang, Sung Min Lim, Sejeong Kook, Kyung In Choi, and Kyoung Sook Kang. Full Article
2010, Feb 18
The clinical systematic review and meta analysis of randomised controlled trials demonstrates that acupuncture is effective in improving post-stroke rehabilitation.
Ping Wu , Edward Mills , David Moher , and Dugald Seely Full Article
Although well-conducted clinical research can help members of the public to make better-informed decisions about their healthcare, we do not make any claims that any particular treatment may be efficacious for any individual person.
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