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Title

Electro-acupuncture for post-stroke spasticity: a systematic review and meta-analysis.

Authors

Cai Y, Zhang CS, Liu S, Wen Z, Zhang AL, Guo X, Lu C, Xue CC.

Journal

Arch Phys Med Rehabil.

Year

2017

Vol (Issue)

Page

pii: S0003-9993(17)30257-5.

doi

10.1016/j.apmr.2017.03.023.

PMID

28455191

Url

http://www.ncbi.nlm.nih.gov/pubmed/28455191

MeSH

Keywords

stroke; muscle spasticity; acupuncture; traditional Chinese medicine; meta-analysis

한글 키워드

뇌졸중; 근육 강직; 침 치료; 중의학; 메타분석

KMCRIC
Summary & Commentary

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Korean Study

Abstract

OBJECTIVE:
To evaluate the effects and safety of electro-acupuncture (EA) for stroke patients with spasticity.
DATA SOURCES:
Five English (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and AMED) and four Chinese databases (CBM, CNKI, CQVIP and Wanfang) were searched from their inception to September 2016.
DATA SELECTION:
Randomized controlled trials were included if they measured spasticity with Modified Ashworth Scale in stroke patients and investigated the add-on effects of electro-acupuncture to routine pharmacotherapy and rehabilitation therapies.
DATA EXTRACTION:
Information on patients, study design, treatment details and outcomes assessing spasticity severity, motor function and activity of daily living were extracted.
DATA SYNTHESIS:
In total, 22 trials met the search criteria and were included involving 1,425 participants. The estimated add-on effects of EA to reduce spasticity in upper limb measured by MAS (SMD: -0.57[-0.84, -0.29]) and improve overall motor function measured by FMA (MD: 10.60[8.67, 12.53]) were significant. It was also found that for spasticity in lower limb, lower-limb motor function and activity of daily living, significant add-on effects of EA were also shown (SMD: -0.88[-1.42, -0.35], MD:4.42[0.06, 8.78] and MD: 6.85[3.64, 10.05] respectively), though with high heterogeneity. For upper-limb motor function, no significant add-on effects of EA was received.
CONCLUSIONS:
Electro-acupuncture combined with conventional routine care has the potential of reducing spasticity in upper and lower limb and improving overall and lower extremity motor function and activity of daily living for spasticity patients within 180 days post stroke. Further studies of high methodological and reporting quality are needed to confirm the effects and safety of electro-acupuncture, and to explore the adequate and optimal protocol of EA for post-stroke spasticity incorporating a group of comprehensive outcome measures in different populations.

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