Acupuncture for the Treatment of Spasticity After Stroke: A Meta-Analysis of Randomized Controlled Trials

Park, S.-W.

Yi, S.-H.

Lee, J.A.

Hwang, P.W.

Yoo, H.C.

Kang, K.S.

Journal of Alternative & Complementary Medicine

2014

20(9)

672-682

Systematic Review

Stroke -- Complications

Muscle Spasticity -- Therapy

Acupuncture

Human

South Korea

Randomized Controlled Trials -- Evaluation

Professional Practice, Evidence-Based

Systematic Review

Meta Analysis

Funding Source

Alternative Therapies

Treatment Outcomes

Cochrane Library

PubMed

CINAHL Database

Embase

Descriptive Statistics

Research Methodology -- Evaluation

Study Design -- Evaluation

Measurement Issues and Assessments

Scales

Data Analysis Software

Chi Square Test

H-Reflex

Motor Neurons

Objectives: Acupuncture has been suggested as a treatment for spasticity in patients with stroke. The available literature was reviewed in an effort to assess its efficacy in this situation. Methods: Randomized trials assessing the effects of acupuncture for the treatment of spasticity after stroke were identified by searching the Cochrane Library, PubMed, ProQuest, EBSCO host, SCOPUS, CINAHL, EMBASE, Alternative Medicine Database, and Chinese and Korean medical literature databases. Two reviewers independently extracted data on study characteristics, patient characteristics, and spasticity outcomes. Results: Eight trials with 399 patients met all the inclusion criteria. Compared with controls without acupuncture, acupuncture had no effect on improving clinical outcomes (as measured by validated instruments such as the Modified Ashworth Scale) or physiologic outcomes (assessed by measures such as the H-reflex/M-response [H/M] ratio at the end of the treatment period). H/M ratios did decrease significantly immediately after the first acupuncture treatment. Methodologic quality of all evaluated trials was considered inadequate. Conclusions: The effect of acupuncture for spasticity in patients with stroke remains uncertain, primarily because of the poor quality of the available studies. Larger and more methodologically sound trials are needed to definitively confirm or refute any effect of acupuncture as a treatment for spasticity after stroke.

10.1089/acm.2014.0097

Accession Number: 103889719. Language: English. Entry Date: 20140909. Revision Date: 20150901. Publication Type: Journal Article; meta analysis; research; systematic review; tables/charts. Journal Subset: Alternative/Complementary Therapies; Editorial Board Reviewed; Expert Peer Reviewed; Peer Reviewed; USA. Special Interest: Evidence-Based Practice. Instrumentation: Jadad Scale. Grant Information: This research was supported by a grant (08-B-02) from the Korea National Rehabilitation Center Research Institute.. NLM UID: 9508124.