Abstract
Objective
To evaluate the effects and safety of electroacupuncture (EA) for stroke patients
with spasticity.
Data Sources
Five English databases (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled
Trials, Allied and Complementary Medicine Database) and 4 Chinese databases (Chinese
Biomedical Database, Chinese National Knowledge Infrastructure, Chongqing VIP Database,
Wanfang Database) were searched from their inception to September 2016.
Study Selection
Randomized controlled trials were included if they measured spasticity with the Modified
Ashworth Scale (MAS) in stroke patients and investigated the add-on effects of electroacupuncture
to routine pharmacotherapy and rehabilitation therapies.
Data Extraction
Information on patients, study design, treatment details and outcomes assessing spasticity
severity, motor function, and activities of daily living was extracted.
Data Synthesis
In total, 22 trials involving 1425 participants met the search criteria and were included.
The estimated add-on effects of EA to reduce spasticity in the upper limbs as measured
by the MAS (standardized mean difference [SMD]=−.57; 95% confidence interval [CI],
−.84 to −.29), and to improve overall motor function as measured by the Fugl-Meyer
Assessment of Sensorimotor Recovery (mean difference [MD]=10.60; 95% CI, 8.67–12.53)
were significant. Significant add-on effects of EA were also shown for spasticity
in the lower limbs, lower-limb motor function, and activities of daily living ([SMD=−.88;
95% CI, −1.42 to −.35;], [MD=4.42; 95% CI, .06–8.78], and [MD=6.85; 95% CI, 3.64–10.05],
respectively), although with high heterogeneity. For upper-limb motor function, no
significant add-on effects of EA were found.
Conclusions
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.
Keywords
List of abbreviations:
BI (Barthel Index), CI (confidence interval), EA (electroacupuncture), FMA (Fugl-Meyer Assessment of Sensorimotor Recovery), MAS (Modified Ashworth Scale), MD (mean difference), MDD (minimum detectable difference), RC (routine care), SMD (standardized mean difference)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 25, 2017
Footnotes
Supported by Guangdong Provincial Science and Technology Department and the Guangdong Provincial Academy of Chinese Medical Sciences (GPACMS) (grant no. 2012A032500009); and in part by a grant from the International Science and Technology Cooperation Project of the Ministry of Science and Technology of China (grant no. 2012DFA31760) and the China-Australia International Research Centre for Chinese Medicine, funded by GPACMS and Guangdong Provincial Hospital of Chinese Medicine, Guangdong China and RMIT University, Australia.
Disclosures: none.
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© 2016 by the American Congress of Rehabilitation Medicine
