Acupuncture for stroke rehabilitation

Wu HM, Tang J-L, Lin XP, Lau JTF, Leung PC, Woo J, Li Y

Published Online:

January 21, 2009

There is no clear evidence of the effects of acupuncture on stroke rehabilitation. Acupuncture has biological effects that might improve recovery from stroke or facilitate rehabilitation. This review looked for randomised trials comparing acupuncture with control in patients who had a stroke more than one month previously. Five trials were identified but all the trials were of poor quality and no definite conclusions could be drawn about the effects of acupuncture in such patients. More large, high quality randomised trials are needed.

Abstract (click to read)

Background:

Stroke is the third leading cause of death in Western society; in China it is the second most common cause of death in cities and the third in rural areas. It is also a main cause of adult disability and dependency. Acupuncture for stroke has been used in China for hundreds of years and is increasingly practiced in some Western countries.

Objectives:

To assess the efficacy and safety of acupuncture for patients with stroke in the subacute or chronic stage.

Search strategy:

We searched the Cochrane Stroke Group Trials Register (November 2005), the Cochrane Complementary Medicine Field Trials Register (November 2005), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2005), MEDLINE (1966 to November 2005), EMBASE (1980 to November 2005), CINAHL (1982 to November 2005), AMED (1985 to November 2005), the Chinese Stroke Trials Register (November 2005), the Chinese Acupuncture Trials Register (November 2005), the Chinese Biological Medicine Database (1977 to November 2005), the National Center for Complementary and Alternative Medicine Register (November 2005), and the National Institute of Health Clinical Trials Database (November 2005). We handsearched four Chinese journals and checked reference lists of all papers identified for further trials.

Selection criteria:

Truly randomised unconfounded clinical trials among patients with ischemic or hemorrhagic stroke, in the subacute or chronic stage, comparing acupuncture involving needling with placebo acupuncture, sham acupuncture or no acupuncture.

Data collection and analysis:

Two review authors independently selected trials for inclusion, assessed quality, extracted and cross-checked the data.

Main results:

Five trials (368 patients) met the inclusion criteria. Methodological quality was considered inadequate in all trials. Although the overall estimate from four trials suggested the odds of improvement in global neurological deficit was higher in the acupuncture group compared with the control group (odds ratio (OR) 6.55, 95% confidence interval (CI) 1.89 to 22.76), this estimate may not be reliable since there was substantial heterogeneity (I2 = 68%). One trial showed no significant improvement of motor function between the real acupuncture group and the sham acupuncture group (OR 9.00, 95% CI 0.40 to 203.30), but the confidence interval was wide and included clinically significant effects in both directions. No data on death, dependency, institutional care, change of neurological deficit score, quality of life or adverse events were available.

Authors' conclusions:

Currently there is no clear evidence on the effects of acupuncture on subacute or chronic stroke. Large, methodologically-sound trials are required.

This record should be cited as:

Wu HM, Tang J-L, Lin XP, Lau JTF, Leung PC, Woo J, Li Y. Acupuncture for stroke rehabilitation. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD004131. DOI: 10.1002/14651858.CD004131.pub2

Assessed as up to date:

March 16, 2006

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Primary Review Group:

Stroke Group

Health topics:

Heart & circulation > Stroke > Ischemic stroke/TIA: treatment

Heart & circulation > Stroke > Prevention & treatment of complications

Neurology > Stroke > Ischemic stroke/TIA: treatment

Neurology > Stroke > Prevention & treatment of complications

Complementary & alternative medicine > Heart & circulation > Stroke