Study: acupuncture and stroke restoration

reference

KONG JC, Lee MS, Shin BC, Song Ys, Ernst E. Acupuncture for functional recovery after stroke: a systematic review of the randomized clinical studies. cmaj . 2010; 182 (16): 1723-1729.

design

meta -analysis of randomized controlled studies to compare the effects of acupuncture with bogus acupuncture. Ten of 664 potentially relevant studies met the inclusion criteria. For acute and subacute stages after a stroke, the authors included seven studies.

results

The meta -analysis of 5 studies that aimed at functionality showed no significant difference in favor of acupuncture at high heterogeneity. A post-hoc sensitivity analysis of three studies with a low risk of distortion showed no positive effects of acupuncture on the activities of everyday life at the end of the intervention period. In the chronic stage after a stroke, the effects of acupuncture on the function according to the modified Ashworth scale were tested in three studies. All showed no positive effects.

interpretation

meta -analyzes of data from strictly randomized, sham -controlled studies showed no positive effect of acupuncture as treatment for functional recovery after a stroke. Only a few randomized, sham -controlled studies have tested the effectiveness of acupuncture during stroke rehabilitation.

discussion

According to the authors of this study, there are several possible explanations for these results: Acupuncture could be ineffective, existing studies could be inadequate or the treatment may not have been carried out correctly. For example, several of the studies included patients who were treated more than six months after a stroke, which may take too long after the injury to expect significant improvements. In addition, the treatment protocols varied significantly with regard to the type of acupuncture treatments used, whether electro acupuncture was included or not, the number and frequency of visits and other treatment variables.

It is commendable that the authors did not use only in English-language studies, but have carried out extensive research in order to include all clinically relevant studies that they could find, including those from China, Japan and Korea, where acupuncture is used much more often than in the west in post-work and often much closer to the event of stroke, may lead to more positive results. For example, in my over 21 years as an approved acupunctor, I only treated a relative handful of patients for post-promoters. They recovered from a stroke, and in all the time of their stroke was at least six months ago, which significantly restricted the expected effectiveness of the treatment.

Although this meta -analysis is the most comprehensive that I have ever checked, I have some concerns about the study design. In their interpretation, the authors admit that bogus acupuncture is not ineffective and demonstrably causes physiological effects. ^{1 The reduction of 664 studies to only 10, which have been compared with "appearance" acupuncture, could have been selected according to criteria that have been selected that may have shown real and positive effects.}