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Acupuncture for the treatment of spasticity after stroke: a meta-analysis of randomized controlled trials
Si-Woon Park1, Sook-Hee Yi, Jung Ah Lee
11 Department of Rehabilitation Medicine, Korea National Rehabilitation Center , Seoul, Korea.
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, EBSCOhost, 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.
