Acupuncture Therapy on Patients with Flaccid Hemiplegia after Stroke: A Systematic Review and Meta-Analysis

Abstract

Background. Acupuncture is a commonly used complementary treatment for flaccid hemiplegia caused by stroke, but evidences from previous randomized trials were inconclusive. The purpose of this study was to evaluate the efficacy and safety of acupuncture in a comprehensive synthesis. Methods. We searched literature from eight databases from their inception to December 2020. We included randomized controlled trials of acupuncture for the treatment of flaccid hemiplegia following stroke. The meta-analysis was carried out using Review Manager 5.3 and Stata 16.0. The main indicator was the Fugl-Meyer Assessment scale. The modified Barthel Index scale, Quality Of Life Assessment scale, Mini-Mental State Examination scale, Berg Balance Scale, Neurological Deficit Assessment scale, and the treatment effective rate were used to measure the secondary indicators. Adverse events from individual studies were used to determine safety. Results. Our search returned 7624 records, of which 27 studies involving a total of 1,293 patients fulfilled our inclusion criteria. To be noted, our results indicated that significant improvements in the scores of the primary indicator showed better clinical scores among the three groups with acupuncture than without acupuncture: acupuncture compared with rehabilitation, 13.53 (95% CI 11.65–14.41, $P<0.01$ ); acupuncture plus rehabilitation compared with rehabilitation, 9.84 (95% CI 6.45–13.24, $P<0.01$ , I2 = 98%); and acupuncture plus Western medicine therapy compared with Western medicine, 16.86 (95% CI 15.89–17.84, $P<0.01$ , I2 = 38%), and the secondary indicators showed the same tendency. Conclusion. Acupuncture was effective and safe in the patients with flaccid hemiplegia after stroke, although there was high heterogeneity between studies.