Acupuncture therapy for post-stroke spastic paralysis: an overview of systematic reviews_Chinese Journal of Evidence-Based Medicine

Authors：

YANG Han , LI Juan , LI Yuxi , YE Jing , ZHONG Dongling , ZHANG Ya , XIAO Qiwei , WANG Xu , REN Yulan ,  LIANG Fanrong

Chengdu University of TCM, Chengdu, 610075, P.R.China;

Corresponding author：

LIANG Fanrong, Email: acuresearch@126.com

Keywords：

Post-stroke spastic paralysis; Acupuncture therapy; Overview of systematic reviews; AMSTAR 2; GRADE

DOI：

10.7507/1672-2531.201903078

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objectives To evaluate the quality of methodology and evidence of the exiting systematic reviews (SRs) of acupuncture therapy for post-stroke spastic paralysis.Methods CNKI, CBM, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect SRs of acupuncture therapy for post-stroke spastic paralysis from inception to December 16^th, 2018. Two reviewers independently screened literature, extracted data, and evaluated the quality of methodology and evidence by AMSTAR 2 scale and GRADE system.Results A total of 7 SRs were included. The results showed that acupuncture therapy had obvious advantages in treating post-stroke spastic paralysis without obvious adverse reactions. The results of AMSTAR 2 scale showed that the failure of key items 2 and 7 resulted in extremely low methodological quality. The results of GRADE system showed that 46.15% of which were low-level evidence quality, 42.31% were medium, 11.54% were extremely low, and no evidence quality were high.Conclusions Current evidence shows that acupuncture and moxibustion therapy is effective in treating spastic paralysis after stroke, however, the quality of the SRs is low. The studies are required to be standardized and combined with the characteristics of TCM to obtain high quality evidence in the future.

Citation： YANG Han, LI Juan, LI Yuxi, YE Jing, ZHONG Dongling, ZHANG Ya, XIAO Qiwei, WANG Xu, REN Yulan, LIANG Fanrong. Acupuncture therapy for post-stroke spastic paralysis: an overview of systematic reviews. Chinese Journal of Evidence-Based Medicine, 2019, 19(10): 1233-1239. doi: 10.7507/1672-2531.201903078 Copy

1.	Murray CJ, Vos T, Lozano R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2197-2223.
2.	Bousser MG. Stroke prevention: an update. Front Med, 2012, 6(1): 22-34.
3.	Wu P, Mills E, Moher D, et al. Acupuncture in post stroke rehabilitation: a systematic review and meta-analysis of randomized trials. Stroke, 2010, 41(4): e171-e179.
4.	Sui HL, Wong YO, Chu MK, et al. Abstract 3506: acupuncture in managing of spasticity of post stroke survivor: a systematic review. Stroke, 2012, 43(2): A3506.
5.	Zorowitz RD, Gillard PJ, Brainin M. Post stroke spasticity: sequelae and burden on stroke survivors and caregivers. Neurology, 2013, 80(3 Suppl 2): S45-S52.
6.	Sommerfeld DK, Eek EU, Svensson AK, et al. Spasticity after stroke: its occurrence and association with motor impairments and activity limitations. Stroke, 2004, 35(1): 134-139.
7.	Demetrios M, Khan F, Turner-Stokes L, et al. Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity. Cochrane Database Syst Rev, 2013, (6): CD009689.
8.	Francisco GE, McGuire JR. Post stroke spasticity management. Stroke, 2012, 43(11): 3132-3136.
9.	Ng SS, Hui-Chan CW. Contribution of ankle dorsiflex or strength to walking endurance in people with spastic hemiplegia after stroke. Arch Phys Med Rehabil, 2012, 93(6): 1046-1051.
10.	Lundström E, Smits A, Borg J, et al. Four-fold increase in direct costs of stroke survivors with spasticity compared with stroke survivors without spasticity: the first year after the event. Stroke, 2010, 41(2): 319-324.
11.	Zhuang L, He J, Zhuang X, et al. Quality of reporting on randomized controlled trials of acupuncture for stroke rehabilitation. BMC Complement Altern Med, 2014, 14: 151.
12.	祁丽丽, 陈文华, 褚立希. 互动式头针结合 PNF 技术对缺血性卒中痉挛性偏瘫上肢功能的影响. 中国针灸, 2018, 38(3): 234-238.
13.	Stevenson VL. Rehabilitation in practice: Spasticity management. Clin Rehabil, 2010, 24(4): 293-304.
14.	Barzel A, Ketels G, Tetzlaff B, et al. Enhancing activities of daily living of chronic stroke patients in primary health care by modified constraint-induced movement therapy (HOMECIMT): study protocol for a cluster randomized controlled trial. Trials, 2013, 14: 334.
15.	梁繁荣, 吴曦, 李瑛, 等. 循证针灸学. 北京: 人民卫生出版社, 2009.
16.	刘鸣. 系统评价、Meta-分析设计与实施方法. 北京: 人民卫生出版社, 2011.
17.	熊俊, 杜元灏. 关于国内针灸系统评价/Meta 分析方法学质量的思考. 针刺研究, 2011, (1): 72-75.
18.	熊俊, 陈日新, 李万瑶. 针灸治疗颈椎病系统评价/Meta 分析文献质量多元评价研究. 中华中医药杂志, 2012, 27(4): 1064-1068.
19.	陶欢, 杨乐天, 平安, 等. 随机或非随机防治性研究系统评价的质量评价工具AMSTAR 2解读. 中国循证医学杂志, 2018, 18(1): 101-108.
20.	曾宪涛, 冷卫东, 李胜, 等. 如何正确理解及使用 GRADE 系统. 中国循证医学杂志, 2011, 11(9): 985-990.
21.	Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
22.	Cai Y, Zhang CS, Liu S, et al. Electro acupuncture for post stroke spasticity: a systematic review and meta-analysis. Arch Phys Med Rehabil, 2017, 98(12): 2578-2589.
23.	叶涛, 朱路文, 唐强. 针刺结合康复训练治疗脑卒中后肢体痉挛的 Meta 分析. 中国康复医学杂志, 2017, (3): 318-324.
24.	严晓艺, 贾丽燕, 张云皎, 等. 针刺治疗脑卒中后肌痉挛的系统综述与 Meta 分析. 北京中医药大学学报, 2017, 40(1): 52-58.
25.	汪伟, 柴铁劬, 王春, 等. 针刺治疗脑卒中后痉挛性瘫痪疗效比较的系统评价与 Meta 分析. 成都中医药大学学报, 2016, 39(3): 117-122.
26.	于川, 申斌, 许世闻. 针灸治疗中风后痉挛瘫痪的系统评价. 中医临床研究, 2016, 8(22): 12-15.
27.	李翊. 针灸治疗中风后痉挛性瘫痪的系统评价与 Meta 分析. 黑龙江: 黑龙江中医药大学, 2017.
28.	张瑜. 经筋刺法治疗脑卒中后痉挛性瘫痪的系统评价与 Meta 分析. 辽宁: 辽宁中医药大学, 2016.
29.	Wei YX, Zhao X, Zhang BC. Synergistic effect of moxibustion and rehabilitation training in functional recovery of post-stroke spastic hemiplegia. Complement Ther Med, 2016, 26: 55-60.
30.	张自茂, 冯崇廉, 皮周凯, 等. 针刺治疗脑卒中后上肢痉挛疗效观察. 中国针灸, 2008, 28(4): 257-260.
31.	王秀娟, 刘强, 林翠茹, 等. 头体针结合治疗中风后上肢痉挛疗效观察. 上海针灸杂志, 2013, 32(8): 630-632.
32.	祁营洲, 傅立新, 熊俊, 等. 针刺治疗中风后痉挛性瘫痪的系统评价. 中国针灸, 2009, 29(8): 683-688.
33.	Macpherson H, Altman DG, Hammerschlag R, et al. Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): Extending the CONSORT Statement. J Evid Based Med, 2010, 3(3): 140-155.
34.	Tarsilla M. Cochrane Handbook for Systematic Reviews of Interventions. Naunyn Schmiedebergs Arch Exp Pathol Pharmakol, 2011, 5(2): S38.

1. Murray CJ, Vos T, Lozano R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(9859): 2197-2223.
2. Bousser MG. Stroke prevention: an update. Front Med, 2012, 6(1): 22-34.
3. Wu P, Mills E, Moher D, et al. Acupuncture in post stroke rehabilitation: a systematic review and meta-analysis of randomized trials. Stroke, 2010, 41(4): e171-e179.
4. Sui HL, Wong YO, Chu MK, et al. Abstract 3506: acupuncture in managing of spasticity of post stroke survivor: a systematic review. Stroke, 2012, 43(2): A3506.
5. Zorowitz RD, Gillard PJ, Brainin M. Post stroke spasticity: sequelae and burden on stroke survivors and caregivers. Neurology, 2013, 80(3 Suppl 2): S45-S52.
6. Sommerfeld DK, Eek EU, Svensson AK, et al. Spasticity after stroke: its occurrence and association with motor impairments and activity limitations. Stroke, 2004, 35(1): 134-139.
7. Demetrios M, Khan F, Turner-Stokes L, et al. Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity. Cochrane Database Syst Rev, 2013, (6): CD009689.
8. Francisco GE, McGuire JR. Post stroke spasticity management. Stroke, 2012, 43(11): 3132-3136.
9. Ng SS, Hui-Chan CW. Contribution of ankle dorsiflex or strength to walking endurance in people with spastic hemiplegia after stroke. Arch Phys Med Rehabil, 2012, 93(6): 1046-1051.
10. Lundström E, Smits A, Borg J, et al. Four-fold increase in direct costs of stroke survivors with spasticity compared with stroke survivors without spasticity: the first year after the event. Stroke, 2010, 41(2): 319-324.
11. Zhuang L, He J, Zhuang X, et al. Quality of reporting on randomized controlled trials of acupuncture for stroke rehabilitation. BMC Complement Altern Med, 2014, 14: 151.
12. 祁丽丽, 陈文华, 褚立希. 互动式头针结合 PNF 技术对缺血性卒中痉挛性偏瘫上肢功能的影响. 中国针灸, 2018, 38(3): 234-238.
13. Stevenson VL. Rehabilitation in practice: Spasticity management. Clin Rehabil, 2010, 24(4): 293-304.
14. Barzel A, Ketels G, Tetzlaff B, et al. Enhancing activities of daily living of chronic stroke patients in primary health care by modified constraint-induced movement therapy (HOMECIMT): study protocol for a cluster randomized controlled trial. Trials, 2013, 14: 334.
15. 梁繁荣, 吴曦, 李瑛, 等. 循证针灸学. 北京: 人民卫生出版社, 2009.
16. 刘鸣. 系统评价、Meta-分析设计与实施方法. 北京: 人民卫生出版社, 2011.
17. 熊俊, 杜元灏. 关于国内针灸系统评价/Meta 分析方法学质量的思考. 针刺研究, 2011, (1): 72-75.
18. 熊俊, 陈日新, 李万瑶. 针灸治疗颈椎病系统评价/Meta 分析文献质量多元评价研究. 中华中医药杂志, 2012, 27(4): 1064-1068.
19. 陶欢, 杨乐天, 平安, 等. 随机或非随机防治性研究系统评价的质量评价工具AMSTAR 2解读. 中国循证医学杂志, 2018, 18(1): 101-108.
20. 曾宪涛, 冷卫东, 李胜, 等. 如何正确理解及使用 GRADE 系统. 中国循证医学杂志, 2011, 11(9): 985-990.
21. Atkins D, Best D, Briss PA, et al. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454): 1490.
22. Cai Y, Zhang CS, Liu S, et al. Electro acupuncture for post stroke spasticity: a systematic review and meta-analysis. Arch Phys Med Rehabil, 2017, 98(12): 2578-2589.
23. 叶涛, 朱路文, 唐强. 针刺结合康复训练治疗脑卒中后肢体痉挛的 Meta 分析. 中国康复医学杂志, 2017, (3): 318-324.
24. 严晓艺, 贾丽燕, 张云皎, 等. 针刺治疗脑卒中后肌痉挛的系统综述与 Meta 分析. 北京中医药大学学报, 2017, 40(1): 52-58.
25. 汪伟, 柴铁劬, 王春, 等. 针刺治疗脑卒中后痉挛性瘫痪疗效比较的系统评价与 Meta 分析. 成都中医药大学学报, 2016, 39(3): 117-122.
26. 于川, 申斌, 许世闻. 针灸治疗中风后痉挛瘫痪的系统评价. 中医临床研究, 2016, 8(22): 12-15.
27. 李翊. 针灸治疗中风后痉挛性瘫痪的系统评价与 Meta 分析. 黑龙江: 黑龙江中医药大学, 2017.
28. 张瑜. 经筋刺法治疗脑卒中后痉挛性瘫痪的系统评价与 Meta 分析. 辽宁: 辽宁中医药大学, 2016.
29. Wei YX, Zhao X, Zhang BC. Synergistic effect of moxibustion and rehabilitation training in functional recovery of post-stroke spastic hemiplegia. Complement Ther Med, 2016, 26: 55-60.
30. 张自茂, 冯崇廉, 皮周凯, 等. 针刺治疗脑卒中后上肢痉挛疗效观察. 中国针灸, 2008, 28(4): 257-260.
31. 王秀娟, 刘强, 林翠茹, 等. 头体针结合治疗中风后上肢痉挛疗效观察. 上海针灸杂志, 2013, 32(8): 630-632.
32. 祁营洲, 傅立新, 熊俊, 等. 针刺治疗中风后痉挛性瘫痪的系统评价. 中国针灸, 2009, 29(8): 683-688.
33. Macpherson H, Altman DG, Hammerschlag R, et al. Revised STandards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): Extending the CONSORT Statement. J Evid Based Med, 2010, 3(3): 140-155.
34. Tarsilla M. Cochrane Handbook for Systematic Reviews of Interventions. Naunyn Schmiedebergs Arch Exp Pathol Pharmakol, 2011, 5(2): S38.

Previous Article
Home-based telerehabilitation for stroke survivors: a systematic review
Next Article
Creation and connotation of evidence-based education

Chinese Journal of Evidence-Based Medicine

Acupuncture therapy for post-stroke spastic paralysis: an overview of systematic reviews

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content