Abstract
Objective Physical therapy combined with acupuncture is the current research hotspot in the treatment of poststroke cognitive impairment, but which combination treatment is the best is still controversial. Based on the network meta-analysis method, we evaluated the efficacy of various physical therapies combined with acupuncture for the treatment of poststroke cognitive impairment. Methods We retrieved diverse randomized controlled trials of various physical therapies combined with acupuncture for the treatment of cognitive dysfunction after stroke. We selected studies, extracted data, and evaluated the risk of literature bias for the included randomized controlled trials. We used STATA 14.0 for the current network meta-analysis. Results Fifteen randomized controlled trials involving 1288 patients were included, which involved 7 treatment plans that included 3 control treatment plans and 4 acupuncture treatment plans combined with physical therapy. The best treatment plan for improving the Mini-Mental State Examination score of poststroke cognitive impairment is acupuncture combined with hyperbaric oxygen therapy. The best treatment option for improving the Montreal Cognitive Assessment score of poststroke cognitive impairment is acupuncture combined with hyperbaric oxygen therapy. The best option for improving the Barthel index score of poststroke cognitive impairment is acupuncture combined with transcranial magnetic stimulation. In terms of improving the overall clinical effectiveness of poststroke cognitive impairment, the best treatment option is acupuncture combined with transcranial magnetic stimulation. Conclusion The analysis of all the results shows that acupuncture combined with hyperbaric oxygen therapy can significantly improve poststroke cognitive impairment compared with other combined treatments. However, due to the overall quality and quantity of the included studies, more randomized controlled trials focusing on clinical research on acupuncture combined with physical therapy for poststroke cognitive impairment are required to support the current evidence. This trial is registered with CRD42020200092.
Highlights
Stroke is a global problem that occurs primarily in middleaged and elderly people. e mortality rate is around 30%
Included treatment (MD 2.67, 95% credibility interval (CI) [1.13, 4.21]), acupuncture combined with transcranial magnetic stimulation (TMS) (MD 2.55, 95% CI [1.71, 3.39]), acupuncture combined with hyperbaric oxygen therapy (HBO) (MD 5.98, 95% CI [4.46, 7.5]), acupuncture combined with ultrashort-wave electrotherapy (UWE) (MD 5.82, 95% CI [4.36, 7.28]), and acupuncture combined with RehaCom (MD 3.62, 95% CI [3.22, 4.02]) could significantly increase the Mini-Mental State Examination (MMSE) score
Acupuncture combined with TMS (MD 1.08, 95% CI [0.38, 1.78]), acupuncture combined with HBO (MD 4.51, 95% CI [3.04, 5.98]), acupuncture combined with UWE (MD 4.35, 95% CI [2.97, 5.73]), and acupuncture combined with RehaCom (MD 2.15, 95% CI [1.67, 2.63]) could significantly increase the MMSE score and have better curative effects than acupuncture treatment alone
Summary
Physical therapy combined with acupuncture is the current research hotspot in the treatment of poststroke cognitive impairment, but which combination treatment is the best is still controversial. Based on the network meta-analysis method, we evaluated the efficacy of various physical therapies combined with acupuncture for the treatment of poststroke cognitive impairment. E best treatment option for improving the Montreal Cognitive Assessment score of poststroke cognitive impairment is acupuncture combined with hyperbaric oxygen therapy. In terms of improving the overall clinical effectiveness of poststroke cognitive impairment, the best treatment option is acupuncture combined with transcranial magnetic stimulation. E analysis of all the results shows that acupuncture combined with hyperbaric oxygen therapy can significantly improve poststroke cognitive impairment compared with other combined treatments. Due to the overall quality and quantity of the included studies, more randomized controlled trials focusing on clinical research on acupuncture combined with physical therapy for poststroke cognitive impairment are required to support the current evidence. Due to the overall quality and quantity of the included studies, more randomized controlled trials focusing on clinical research on acupuncture combined with physical therapy for poststroke cognitive impairment are required to support the current evidence. is trial is registered with CRD42020200092
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