Abstract
This study aimed to evaluate the effect of acupuncture intervention and manipulation types on poststroke dysarthria. Electronic database, including PubMed, CENTRAL, Scopus, RISS, and CNKI, were searched for randomized controlled trials (RCT), treating dysarthria using acupuncture, speech-language therapy (SLT), and general management (GM), published before April 2019. The number, distribution, intensity, depth, and repetition of acupuncture and bleeding therapy on the sublingual veins were considered as manipulation types. Risk of bias of the included trials was evaluated, and their efficacy was assessed using risk ratio (RR) and the standard mean differences in the Frenchay Dysarthria Assessment and Speech Function Grading, with 95% confidence intervals (CIs).Fifteen RCT trials involving 1453 patients were isolated. Electroacupuncture plus SLT and manual acupuncture plus SLT were more effective than SLT only, respectively (RR = 1.520, 95% CI [1.183–1.952], RR = 1.380, 95% CI [1.281–1.488]). The clinical efficacy of acupuncture plus GM was higher than that of GM alone (RR = 1.165, 95% CI [1.050–1.293]). Meta-ANOVA showed that none of the manipulation types increased the clinical efficacy of acupuncture on dysarthria. The methodological quality was low. In conclusion, our study suggests that the effect of acupuncture on poststroke dysarthria may be maximized when manual acupuncture or electroacupuncture is combined with SLT, irrespective of manipulation types.
Highlights
IntroductionE 5 million survivors suffer various physical and mental disabilities, including dysarthria: a condition of speech impairment involving articulation, phonation, nasality, intelligibility, and efficiency [2]
Stroke is the second leading cause of death, following heart disease, with 15 million people suffering strokes annually [1].e 5 million survivors suffer various physical and mental disabilities, including dysarthria: a condition of speech impairment involving articulation, phonation, nasality, intelligibility, and efficiency [2]
Acupuncture treatment (AT) has been widely used for poststroke rehabilitation, and many systematic review and meta-analysis studies have addressed the effects of acupuncture on poststroke complications such as shoulder pain [6], spasticity [7], depression [8], insomnia [9], and dysphagia [10]
Summary
E 5 million survivors suffer various physical and mental disabilities, including dysarthria: a condition of speech impairment involving articulation, phonation, nasality, intelligibility, and efficiency [2]. 20–22% of patients suffer dysarthria after stroke [3, 4]. Dysarthria impairs patients’ self-identity, social relationships, education, and quality of life [5]. Speech and language therapy (SLT)—including strategies to improve the strength of oral and vocal muscular movements, as well as respiratory support, phonation, and resonance—is primarily considered to treat dysarthria [2]. Chen’s study did not limit the control group to general management or SLT and included herbs or multiple acupuncture interventions in the treatment group, which may have confounded the pure effect of AT on dysarthria with the effect of other interventions
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