Efficacy of meridian massage for motor function after a stroke: a systematic review and Meta-analysis.

Abstract

To evaluate the efficacy of meridian massage on motor function after a stroke. This systematic review and Meta-analysis of randomised (RCTs) and quasi-randomised controlled trials (qRCTs) was performed to determine the effects of meridian massage on motor dysfunction following a stroke. Articles published until December 2020 related to stroke and meridian massage from National Library of Medicine, Cochrane Central Register of Controlled Trials, Embase, KoreaMed, Japan science and Technology Agency, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Biomedical Literature Database and China Science and Technology Journal Database were searched. The primary outcomes included Fugl-Mayer Assessment (FMA), modified Barthel Index (mBI) and clinical efficiency, while the secondary outcomes included modified Ashworth (mAS) and Berg Balance Scale (BBS). Two authors independently selected the literature, extracted the data and assessed the risk of bias, after which Meta-analysis with subgroups and sensitivity analysis was conducted. A total of 16 RCTs and 3 q-RCTs involved 1556 patients satisfied the inclusion. Meta-analysis showed that compared to conventional rehabilitation, meridian massage had significantly better FMA [mean difference () = 1.16, 95% confidence interval (): 0.43, 1.89, = 0.002], FMA-L ( = 3.21, 95% : 1.97, 4.45, = 0.000 01), mBI ( = 8.87, 95% : 4.24, 13.49, = 0.000 02), clinical efficiency [relative risk (RR) = 1.37,95% : 1.24, 1.51, < 0.000 01], mAS ( = -0.69, 95% : -1.26, -0.11, = 0.02) and BBS ( = 5.07, 95% : 2.22, 7.93, = 0.0005). Subgroup analysis indicated no significant difference between meridian massage and control group when the intervention duration was >8 weeks ( = 0.89, 95% : -0.64, 2.42, = 0.25) but improving motor function in the meridian massage when the intervention duration was ≤ 8 weeks (< 4 weeks intervention duration = 0.84, 95% : 0.59, 1.10, < 0.000 01; 4-8 weeks = 2.41, 95% : 0.80, 4.01, = 0.003). Meridian massage as an alternative and complementary therapy seems to have short-term benefits in improving post-stroke motor function (particularly in the lower limbs), quality of life, clinical efficiency, and balance stability and muscle spasms. The high heterogeneity of the included studies and the low methodological quality certainly limits the confidence placed in this systematic review and Meta-analysis, warranting future well-designed studies.