Abstract
Background Previous studies have shown that electroacupuncture (EA) has a positive effect on motor and sensory function in patients with spinal cord injury (SCI). This review evaluated the effectiveness of EA for improvement in activities of daily living in patients with SCI. Methods We searched the Cochrane Library, PubMed, Web of Science, CNKI, WanFang Data, and VIP databases using a search strategy according to the guidelines of the Cochrane Handbook for Systematic Review of Interventions up to 30th September 2020. Only randomized controlled trials (RCTs) of EA in patients with SCI were included. We analyzed the data using RevMan (version 5.3) and graded the quality of evidence using GRADE profiler 3.6.1. Results This meta-analysis included 10 RCTs with 712 patients. Three studies revealed that the functional independence measure score for SCI patients in the EA group was higher than that in the control group (mean difference [MD] = 13.46, 95% CI: 8.00 to 18.92, P < 0.00001). Five studies showed that the modified Barthel index in the EA group was higher than that in the control group (MD = 6.92, 95% CI: 4.96 to 8.89, P < 0.00001). Five studies showed that the American Spinal Injury Association-motor score (ASIA-motor score) in the EA group was higher than that in the control group (standard MD = 0.96, 95% CI: 0.75 to 1.18, P < 0.00001). Three studies reported the ASIA-tactile and pain scores and also reported that the scores in the EA group were higher than those in the control group, with high homogeneity (tactile I2 = 86%, P = 0.0008; pain I2 = 54%, P = 0.11). The quality of evidence for the use of EA for improvement in motor and sensory function in SCIs was moderate according to the GRADE system. Conclusion This review suggested that EA improves activities of daily living and motor function in patients with SCI, with a moderate level of evidence.
Highlights
Spinal cord injury (SCI), which can be caused by many factors, such as trauma, inflammation, and tumor compression, leads to partial or complete loss of sensory and motor functions below the injured segment and even loss of respiratory function
For a study to be included in this review, it should have reported on one or more of the following three main outcome measures: functional independence measure (FIM), modified Barthel index/Barthel index (MBI/BI), or the American Spinal Injury Association (ASIA) impairment scale for patients with spinal cord injury (SCI)
Our results showed that the ASIA-motor score of the EA group was higher than that of the control group (SMD 0.96, 95% CI: 0.75 to 1.18, P < 0.00001; Figure 3(c))
Summary
Spinal cord injury (SCI), which can be caused by many factors, such as trauma, inflammation, and tumor compression, leads to partial or complete loss of sensory and motor functions below the injured segment and even loss of respiratory function. There are many clinical treatments for SCI, such as timely decompression [4, 5], methylprednisolone [6], stem cell transplant [7, 8], nerve growth factor therapy [9, 10], and spinal cord electrical stimulation therapy [11]. Many therapies have been used to treat SCIs, rehabilitation is important for improvement in motor and sensory functions [12, 13]. E present study systematically evaluated the clinical efficacy of EA for motor and sensory functions and activities of daily living (ADLs) in patients with SCI. Is article is more inclined to the improvement of ADLs since the current rehabilitation concept pays more attention to the recovery of overall function and even returns to their profession. is study was conducted according to the principles of evidence-based medicine
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