Scalp acupuncture for stroke recovery: A systematic review and meta-analysis of randomized controlled trials

Abstract

AimScalp acupuncture (SA) for stroke recovery has been widely used in many Asian countries. We conducted a systematic review and meta-analysis to assess the evidence of SA for use in integrated stroke management. MethodsSystematic searches of 16 electronic databases were conducted for articles published through June 2012. All randomized controlled trials that compared SA as a sole or adjunct treatment with any relevant controls for stroke were included. Methodological quality was assessed using the Cochrane risk of bias tool. ResultsIn total, 21 studies were included. Fourteen of these studies dealt with acute or subacute stroke patients. Of these 14 trials, 8 used the total efficacy rate as the main outcome, and their meta-analysis showed a favorable effect on outcomes of SA plus conventional care compared to conventional care alone (medication (p=0.007) and rehabilitation (p=0.02)). Similar favorable results were shown in the outcomes of the Barthel index (medication (p<0.0001), rehabilitation (p<0.00001)) and neurological function outcomes (medication (p<0.00001)), but not in the Fugl–Meyer assessment (p=0.30). No significant differences were shown in total efficacy rate, Barthel index, or Fugl-Meyer assessment values for sole SA compared with conventional care alone. For the chronic (3 studies) and mixed (4 studies) stages of stroke, no meaningful results were obtained. ConclusionsThis review showed positive but limited effectiveness of SA as an adjunct treatment to the conventional care. The major limitation was the poor methodological quality of the included trials. Sham-controlled, well-designed trials with a standardized therapeutic method are needed.