Abstract
Many acupuncture therapies were used to treat spinal cord injury (SCI) and its complications. The difference in efficacy among these therapies has not been assessed. To compare the efficacy of different acupuncture therapies for SCI, we searched databases (PubMed, Embase, Cochrane Library, CNKI, and WanFang) for relevant RCTs in both English and Chinese before June 2019 that reported the association between acupuncture therapies and SCI. The RCTs were categorized according to the location of the acupoints used in them. The neural function was assessed by American Spinal Injury Association (ASIA) motor score, and daily living ability was accessed by Modified Barthel Index (MBI) after SCI. In total, 22 trials involving 1644 participants were included. The pairwise meta-analysis and random effects model network meta-analysis were conducted. The results indicated that exercise combined with electro-acupuncture (EA) is superior to exercise without acupuncture in improving the ASIA motor score. EA was associated with a significantly higher improvement in the MBI score than exercise alone, except for EA of head + limbs and limbs. Additionally, EA on the head + back and back + front (chest and abdomen) rank the top in both increasing the ASIA motor score and the MBI score. Acupuncture can significantly increase motor function and daily living ability of individuals who suffer from SCI, especially acupuncture of the back + front or the head + back. The evidence supports acupuncture of the back + front or the head + back as an effective treatment for SCI.
Highlights
spinal cord injury (SCI) and its secondary complications have always been a great social and economic burden for the patients’ families and health care system
[2] there have been reports of positive outcomes following treatment options such as surgery [3], pharmacological interventions [4], rehabilitation [5], and alternative methods such as acupuncture [6,7,8,9], reviews by a number of researchers concluded that use of acupuncture or EA in acute SCI can significantly improve functional recovery in long-term and help the management of chronic pain associated with these injuries, with a risk that could be considered minimum [6, 7, 10,11,12]
E direct and indirect comparisons for each specific pair of treatments were combined by modeling the outcomes in every treatment group of included studies. e ASIA motor and Modified Barthel Index (MBI) score were reported as a standard mean difference (SMD) with 95% confidence intervals (CI) for direct comparisons or 95% credible intervals (CrI) for indirect comparisons. e Brooks–Gelman–Rubin method was used to assess the convergence between direct and indirect variances
Summary
The Effect of Different Acupuncture Therapies on Neurological Recovery in Spinal Cord Injury: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Many acupuncture therapies were used to treat spinal cord injury (SCI) and its complications. E neural function was assessed by American Spinal Injury Association (ASIA) motor score, and daily living ability was accessed by Modified Barthel Index (MBI) after SCI. EA was associated with a significantly higher improvement in the MBI score than exercise alone, except for EA of head + limbs and limbs. Acupuncture can significantly increase motor function and daily living ability of individuals who suffer from SCI, especially acupuncture of the back + front or the head + back. Acupuncture can significantly increase motor function and daily living ability of individuals who suffer from SCI, especially acupuncture of the back + front or the head + back. e evidence supports acupuncture of the back + front or the head + back as an effective treatment for SCI
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