The Effectiveness and Safety of Manual Acupuncture Therapy in Patients with Poststroke Cognitive Impairment: A Meta-analysis

Wei Liu,Chang Rao,Yuzheng Du,Jipeng Yang,Lili Zhang,Zhen Zheng

doi:10.1155/2020/8890521

Abstract

Background. Poststroke cognitive impairment (PSCI) is a common cause of disability among patients with stroke. Meanwhile, acupuncture has increasingly been used to improve motor and cognitive function for stroke patients. The aim of the present study was to summarize and evaluate the evidence on the effectiveness of acupuncture in treating PSCI. Methods. Eight databases (PubMed, The Cochrane Library, CNKI, WanFang Data, VIP, CBM, Medline, Embase databases) were searched from January 2010 to January 2020. Meta-analyses were conducted for the eligible randomized controlled trials (RCTs). Assessments were performed using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Barthel Index (BI), or modified Barthel Index (MBI). Results. A total of 657 relevant RCTs were identified, and 22 RCTs with 1856 patients were eventually included. Meta-analysis showed that acupuncture appeared to be effective for improving cognitive function as assessed by MMSE ( mean difference MD = 1.73 , 95% confidence interval (CI) (1.39, 2.06), P < 0.00001 ) and MoCA ( MD = 2.32 , 95% CI (1.92, 2.73), P < 0.00001 ). Furthermore, it also suggested that acupuncture could improve the activities of daily life (ADL) for PSCI patients as assessed by BI or MBI ( SMD = 0.97 , 95% CI (0.57, 1.38), P < 0.00001 ). Conclusions. Compared with nonacupuncture group, acupuncture group showed better effects in improving the scores of MMSE, MoCA, BI, and MBI. This meta-analysis provided positive evidence that acupuncture may be effective in improving cognitive function and activities of daily life for PSCI patients. Meanwhile, long retention time of acupuncture may improve cognitive function and activities of daily life, and twist technique may be an important factor that could influence cognitive function. However, further studies using large samples and a rigorous study design are needed to confirm the role of acupuncture in the treatment of PSCI.

Highlights

Stroke ranks only second to ischemic heart disease as the leading cause of death and the third leading cause of disability-adjusted life-years (DALYs) lost worldwide [1]
We found that there were few systematic reviews or meta-analysis focused on the effectiveness of acupuncture in treating Poststroke cognitive impairment (PSCI) recently, the number of papers related to this area has an upward trend in the last five years
After searching PubMed, the Cochrane Library, CNKI, WanFang Data, VIP, CBM, Medline, and Embase databases, 657 relevant randomized controlled trials (RCTs) were found in this meta-analysis, and 22 RCTs with 1856 patients were eventually included

Summary

Introduction

Stroke ranks only second to ischemic heart disease as the leading cause of death and the third leading cause of disability-adjusted life-years (DALYs) lost worldwide [1]. Meta-analysis showed that acupuncture appeared to be effective for improving cognitive function as assessed by MMSE (mean difference ðMDÞ = 1:73, 95% confidence interval (CI) (1.39, 2.06), P < 0:00001) and MoCA (MD = 2:32, 95% CI (1.92, 2.73), P < 0:00001). It suggested that acupuncture could improve the activities of daily life (ADL) for PSCI patients as assessed by BI or MBI (SMD = 0:97, 95% CI (0.57, 1.38), P < 0:00001). Acupuncture group showed better effects in improving the scores of MMSE, MoCA, BI, and MBI. This meta-analysis provided positive evidence that acupuncture may be effective in improving cognitive function and activities of daily life for PSCI patients.

Objectives

Methods

Results

Discussion

Conclusion