Acupuncture treatment vs. cognitive rehabilitation for post-stroke cognitive impairment: A systematic review and meta-analysis of randomized controlled trials
BackgroundCognitive impairment is one of the common sequelae after stroke, which not only hinders the recovery of patients but also increases the financial burden on families. In the absence of effective therapeutic measures, acupuncture treatment has been widely used in China to treat post-stroke c...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-02-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1035125/full |
| _version_ | 1811168402827378688 |
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| author | Yang Liu Yang Liu Fuyan Chen Fuyan Chen Peng Qin Peng Qin Lu Zhao Lu Zhao Xingping Li Xingping Li Jiangqin Han Jiangqin Han Zi Ke Zi Ke Honghang Zhu Honghang Zhu Bangqi Wu Bangqi Wu |
| author_facet | Yang Liu Yang Liu Fuyan Chen Fuyan Chen Peng Qin Peng Qin Lu Zhao Lu Zhao Xingping Li Xingping Li Jiangqin Han Jiangqin Han Zi Ke Zi Ke Honghang Zhu Honghang Zhu Bangqi Wu Bangqi Wu |
| author_sort | Yang Liu |
| collection | DOAJ |
| description | BackgroundCognitive impairment is one of the common sequelae after stroke, which not only hinders the recovery of patients but also increases the financial burden on families. In the absence of effective therapeutic measures, acupuncture treatment has been widely used in China to treat post-stroke cognitive impairment (PSCI), but the specific efficacy is unclear. Therefore, this review aimed to evaluate the true efficacy of acupuncture treatment in patients with PSCI.MethodsWe searched eight databases [PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China Biomedical Literature Database (CBM), China Science and Technology Journal (VIP) database, the China National Knowledge Infrastructure (CNKI) database, and Wan fang database] from the inception to May 2022 for randomized controlled trials (RCTs) related to acupuncture treatment combined with cognitive rehabilitation (CR) for PSCI. Two investigators independently used a pre-designed form to extract valid data from eligible RCTs. The risk of bias was assessed through tools provided by the Cochrane Collaboration. The meta-analysis was implemented through Rev Man software (version 5.4). The strength of the evidence obtained was evaluated using GRADE profiler software. Adverse events (AEs) were collected by reading the full text and used to evaluate the safety of acupuncture treatment.ResultsThirty-eight studies involving a total of 2,971 participants were included in this meta-analysis. Overall, the RCTs included in this meta-analysis were poor in methodological quality. The combined results showed that acupuncture treatment combined with CR showed significant superiority compared to CR alone in terms of improving cognitive function [Mean Difference (MD) = 3.94, 95% confidence intervals (CI): 3.16–4.72, P < 0.00001 (MMSE); MD = 3.30, 95%CI: 2.53–4.07, P < 0.00001 (MoCA); MD = 9.53, 95%CI: 5.61–13.45, P < 0.00001 (LOTCA)]. Furthermore, the combination of acupuncture treatment and CR significantly improved patients' self-care ability compared to CR alone [MD = 8.66, 95%CI: 5.85–11.47, P < 0.00001 (MBI); MD = 5.24, 95%CI: 3.90–6.57, P < 0.00001 (FIM)]. Meanwhile, subgroup analysis showed that MMSE scores were not sufficiently improved in the comparison of electro-acupuncture combined with CR versus CR alone (MD = 4.07, 95%CI: −0.45–8.60, P = 0.08). However, we also observed that electro-acupuncture combined with CR was superior to the use of CR alone in improving MoCA and MBI scores in patients with PSCI [MD = 2.17, 95%CI: 0.65–3.70, P = 0.005 (MoCA); MD = 1.74, 95%CI: 0.13–3.35, P = 0.03 (MBI)]. There was no significant difference in the occurrence of adverse events (AE) between acupuncture treatment combined with CR and CR alone (P > 0.05). The certainty of the evidence was rated low level because of flaws in the study design and considerable heterogeneity among the included studies.ConclusionThis review found that acupuncture treatment combined with CR may have a positive effect on improving cognitive function and self-care ability in PSCI patients. However, our findings should be treated with caution owing to the existence of methodological quality issues. High-quality studies are urgently required to validate our results in the future.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022338905, identifier: CRD42022338905. |
| first_indexed | 2024-04-10T16:25:42Z |
| format | Article |
| id | doaj.art-565e8a39b57d4de3b7046a8990240801 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-10T16:25:42Z |
| publishDate | 2023-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-565e8a39b57d4de3b7046a89902408012023-02-09T04:38:33ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-02-011410.3389/fneur.2023.10351251035125Acupuncture treatment vs. cognitive rehabilitation for post-stroke cognitive impairment: A systematic review and meta-analysis of randomized controlled trialsYang Liu0Yang Liu1Fuyan Chen2Fuyan Chen3Peng Qin4Peng Qin5Lu Zhao6Lu Zhao7Xingping Li8Xingping Li9Jiangqin Han10Jiangqin Han11Zi Ke12Zi Ke13Honghang Zhu14Honghang Zhu15Bangqi Wu16Bangqi Wu17Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaDepartment of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, ChinaNational Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, ChinaBackgroundCognitive impairment is one of the common sequelae after stroke, which not only hinders the recovery of patients but also increases the financial burden on families. In the absence of effective therapeutic measures, acupuncture treatment has been widely used in China to treat post-stroke cognitive impairment (PSCI), but the specific efficacy is unclear. Therefore, this review aimed to evaluate the true efficacy of acupuncture treatment in patients with PSCI.MethodsWe searched eight databases [PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China Biomedical Literature Database (CBM), China Science and Technology Journal (VIP) database, the China National Knowledge Infrastructure (CNKI) database, and Wan fang database] from the inception to May 2022 for randomized controlled trials (RCTs) related to acupuncture treatment combined with cognitive rehabilitation (CR) for PSCI. Two investigators independently used a pre-designed form to extract valid data from eligible RCTs. The risk of bias was assessed through tools provided by the Cochrane Collaboration. The meta-analysis was implemented through Rev Man software (version 5.4). The strength of the evidence obtained was evaluated using GRADE profiler software. Adverse events (AEs) were collected by reading the full text and used to evaluate the safety of acupuncture treatment.ResultsThirty-eight studies involving a total of 2,971 participants were included in this meta-analysis. Overall, the RCTs included in this meta-analysis were poor in methodological quality. The combined results showed that acupuncture treatment combined with CR showed significant superiority compared to CR alone in terms of improving cognitive function [Mean Difference (MD) = 3.94, 95% confidence intervals (CI): 3.16–4.72, P < 0.00001 (MMSE); MD = 3.30, 95%CI: 2.53–4.07, P < 0.00001 (MoCA); MD = 9.53, 95%CI: 5.61–13.45, P < 0.00001 (LOTCA)]. Furthermore, the combination of acupuncture treatment and CR significantly improved patients' self-care ability compared to CR alone [MD = 8.66, 95%CI: 5.85–11.47, P < 0.00001 (MBI); MD = 5.24, 95%CI: 3.90–6.57, P < 0.00001 (FIM)]. Meanwhile, subgroup analysis showed that MMSE scores were not sufficiently improved in the comparison of electro-acupuncture combined with CR versus CR alone (MD = 4.07, 95%CI: −0.45–8.60, P = 0.08). However, we also observed that electro-acupuncture combined with CR was superior to the use of CR alone in improving MoCA and MBI scores in patients with PSCI [MD = 2.17, 95%CI: 0.65–3.70, P = 0.005 (MoCA); MD = 1.74, 95%CI: 0.13–3.35, P = 0.03 (MBI)]. There was no significant difference in the occurrence of adverse events (AE) between acupuncture treatment combined with CR and CR alone (P > 0.05). The certainty of the evidence was rated low level because of flaws in the study design and considerable heterogeneity among the included studies.ConclusionThis review found that acupuncture treatment combined with CR may have a positive effect on improving cognitive function and self-care ability in PSCI patients. However, our findings should be treated with caution owing to the existence of methodological quality issues. High-quality studies are urgently required to validate our results in the future.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022338905, identifier: CRD42022338905.https://www.frontiersin.org/articles/10.3389/fneur.2023.1035125/fullacupuncture treatmentpost-stroke cognitive impairmentmeta-analysiscognitive rehabilitationnon-pharmacological treatment |
| spellingShingle | Yang Liu Yang Liu Fuyan Chen Fuyan Chen Peng Qin Peng Qin Lu Zhao Lu Zhao Xingping Li Xingping Li Jiangqin Han Jiangqin Han Zi Ke Zi Ke Honghang Zhu Honghang Zhu Bangqi Wu Bangqi Wu Acupuncture treatment vs. cognitive rehabilitation for post-stroke cognitive impairment: A systematic review and meta-analysis of randomized controlled trials Frontiers in Neurology acupuncture treatment post-stroke cognitive impairment meta-analysis cognitive rehabilitation non-pharmacological treatment |
| title | Acupuncture treatment vs. cognitive rehabilitation for post-stroke cognitive impairment: A systematic review and meta-analysis of randomized controlled trials |
| title_full | Acupuncture treatment vs. cognitive rehabilitation for post-stroke cognitive impairment: A systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Acupuncture treatment vs. cognitive rehabilitation for post-stroke cognitive impairment: A systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Acupuncture treatment vs. cognitive rehabilitation for post-stroke cognitive impairment: A systematic review and meta-analysis of randomized controlled trials |
| title_short | Acupuncture treatment vs. cognitive rehabilitation for post-stroke cognitive impairment: A systematic review and meta-analysis of randomized controlled trials |
| title_sort | acupuncture treatment vs cognitive rehabilitation for post stroke cognitive impairment a systematic review and meta analysis of randomized controlled trials |
| topic | acupuncture treatment post-stroke cognitive impairment meta-analysis cognitive rehabilitation non-pharmacological treatment |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1035125/full |
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