Warm-needle acupuncture for limb spasticity post-stroke:a systematic review

摘要

Background:Warm acupuncture,or warm-needle acupuncture,is a traditional external treatment widely used in China for thousands of years.However,the effects of different treatment times on limb spasticity post-stroke have not been evaluated.Methods:We searched PubMed,Embase,the Cochrane Library,the Web of Science,the China National Knowledge Infrastructure,the Chinese Scientific and Journal Database,the Wanfang database,and the Chinese Biomedical Literature Database from inception to May 21st,2020,to seek information regarding randomized controlled trials studying warm-needle acupuncture for limb spasticity post-stroke.Two authors selected 24 studies fitting the eligibility criteria and developed this systematic review and meta-analysis.Results:Warm-needle acupuncture is shown to be more effective than other treatments used in the control groups(odds ratio(OR)=3.61,95%confidence intervals(CI)(2.51,5.19),P<0.001).This treatment decreased limb spasticity as assessed with the Modified Ashworth Scale(mean differences(MD)=−0.78,95%CI(−1.00,−0.56),P<0.001)and the Clinic Spasticity Index(MD=1.06,95%CI(0.51,1.60),P=0.0002),improved sensorimotor impairments according to the Fugl-Meyer Assessment(MD=9.51,95%CI(6.99,12.03),P<0.001),and improved activities of daily living according to the Barthel Index(MD=9.70,95%CI(6.27,13.12),P<0.001).Subgroup analysis based on the length of the treatment using the Modified Ashworth Scale,Fugl-Meyer Assessment,and Barthel Index showed better outcomes for patients who received more than 20 days of treatments(P<0.001).Conclusion:Warm-needle acupuncture is an effective treatment for limb spasticity post-stroke.A treatment frequency of more than 20 days appears to have better effectiveness than that of less than 20 days.