Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system: a systematic review and meta-analysis

Abstract

Objective:

To investigate the effectiveness of traditional manual acupuncture combined with rehabilitation therapy versus rehabilitation therapy alone for shoulder hand syndrome after stroke.

Data sources:

PubMed, EMBASE, the Cochrane Library, Chinese Biomedicine Database, China National Knowledge Infrastructure, VIP Information Database, Wan Fang Database and reference lists of the eligible studies were searched up to July 2017 for relevant studies.

Methods:

Randomized controlled trials that compared the combined effects of traditional manual acupuncture and rehabilitation therapy to rehabilitation therapy alone for shoulder hand syndrome after stroke were included. Two reviewers independently screened the searched records, extracted the data and assessed risk of bias of the included studies. The treatment effect sizes were pooled in a meta-analysis using RevMan 5.3 software.

Results:

A total of 20 studies involving 1918 participants were included in this study. Compared to rehabilitation therapy alone, the combined therapy significantly reduced pain on the visual analogue scale and improved limb movement on the Fugl–Meyer Assessment scale and the performance of activities of daily living (ADL) on the Barthel Index scale or Modified Barthel Index scale. Of these, the visual analogue scale score changes were significantly higher (mean difference = 1.49, 95% confidence interval = 1.15–1.82, P < 0.00001) favoring the combined therapy after treatment, with severe heterogeneity (I² = 71%, P = 0.0005).

Conclusion:

Current evidence suggests that traditional manual acupuncture integrated with rehabilitation therapy is more effective in alleviating pain, improving limb movement and ADL. However, considering the relatively low quality of available evidence, further rigorously designed and large-scale randomized controlled trials are needed to confirm the results.

Keywords

Traditional manual acupuncture rehabilitation therapy shoulder hand syndrome stroke

Get full access to this article

View all access options for this article.

References

Hartwig

Gelbrich

Griewing

Functional orthosis in shoulder joint subluxation after ischaemic brain stroke to avoid post-hemiplegic shoulder-hand syndrome: a randomized clinical trial. Clin Rehabil 2012; 26: 807–816.

Pervane Vural

Nakipoglu Yuzer

Sezgin Ozcan

et al . Effects of mirror therapy in stroke patients with complex regional pain syndrome type 1: a randomized controlled study. Arch Phys Med Rehab 2016; 97: 575–581.

Pertoldi

Di Benedetto

Shoulder-hand syndrome after stroke: a complex regional pain syndrome. Eura Medicophys 2005; 41: 283–292.

Forouzanfar

Koke

van Kleef

et al . Treatment of complex regional pain syndrome type I. Eur J Pain: London 2002; 6: 105–122.

Advances in the clinical treatment of shoulder-hand syndrome after stroke. Chin J Acupunct Moxibust 2015; 4: 201–204.

Chen

Yang

Liu

et al . Manual acupuncture for treatment of diabetic peripheral neuropathy: a systematic review of randomized controlled trials. PLoS ONE 2013; 8: e73764.

Huskisson

EC.

Measurement of pain. Lancet 1974; 2: 1127–1131.

Fugl-Meyer

Jaasko

Leyman

et al . The post-stroke hemiplegic patient 1: a method for evaluation of physical performance. Scand J Rehabil Med 1975; 7: 13–31.

Mahoney

Barthel

DW.

Functional evaluation: the Barthel index. Maryland State Med J 1965; 14: 61–65.

10.

Shah

Vanclay

Cooper

Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 1989; 42: 703–709.

11.

MacPherson

Altman

Hammerschlag

et al . Revised Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA): extending the CONSORT statement. PLoS Med 2010; 7: e1000261.

12.

Higgins

Sally

Cochrane handbook for systematic reviews of interventions version 5.1.0 (updated March 2011). Available at: http://handbook.cochrane.org/ (accessed 20 March 2011).

13.

Egger

Davey Smith

Fau-Schneider

et al . Bias in meta-analysis detected by a simple, graphical test. BMJ 1997; 315: 629–634.

14.

Chai

GH.

Acupuncture combined with rehabilitation training for 59 patients with shoulder hand syndrome. China Nat 2016; 24: 35–36.

15.

Chang

Liu

Therapeutic effect of acupuncture combined with rehabilitation exercise in patients with shoulder hand syndrome. J Fourth Mil Med Univ 2005; 26: 2295–2297.

16.

Chen

Huang

Liu

KC.

Clinical research of using acupuncture and rehabilitation training in the treatment of post-stroke shoulder hand syndrome. J Sichuan Trad Chin Med 2015; 33: 150–152.

17.

Gao

Effectiveness evaluation of acupuncture combined with rehabilitation exercise for shoulder hand syndrome. Guide China Med 2016; 14: 198.

18.

Wang

Liu

Acupuncture combined with rehabilitation training for shoulder hand syndrome after apoplexy. Chin J Trad Med Sci Technol 2012; 19: 552–553.

19.

Clinical observation of acupuncture for 46 patients with shoulder hand syndrome after stroke. Chin J Ethnomed and Ethnophar 2015; 24: 78–79.

20.

Liang

Zhang

Liu

YH.

Acupuncture combined rehabilitation training for 30 patients with post stroke should hand. Lab Med 2016; 31: 203.

21.

Liao

HW.

Clinical observations on the efficacy of occupational therapy plus acupuncture for treating reflex sympathetic dystrophy. Shanghai J Acupunct Moxibust 2006; 25: 9–10.

22.

Niu

GP.

Clinical study of acupuncture combined with rehabilitation training for shoulder hand syndrome. Henan Trad Chin Med 2015; 35: 2846–2847.

23.

Shang

Cai

et al . Clinical study on acupuncture combined with rehabilitation therapy for treatment of post stroke shoulder-hand syndrome. Chin Acupunct Moxibust 2008; 28: 331–333.

24.

Shen

ZH.

Clinical observation of acupuncture combined with rehabilitation training for shoulder hand syndrome. Shenzhen J Integr Trad Chin West Med 2014; 24: 56–58.

25.

Sun

Wang

Effect of acupuncture plus rehabilitation training on shoulder-hand syndrome due to ischemic stroke. J Acupunct Tuina Sci 2012; 10: 109–113.

26.

Tie

Effectiveness of rehabilitation training for shoulder hand syndrome after stroke. Contemp Med Symp 2016; 14: 144–145.

27.

Wan

Wang

Cheng

et al . Post stroke shoulder hand syndrome treated with acupuncture and rehabilitation: a randomized controlled trial. Chin Acupunct Moxibust 2013; 33: 970–974.

28.

Wang

Gao

Acupuncture combined with rehabilitation on the influence of PRI, FMA and MBI in patients with shoulder hand syndrome with stroke. Glob Trad Chin Med 2017; 10: 361–363.

29.

ZG.

Acupuncture combined with rehabilitation training for 100 patients with shoulder-hand syndrome after stroke. Chin Med Mod Distance Educ China 2014; 12: 81–82.

30.

Zhang

Acupuncture combined with rehabilitation training for shoulder hand syndrome after ischemic stroke Chinese: a randomized controlled trial. J Trauma Disabil Med 2015; 23: 141–142.

31.

Zhang

XR.

Clinical effectiveness analyses of acupuncture combined with rehabilitation training for shoulder hand syndrome after stroke. China Med Eng 2015; 23: 200.

32.

Zhao

Song

Acupuncture for 30 patients with shoulder hand syndrome after stroke. Chinese J Inf Trad Med 2004; 11: 532–533.

33.

Zhong

Feng

Synthetic rehabilitation therapy for shoulder hand syndrome after stroke. Prac J Clin Med 2011; 8: 115–116.

34.

Neurology Branch of Chinese Medicine Association. Key points for diagnosing cerebrovascular diseases. Chin J Neurol 1996; 29: 379–380.

35.

Miao

Zhu

LL.

Rehabilitation Evaluation and Treatment for Stroke. Beijing, China: Huaxia Publishing House 1996, pp.149–150.

36.

Quackwatch. Available at: http://www.quackwatch.org/01QuackeryRelatedTopics/acu.html

37.

Chou

Kao

Lin

JG.

Probable mechanisms of needling therapies for myofascial pain control. Evid-Based Compl Alt 2012; 2012: 705327.

38.

Tian

Wang

et al . Therapeutic effect of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients: a clinical two-center randomized controlled trial. J Tradit Chin Med 2012; 32: 343–349.

39.

Lee

Park

Hwang

et al . Acupuncture for shoulder pain after stroke: a systematic review. J Altern Complem Med 2012; 18: 818–823.

40.

Oerlemans

Oostendorp

de Boo

et al . Pain and reduced mobility in complex regional pain syndrome I: outcome of a prospective randomised controlled clinical trial of adjuvant physical therapy versus occupational therapy. Pain 1999; 83: 77–83.

41.

Manheimer

Linde

Lao

et al . Meta-analysis: acupuncture for osteoarthritis of the knee. Ann Intern Med 2007; 146: 868–877.

42.

Liu

Manheimer

Shi

et al . Chinese herbal medicine for severe acute respiratory syndrome: a systematic review and meta-analysis. J Altern Complem Med 2004; 10: 1041–1051.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.50 MB

0.39 MB

0.17 MB