American journal of translational research · 2025
Enhancing symptom relief and quality of life in patients with stroke-induced spastic hemiplegia: a comprehensive systematic review and meta-analysis of acupuncture modalities' effectiveness.
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Su Yi, Xiao Meihua, Liu Songchun, Ye Min
Аннотация
BACKGROUND: Stroke survivors often experience diminished quality of life due to physical, cognitive, and emotional challenges. While rehabilitative interventions are considered the cornerstone of treatment for stroke recovery, complementary therapies, such as acupuncture, herbal, or aroma therapies, have also gained recognition for their potential to enhance post-stroke recovery.
METHODS: A comprehensive search of electronic databases yielded 30 studies meeting the inclusion criteria. Studies employing acupuncture and rehabilitation interventions, alone or in combination, were included. Quality assessment was performed using the JADAD and PEDro scale. Standardized mean differences (SMD) were calculated to quantify the effect sizes. Random and fixed-effects models were applied to analyze the data.
RESULTS: The meta-analysis revealed a significant improvement in both spastic paralysis functions and quality of life following acupuncture and rehabilitation interventions. For motor function (19 studies, 1353 participants), the pooled effect size indicated a substantial positive impact (SMD = 1.15, 95% CI: [0.10; 2.20], P < 0.0001). Similarly, there were improvement on hand function (3 studies, SMD = 0.65, 95% CI: [0.19; 1.1], P = 0.006), upper limb function (3 studies, SMD = 0.53, 95% CI: [0.04; 1.03], P = 0.021), and lower limb function (4 studies, SMD = 0.52, 95% CI: [0.31; 0.74], P < 0.0001). For quality of life (20 studies, 1503 participants), the pooled effect size was also significant (SMD = 0.8379, 95% CI: [0.7306; 0.9452], P < 0.0001). The heterogeneity across studies was moderate to high (I2 = 77.7% for quality of life and I2 = 88.3% for motor function). While funnel plot analysis suggested potential publication bias for motor function outcomes, sensitivity analyses confirmed the robustness of the quality of life findings. Reported adverse events were generally mild and transient.
CONCLUSION: This meta-analysis provides robust evidence supporting the positive effect of acupuncture and rehabilitation interventions on both spastic paralysis functions and the quality of life among stroke survivors. The findings highlight the potential of these therapies in promoting holistic recovery and underscore the need for their integration into standard post-stroke care protocols. Healthcare providers and policymakers should consider these results in shaping comprehensive rehabilitation strategies for stroke survivors, ultimately fostering improved well-being and long-term outcomes.
METHODS: A comprehensive search of electronic databases yielded 30 studies meeting the inclusion criteria. Studies employing acupuncture and rehabilitation interventions, alone or in combination, were included. Quality assessment was performed using the JADAD and PEDro scale. Standardized mean differences (SMD) were calculated to quantify the effect sizes. Random and fixed-effects models were applied to analyze the data.
RESULTS: The meta-analysis revealed a significant improvement in both spastic paralysis functions and quality of life following acupuncture and rehabilitation interventions. For motor function (19 studies, 1353 participants), the pooled effect size indicated a substantial positive impact (SMD = 1.15, 95% CI: [0.10; 2.20], P < 0.0001). Similarly, there were improvement on hand function (3 studies, SMD = 0.65, 95% CI: [0.19; 1.1], P = 0.006), upper limb function (3 studies, SMD = 0.53, 95% CI: [0.04; 1.03], P = 0.021), and lower limb function (4 studies, SMD = 0.52, 95% CI: [0.31; 0.74], P < 0.0001). For quality of life (20 studies, 1503 participants), the pooled effect size was also significant (SMD = 0.8379, 95% CI: [0.7306; 0.9452], P < 0.0001). The heterogeneity across studies was moderate to high (I2 = 77.7% for quality of life and I2 = 88.3% for motor function). While funnel plot analysis suggested potential publication bias for motor function outcomes, sensitivity analyses confirmed the robustness of the quality of life findings. Reported adverse events were generally mild and transient.
CONCLUSION: This meta-analysis provides robust evidence supporting the positive effect of acupuncture and rehabilitation interventions on both spastic paralysis functions and the quality of life among stroke survivors. The findings highlight the potential of these therapies in promoting holistic recovery and underscore the need for their integration into standard post-stroke care protocols. Healthcare providers and policymakers should consider these results in shaping comprehensive rehabilitation strategies for stroke survivors, ultimately fostering improved well-being and long-term outcomes.