The effectiveness of acupuncture in motor function recovery during cerebrovascular accident rehabilitation

Abstract

Overview of the topic: Cerebrovascular accident occurs when a rapid development of clinical signs of focal or global disturbance happens in the cerebral function, which last more than 24 hours or has the potential to death, and must be caused by its vascular origin (Hatano, 1976). As a result, a type of disability can be manifested, such as disabilities associated with motor function control. Conventional stroke rehabilitation therapy plays an important role in motor function recovery, however more than half of the survivors remain with a certain degree of impairment (NINDS, 2011). Thereby, the aim of this dissertation is to search for other modalities of care, such as the use of Acupuncture, in the attempt to further improve the outcomes in stroke survivors. Thereby, the main aim is to identify evidence of whether the additional of needle penetrating acupuncture would add a therapeutic effect in stroke patients with motor impairment undergoing rehabilitation. Research question: In adults undergoing conventional stroke rehabilitation within the first 3 months of stroke onset, does the addition of needle penetration acupuncture during stroke rehabilitation therapy, result in improved motor function? PICO elements: The population (P) under investigation is the post-stroke adult patients undergoing rehabilitation within the first 3 months of stroke onset. The intervention (I) and comparison (C) are the use of Acupuncture using needle penetration at the acupuncture points and conventional stroke rehabilitation versus Conventional stroke rehabilitation. The outcome (O) is to improve motor function recovery. Inclusion/exclusion criteria: Only articles in English language, concerning adults who suffered from stroke, undergoing a type of rehabilitation and without cognitive impairment and genetic factors associated with neural plasticity were included. Search Outcome: 8 studies were found being 1 Meta-analysis and 7 Randomised controlled trials (RCTs), which specifically answered the PICO question. Quality Assessment: The Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist was used to critically appraise the Meta-analysis, while the Critical Appraisal Skills Programme (CASP) tool was used to critically appraise the seven RCTS. Main results: The studies included in this review reported inconsistent results. Conclusion: To date, the additional of acupuncture for motor function recovery in patients during the first 3 months of stroke recovery remains inconclusive and debatable. Recommendations: Further research is required, where more rigorously, designed large multicentre randomized trials are needed.