The reduction of hypokinetic episodes in people with Parkinson’s disease using acupuncture techniques : an evidence-based literature review

Abstract

Overview of the topic: Parkinson’s Disease (PD) is one of the most common neurodegenerative disorders in the world, affecting motor, non-motor and psychosocial parts of the patient’s life. PD is still predominately managed pharmaceutically with susceptibility to adverse effects. Existing studies recommend the use of acupuncture as a safe treatment in the management of this condition. However, due to yet little evidence, it is still unclear on the potential benefit that such interventions might have on PD. Research question: This review made use of the Population Intervention Comparison and Outcome (PICO) framework, to create the research question: “In Parkinson’s Disease patients (P), does acupuncture, as adjunctive therapy to conventional treatment (I), provide the best outcome to lower hypokinetic episodes (O) versus solely conventional therapy (C)?” Search methods: Several databases were used: PubMed, HyDi Cochrane and Google Scholar, and a literary search was conducted using different keywords to produce relevant articles including; Acupuncture, Parkinson’s disease and hypokinetic episodes. Studies not available in English, assessed participants younger than fifty and/or those that were published prior to 2010 were excluded. After screening, a combination of five selected articles were chosen to be additionally appraised. Which comprised of four systematic reviews (SRs) and one Randomised Controlled Trail (RCT). Critical appraisal tools were used to assess the quality of the articles, namely: the Critical Appraisal Skills Programme (CASP) and the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA). Results: Although the outcomes and results of the selected articles differed from one another, they all, indicated significant benefits in using acupunctural interventions with PD. Amongst the studies insignificant difference between the different types of acupuncture-therapies was also observed. However, all indicated significant differences between the intervention groups and controls groups. Conclusions: Though many of the articles spoke favourably regarding the intervention, severe methodological flaws prevented the formulation of a concrete conclusion, and so, using acupunctural treatments with PD remains inconclusive. However, the literature review also highlights that when analysing acupuncture research, the individualized nature of Chinese medicine needs to be taken inconsideration. Recommendations: The lack of properly formulated assessing criterions in acupuncture treatments created numerous difficulties in apprising the articles. Indeed, this review, encourages the need for new future research to be conducted in a more concise and standardized way, in hopes of creating stronger evidence in this field.