Beneficial acupuncture treatment for post-stroke unilateral spatial neglect

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The use of acupuncture in patients who have had a stroke may promote the rehabilitation of cognitive function, activities of daily living (ADL), and motor function, while relieving symptoms of unilateral spatial neglect. The results of these studies have been published in the journal Geriatric nursing.

Unilateral spatial neglect is a common and disabling post-stroke impairment. It has been described as a “syndrome resulting from damage to neural networks essential for spatial attention and related cognitive and motor functions,” the researchers explained. Patients with unilateral spatial neglect experience disturbances in cognitive function, proprioception, and balance function, which impact their ADLs and overall rehabilitation.

In an effort to integrate and analyze secondary RCTs published on the use of acupuncture in post-stroke rehabilitation, the researchers conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). They independently identified eligible studies on the topic and extracted key data.


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Overall, a total of 12 studies involving 731 participants were included. Of these 12 studies, 11 were meta-analyses. All the chosen studies were conducted in China. A total of 9 of the RCTs reported diagnostic criteria for stroke and 9 reported diagnostic criteria for unilateral spatial neglect.

The experimental group in each study received the intervention used in the control group plus acupuncture. The 2 main types of acupuncture used in this review were scalp acupuncture and body acupuncture. Of the 12 included RCTs, 3 used scalp acupuncture only, 1 used body acupuncture only, and 8 used scalp acupuncture in combination with body acupuncture for unilateral spatial neglect and stroke. The frequency of acupuncture used varied between 15 minutes and 6 hours per day, between 5 and 12 times per week. The duration of acupuncture varied from 4 to 8 weeks.

The main outcome measures included the following: (1) tests of cognitive function, such as the Mini-Mental State Examination (MMSE); (2) indicators of one-sided spatial neglect, such as the line bisection test, the cancellation test, the clock drawing test, the copy drawing test, the numerical elimination experiment, the Catherine Bergego Scale (CBS), Behavioral Inattention Test (BIT), and Chinese Behavioral Inattention Test of Hong Kong Version (CBIT-HK); (3) ADL indicators, such as Barthel’s Index (BI), Modified BI (MBI), and Functional Independence Measure (FIM); and (4) indicators of motor function, such as the Fugl-Meyer Rating Scale (FMA). For the above indicators, other than the MMSE, BIT, BI, MBI, FIM, and FMA, lower scores indicated better function.

Study results revealed that compared to the control group, the use of acupuncture was associated with significantly increased scores on the MMSE, BI, MBI, and FMA, as well as significantly reduced scores on unilateral spatial neglect measures (P <.05 for all these results thus demonstrate that the use of acupuncture was linked to improvements in adls cognitive function and motor alleviated degree unilateral spatial neglect suffered by patients following stroke.>

Study limitations included that the quality of some of the studies was not high enough to combine results during data analysis, which may have influenced the final combined data. In addition, the number of included studies was limited, so analyzes based on frequency and/or duration of treatment could not be performed.

The researchers concluded that acupuncture “may be a good complementary treatment to rehabilitation therapy for [unilateral spatial neglect].”

Disclosure: None of the study authors declared any affiliation with any biotechnology, pharmaceutical and/or device companies.

Reference

Lin S, Guo J, Chen X, Lin N, Li Z, Liu F. Effect of acupuncture on unilateral spatial neglect after stroke: a systematic review and meta-analysis of randomized controlled trials. Geriatric nurses. 2022;46:13-20. doi:10.1016/j.gerinurse.2022.04.022

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