The use of acupuncture in patients who have experienced a stroke can promote the rehabilitation of cognitive function, activities of daily living (ADLs), and motor function, along with relieving the symptoms of unilateral spatial neglect. These study findings were published in the journal Geriatric Nursing.
Unilateral spatial neglect is a common, disabling poststroke impairment. It has been described as a “syndrome resulting from damage to the neural networks critical to spatial attention and related cognitive and motor functions,” the researchers explained. Patients who present with unilateral spatial neglect experience disruptions in cognitive function, proprioception, and balance function, which have been shown to impact their ADLs and overall rehabilitation.
In an effort to integrate and analyze published secondary RCTs on the use of acupuncture in 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 the key data.
Overall, a total of 12 studies in 731 participants were included. Of these 12 studies, 11 were meta-analyses. All of the studies chosen had been conducted in China. In all, 9 of the RCTs reported on the diagnostic criteria for stroke and 9 reported on the diagnostic criteria for unilateral spatial neglect.
The experimental group of 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 RCTs included, 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 the acupuncture used varied between 15 minutes to 6 hours per day, between 5 and 12 times per week. The duration of acupuncture varied from 4 to 8 weeks.
The primary outcome indicators included the following: (1) tests of cognitive function, such as the Mini-Mental State Examination (MMSE); (2) indicators of unilateral spatial neglect, such as the line bisection test, the cancellation test, the clock-drawing test, the copying drawing test, the digital elimination experiment, the Catherine Bergego Scale (CBS), the Behavioural Inattention Test (BIT), and the Chinese Behavioural Inattention Test of Hong Kong Version (CBIT-HK); (3) indicators of ADLs, such as the Barthel Index (BI), the modified BI (MBI), and the Functional Independence Measure (FIM); and (4) indicators of motor function, such as the Fugl-Meyer Assessment (FMA) Scale. Regarding the above indicators, other than the MMSE, BIT, BI, MBI, FIM, and FMA, lower scores were indicative of better function.
Study findings revealed that compared with 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 the measures of unilateral spatial neglect (P <.05 for all). These findings thus demonstrate that the use of acupuncture was linked to improvements in ADLs, cognitive function, and motor function, and relieved the degree of unilateral spatial neglect experienced by patients following a stroke.
Study limitations included the fact that the quality of some of the studies was not high enough to combine the results during data analysis, which may have influenced the final combined data. Additionally, the number of included studies was limited, so analyses that were based on the frequency and/or duration of treatment could not be conducted.
The researchers concluded that acupuncture “may be a good complementary treatment to rehabilitation therapy for [unilateral spatial neglect].”
Disclosure: None of the study authors has declared affiliations with biotech, pharmaceutical, and/or device companies.
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. Geriatr Nurs. 2022;46:13-20. doi:10.1016/j.gerinurse.2022.04.022