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| Les deux révisions précédentes Révision précédente Prochaine révision | Révision précédente | ||
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acupuncture:evaluation:neuro-psychiatrie:07. syndrome epaule-main post-avc [10 Dec 2022 08:18] Nguyen Johan [2.1. Choi 2022] |
acupuncture:evaluation:neuro-psychiatrie:07. syndrome epaule-main post-avc [23 May 2025 16:34] (Version actuelle) Nguyen Johan [1.1. Generic Acupuncture] |
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| ===== Systematic Reviews and Meta-Analysis===== | ===== Systematic Reviews and Meta-Analysis===== | ||
| - | | ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture | | + | |
| - | | ☆☆ | Evidence for effectiveness of acupuncture | | + | |
| - | | ☆ |Limited evidence for effectiveness of acupuncture | | + | |
| - | | Ø |No evidence or insufficient evidence | | + | |
| ==== Generic Acupuncture ==== | ==== Generic Acupuncture ==== | ||
| + | |||
| + | === Shi 2025 === | ||
| + | |||
| + | Shi J, Chen F, Liu Y, Bian M, Sun X, Rong R, Liu S. Acupuncture versus rehabilitation for post-stroke shoulder-hand syndrome: a systematic review and meta-analysis of randomized controlled trials. Front Neurol. 2025 Apr 2;16:1488767. https://doi.org/10.3389/fneur.2025.1488767 | ||
| + | ^Backgound| Shoulder-hand syndrome (SHS) is one of the common sequelae after stroke, which not only hinders the recovery of patients, but also increases the economic burden of the family. In the absence of effective treatment measures, acupuncture treatment has been widely used in China to treat post-stroke shoulder-hand syndrome, but the details are unclear. Therefore, this review aims to evaluate the true efficacy of acupuncture in patients with SHS.| | ||
| + | ^Methods| We searched eight databases [PubMed, Embase, Web of Science, Cochrane library, China Biomedical Literature Database (CBM), China Science and Technology Journal (VIP) database, the China National Knowledge Infrastructure (CNKI) database, and Wan fang database] from its inception to March 2025, randomized controlled trials (RCTs) of SHS acupuncture treatment combined with rehabilitation (Rehab). Two investigators independently used pre-designed forms to extract valid data from eligible randomized controlled trials. Meta-analysis was implemented through the Rev. Man software (version 5.4). The strength of the evidence obtained was implemented using the GRADE profiler software. Adverse events (AEs) were collected by reading the full text and used to evaluate the safety of acupuncture treatment.| | ||
| + | ^Results| **Forty-seven studies, involving 4,129 participants**, met the eligibility criteria, and were included in the review. Overall meta-analysis showed that combined acupuncture rehabilitation significantly improved motor function (upper-limb Fugl-Meyer Assessment (FMA): 41 studies, mean difference (MD) 9.50, 95% confidence interval (CI) [8.47, 10.53]) and pain reduction (visual analog score (VAS): 37 studies, MD: -1.49, 95% CI [-1.66, -1.33]). It also improved activities of daily living (ADL) compared to rehabilitation alone (ADL: 17 studies, MD: 11.94, 95% CI [8.26, 13.63]). There was no significant difference in the occurrence of adverse events (AEs) between acupuncture treatment combined with Rehab and Rehab alone (p > 0.05). The certainty of the evidence was rated low level because of flaws in the study design and considerable heterogeneity among the included studies.| | ||
| + | ^Conclusion| This review found that acupuncture treatment combined with Rehab treatment may have a positive promoting effect on improving motor function, reducing pain, and improving daily living ability in SHS patients. However, due to the existing methodological quality issues, our findings should be treated with caution. Future high-quality studies are urgently needed to validate our findings.| | ||
| + | |||
| + | === Zhan 2023 === | ||
| + | |||
| + | Zhan J, Luo Y, Mao W, Zhu L, Xu F, Wang Y, Chen H, Zhan L. Efficacy of acupuncture versus rehabilitation therapy on post-stroke shoulder pain: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2023 Jul 21;102(29):e34266. https://doi.org/10.1097/MD.0000000000034266 | ||
| + | ^Background| Acupuncture and rehabilitation therapy (RT) have been widely used for post-stroke shoulder pain (PSSP), but the efficacy of acupuncture versus RT remains unclear. Our aim was to assess the efficacy of acupuncture versus RT for PSSP.| | ||
| + | ^Methods| Six databases including PubMed, Cochrane Library, China National Knowledge Infrastructure, Chinese biological medicine database, Chinese Scientific Journal Database, and WAN FANG were searched from their inception to March 2022. Randomized controlled trials (RCTs) comparing acupuncture with RT on PSSP were included. Primary outcome was shoulder pain. Secondary outcomes were upper limb motor function, activities of daily living (ADL), and adverse events (AEs). We used RevMan Version 5.3 to pool data. We conducted data synthesis of all outcomes using the random effects model. The methodological quality of all studies was assessed by 2 independent reviewers using the risk of bias (ROB) assessment tool. We also performed subgroup analysis and sensitivity analysis. We assessed the publication bias using the Egger test and funnel plots.| | ||
| + | ^Results| **Eighteen studies** were included in qualitative synthesis, fifteen (83%) studies with 978 patients were included in meta-analysis (MA) because of the outcomes of 3 studies were inappropriate. Nine (50%) studies were considered as moderate to high quality according to ROB assessment tool. The effectiveness of acupuncture for patients with PSSP was similar to that of RT on shoulder pain alleviation (standardized mean difference [SMD]: -0.41, 95% confidence interval [CI]: -0.91 to 0.08, P = .10), improvement of upper limb motor function (weighted mean difference [WMD]: 0.80, 95% CI: -1.19 to 2.79, P = .43), and ADL (WMD: -0.83, 95% CI: -3.17 to 1.51, P = .49). Two (11%) studied reported no acupuncture-related AEs, and fourteen (78%) studies did not mention AEs resulting from acupuncture.| | ||
| + | ^Conclusions| Acupuncture is similar to RT in relieving shoulder pain, improving upper limb motor function and ADL in patients with PSSP. Either acupuncture or RT might be the optimal treatment of PSSP. More well-designed RCTs of this topic are needed in the future. | | ||
| === Zhan 2022 ☆ === | === Zhan 2022 ☆ === | ||
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| ==== Special Acupuncture Techniques ==== | ==== Special Acupuncture Techniques ==== | ||
| + | |||
| + | === Comparison of Acupuncture techniques === | ||
| + | == Huang 2023 == | ||
| + | |||
| + | |||
| + | Huang T, Yao H, Huang J, Wang N, Zhou C, Huang X, Tan X, Li Y, Jie Y, Wang X, Yang Y, Liang Y, Yue S, Mao Y, Lai S, Zheng J, He Y. Effectiveness of acupuncture for pain relief in shoulder-hand syndrome after stroke: a systematic evaluation and Bayesian network meta-analysis. Front Neurol. 2023 Nov 17;14:1268626. https://doi.org/10.3389/fneur.2023.1268626 | ||
| + | ^Background| Shoulder-hand syndrome (SHS) is a common complication after stroke, and SHS-induced pain significantly hampers patients' overall recovery. As an alternative therapy for pain relief, acupuncture has certain advantages in alleviating pain caused by SHS after stroke. However, choosing the best treatment plan from a variety of acupuncture options is still a serious challenge in clinical practice. Therefore, we conducted this Bayesian network meta-analysis to comprehensively compare the effectiveness of various acupuncture treatment methods.| | ||
| + | ^Methods| We systematically searched for randomized controlled trials (RCTs) of acupuncture treatment in patients with post-stroke SHS published in PubMed, Embase, Cochrane, and Web of Science until 9 March 2023. We used the Cochrane bias risk assessment tool to assess the bias risk in the included original studies.| | ||
| + | ^Results| A total of **50 RCTs involving 3,999 subjects** were included, comprising 19 types of effective acupuncture interventions. Compared to single rehabilitation training, the top three interventions for VAS improvement were floating needle [VAS = -2.54 (95% CI: -4.37 to -0.69)], rehabilitation + catgut embedding [VAS = -2.51 (95% CI: -4.33 to -0.68)], and other multi-needle acupuncture combinations [VAS = -2.32 (95% CI: -3.68 to -0.94)]. The top three interventions for improving the Fugl-Meyer score were eye acupuncture [Meyer = 15.73 (95% CI: 3.4627.95)], other multi-needle acupuncture combinations [Meyer = 12.22 (95% CI: 5.1919.34)], and traditional western medicine + acupuncture + traditional Chinese medicine [Meyer = 11.96 (95% CI: -0.59 to 24.63)].| | ||
| + | ^Conclusion| Multiple acupuncture methods are significantly effective in improving pain and upper limb motor function in post-stroke SHS, with relatively few adverse events; thus, acupuncture can be promoted.| | ||
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| | ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) | | | ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) | | ||
| + | |||
| + | ==== Spanish Society of Neurorehabilitation (SSN, Spain) 2025 ⊕==== | ||
| + | Juárez-Belaúnde A, Colomer C, Dorado R, Laxe S, Miguens X, Ferri J, Rodríguez R, Pérez T, López C, Ríos M, González C, Pelayo R, Bernabeu M, Noé E, Gómez A, Quemada I. Guidelines: Basic principles of pain management in acquired brain injury. Recommendations of the Spanish Society of Neurorehabilitation. Neurologia (Engl Ed). 2025 Apr 10:S2173-5808(25)00028-8. https://doi.org/10.1016/j.nrleng.2025.04.005 | ||
| + | |Hemiplegic Shoulder Pain (HSP) after Stroke. \\ -**ICCPN**: Acupuncture may be helpful. Grade of recommendation: Moderate (B). \\ - **AHA/ASA**: The usefulness of acupuncture as a coadjuvant treatment for HSP is unclear. Grade of recommendation: Moderate (B). \\ - **UEMS-PRMS**: Management of HSP may include subacromial or glenohumeral corticosteroid injection, suprascapular nerve block, electrical stimulation of shoulder muscles, botulinum toxin injections targeting the subscapular and/or pectoral muscles, shoulder orthoses, oral anti-inflammatory drugs, massage, gentle mobilisation of the shoulder muscles, and acupuncture. Grade of recommendation: Low (IV). \\ - **IMSERSO**: Combination treatment with aromatherapy and acupressure is recommended to treat pain in HSP. Grade of recommendation: High (A).| | ||
