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acupuncture:evaluation:neuro-psychiatrie:07. syndrome epaule-main post-avc [16 Sep 2023 10:35] Nguyen Johan [1.1. Generic Acupuncture] |
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 2023 === | ||
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| ==== Special Acupuncture Techniques ==== | ==== Special Acupuncture Techniques ==== | ||
| + | |||
| + | === Comparison of Acupuncture techniques === | ||
| + | == Huang 2023 == | ||
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| + | |||
| + | 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).| | ||
