Acupuncture not helpful for stroke recovery

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Acupuncture does not help speed recovery after stroke, according to an analysis of 10 trials using fake or “sham” acupuncture as a control.

“Our meta-analysis of data from rigorous randomized sham-controlled trials did not show a positive effect of acupuncture as a treatment for functional recovery after stroke,” Dr. Jae Cheol Kong of Wonkwang University in Iksan, South Korea, and colleagues conclude in the Canadian Medical Association Journal (CMAJ).

Some recent studies have found no benefit for acupuncture when it is compared to sham acupuncture, a placebo version of the traditional Chinese medicine technique that can involve needling non-acupuncture points, penetrating the skin shallowly, or not penetrating the skin at all. 

For example, recent studies found acupuncture was not effective for inducing labor, while another showed no benefit of the traditional Chinese technique for improving the success of in vitro fertilization (IVF).

While several reviews of the medical literature on acupuncture for stroke recovery have been published, the authors of the current study note, many have had limitations, for example failing to include studies published in Asian countries.

To address this issue, Kong and colleagues searched 25 databases and 12 Korean traditional medicine journals. Among 664 studies on the topic, the researchers found 10 that met their criteria, including 711 patients in all.

Two of the trials compared real acupuncture to sham electrostimulation, while the other eight used sham acupuncture as a placebo. Several different analyses of the trials found acupuncture did not improve patients’ ability to perform activities of daily living, nor did it show improvement in measurements of neurological function. While two studies did find a benefit for acupuncture, “poor reporting and high risks of bias rendered both studies less than reliable,” Kong and colleagues write.

The researchers acknowledge that sham acupuncture may not be a true placebo, and could actually be producing physiological effects, which could explain the lack of difference between the fake and real acupuncture groups. Other “drawbacks” to their findings include the lack of data and the often-poor quality of that data, they add.

In an editorial accompanying the study, Dr. Hongmei Wu of West China Hospital in Chengdu argues that given the small size of the studies, as well as the fact that sham acupuncture may actually have some effect, “it is premature to refute the effects of acupuncture in treatment of stroke rehabilitation.”

“Rigorously designed, large, multicentre randomized trials are needed to assess the effects of acupuncture on stroke rehabilitation further,” Wu concludes.

SOURCE: CMAJ published online September 27, 2010.

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