/*English:Balance Function after Stroke*/ ====== Balance Function after Stroke ====== ====== Troubles de l'équilibre post-AVC : Evaluation de l'acupuncture ====== | //Articles connexes//: - évaluation du [[qigong et taijiquan medical:evaluation:neurologie-psychiatrie:07. troubles de l equilibre post-avc|taiji-qigong]] - | ===== 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 | ==== Li 2022 ☆ ==== Li B, Zhao Q, Du Y, Li X, Li Z, Meng X, Li C, Meng Z, Chen J, Liu C, Cao B, Chi S. Cerebral Blood Flow Velocity Modulation and Clinical Efficacy of Acupuncture for Posterior Circulation Infarction Vertigo: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2022 Jun 28;2022:3740856. https://doi.org/10.1155/2022/3740856 ^Background| Vertigo is a cardinal symptom of posterior circulation infarction (POCI). Acupuncture is demonstrated to have a beneficial effect on posterior circulation infarction vertigo (PCIV). However, the mechanism of acupuncture therapy is not clarified. This study aims to assess the cerebral blood flow velocity modulation and clinical efficacy of acupuncture for PCIV patients.| ^Methods| We conducted this systematic review for clinical randomized controlled trials (RCTs) regarding acupuncture on PCIV. The study duration was from September 2020 to September 2021. We searched the PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP. The publication date was set from inception to August 31, 2020. Based on the inclusion and exclusion criteria, two researchers independently screened literature and extracted data including basic study information, intervention details, outcome details, and adverse events. Outcome measures included the blood flow velocities of vertebrobasilar arteries and the Clinical Effective Rate of posterior circulation infarction vertigo. Pooled data were presented as standardized mean differences (SMDs) and relative risks (RR), with 95% confidence intervals (CIs). The meta-analysis was conducted using Review Manager software version 5.3.0.| ^Results| A total of **20 eligible RCTs (1541 participants)** were included in this review, which compared acupuncture therapy (1 RCT) or acupuncture combined with pharmaceutical therapy (19 RCTs) to pharmaceutical therapy in patients with posterior circulation infarction vertigo. 7 studies assessed the blood flow velocities of the basilar artery examined by Transcranial Doppler (TCD), 8 studies assessed the bilateral vertebral arteries, and 13 studies evaluated the Clinical Effective Rate of posterior circulation infarction vertigo. Meta-analysis results showed that blood flow velocities of the basilar artery (SMD = 0.58, 95% CI = 0.40-0.76; P < 0.05), left vertebral artery (SMD = 0.48, 95% CI = 0.22-0.73; P < 0.05), and right vertebral artery (SMD = 0.44, 95% CI = 0.19-0.69; P < 0.05) were significantly higher in the acupuncture group compared with the control group. Clinical Effective Rate (RR = 1.22, 95% CI = 1.15-1.29; P = 0.792) was significantly better in the acupuncture group compared with the control group.| ^Conclusions| This study shows that acupuncture therapy is useful in improving the blood flow velocity of vertebrobasilar arteries and Clinical Effective Rate in patients with posterior circulation infarction vertigo. However, double-blind, sham-controlled trials with large sample sizes are required to support our conclusions.| === Xu 2016 Ø === Xu Hua,Tang Wei. [Effectiveness of Acupuncture and Rehabilitation Training on Balance Function after Stroke:A Systematic Review] Journal of Clinical Acupuncture and Moxibustion. 2016;​32(11):​56. ​ ​{{:medias+securises:acupuncture:evaluation:neuro-psychiatrie:xu-188602.pdf|[188602]}}. ​ ^ Objectives ​ | To assess the effectiveness of acupuncture combined with rehabilitation training in the treatment of balance dysfunction after stroke. ​ | ^ Methods ​ | Retrieve from CBMdisc, CNKI, v1P and Wanfang database. Collect clinically randomized controlled trials of comparison of acupuncture combined with rehabilitation Training and simple rehabilitation training, and assess the quality of the included studies by using RevMan5. 2 software Meta-analysis. ​ | ^ Results ​ | There were totally **14 literatures,​ involving 1103 patients**, The Berg Balance Scale [SMD=6.1O,​95% CI(5.39,​6.82) P<​O.00001],​FMA function eva1uation [SMD =1.68,95% C1 (1.47,​1.91)P <​0.00001],​ bathel index [SMD =5.90,95% CI(4.78,​7.02)P<​z0.00001] , Modified Bathel Index [SMD = 1.48,95% CI(1.05,​1.91) ,P <0. 0001] ,FMA motor function eva1uation [SMD = 1. 07,95% CI(0.87 , 1. 27) P <0. 0001] , neural function defect score [SMD = - 1. 60 , 95% CI ( - 2. 10, - 1. i 1 ) P < 0.0001〕and the Barthel index were as the basis to eva1uate the curative effect〔RR:​1.16,​95% CI(0.98, 1. 37)P =O. 08〕．There was no significant difference between two groups. ​ | ^ Conclusions ​ | Acupuncture combined with rehabilitation training is effective in the treatment of balance disorder after stroke. Because the quality of the included studies is not high the conclusion still needs to be randomized controlled trials with high quality of strict design and large samples. ​ | === Lin 2015 ☆=== Lin Meiqin, Liu Weilin. [System review of the efficacy of acupuncture on hemiplegic gait in stroke patients]. Journal of Fujian University of Traditional Chinese Medicine. 2015;1:54-62. [186997]. ^ Objectives | In order to obtain objective evidence of acupuncture therapy for stroke patients with hemiplegic gait, we would collect the published studies, and systematic review of the quality, providing reliable evidence for clinical application. | ^ Methods | Computer comprehensively searched Pubmed, EMbase, the Cochrane library, Web of Science, Chinese Science and Technology Database, Wanfang, China National Knowledge Infrastructure, Chinese Biology Medicine and Traditional Chinese Medicine Database. According to bias risk assessment tool of Cochrane, assessed the quality of the studies, evaluated the quality of each study, Re Man 5. 2software was used for meta-analysis and statistical appraisal of effect size. | ^ Results | Participants included 22 studies (n=1, 519), **8 of randomized controlled trials (RCT)**, 14 of controlled clinical trials (CCT). The results suggested that the lower limb Fugl-Meyer assessment scale: at the acute stage which is WMD=6. 71, 95%CI (5. 51, 5. 72) and P<0. 000, 01; at the restoration stage which is WMD=2. 50, 95%CI (1. 49, 3. 50) and P<0. 000, 01; at the sequela stage only 1 trial that has statistical significance (P=0. 003); three trials were aimed at the treatment of post stroke spasm (any course), which is WMD=1. 60, 95%CI (0. 92, 2. 28) and P<0. 000, 01. Acupuncture could improve time-distance parameters, but reported inconsistent results, improve the kinematic parameters of the hip, knee and ankle joint and enhance EMG of back extensor, slow spasm of limbs, increase the balance and walking function, improve the ability of daily life in stroke patients through analysis of quantitative gait. | ^ Conclusions | The existing evidences suggested that acupuncture treatment could **improve time-distance and kinematic parameters of lower limbs, suppress spasm and increase balance in stroke patients**. But the trials involved are low quality, therefore, which remains need to design more rigorous randomized controlled trial to further verification. |