Acupuncture for stroke: Evidence of effectiveness, safety, and cost from systematic reviews

Objective: To provide an overview of evidence from systematic reviews and meta-analysis on the effectiveness, safety, and cost of acupuncture for stroke. Methods: Two authors selected the articles according to inclusion and exclusion criteria, and 2 authors extracted data from the reviews. Potentially relevant systematic reviews were searched through the Cochrane Library, MEDLINE, EMBASE, AMED, CISCOM, Chinese Biological Medicine Database (CBMD), Chinese Scientific Journal Database (VIP), Chinese periodicals in the China National Knowledge Infrastructure (CNKI), and Chinese Evidence-Based Medicine Database. The evidence was based on the reviews and meta-analysis. Results: Nine articles were indentified: 1 focused on acute stroke; 1 focused on subacute or chronic stroke; 5 focused on stroke (the interval after stroke onset was variable in these studies); and 2 addressed dysphagia after stroke. There is a split among reviewers regarding the effectiveness of acupuncture for stroke recovery. The most reliable evidence showed that there was no clear benefit of acupuncture for stroke patients in acute, subacute, or chronic stages. There was not a single economic analysis of acupuncture for treatment of stroke. Conclusions: Acupuncture treatment seems to be relatively safe. The evidence for the effectiveness of acupuncture for stroke was inconclusive, mainly due to poor methodological quality and small samples. For future research, further high-quality, randomized controlled trials with long-term follow-up are needed, as well as economic analysis.