PMID- 37478239
OWN - NLM
STAT- MEDLINE
DCOM- 20230724
LR  - 20231123
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 102
IP  - 29
DP  - 2023 Jul 21
TI  - Efficacy of acupuncture versus rehabilitation therapy on post-stroke shoulder 
      pain: A systematic review and meta-analysis of randomized controlled trials.
PG  - e34266
LID - 10.1097/MD.0000000000034266 [doi]
LID - e34266
AB  - 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.
CI  - Copyright (c) 2023 the Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Zhan, Jie
AU  - Zhan J
AD  - Postdoctoral Programme, Department of Rehabilitation, Guangdong Provincial 
      Hospital of Chinese Medicine, the Second Affiliated Hospital of Guangzhou 
      University of Chinese Medicine, Guangzhou, China.
AD  - Department of Rehabilitation, Guangdong Provincial Hospital of Chinese Medicine, 
      the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 
      Guangzhou, China.
FAU - Luo, Ying
AU  - Luo Y
AUID- ORCID: 0000-0002-5909-932
AD  - Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese 
      Medicine, Guangzhou, China.
FAU - Mao, Wenjin
AU  - Mao W
AD  - Department of Rehabilitation, Guangdong Provincial Hospital of Chinese Medicine, 
      the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 
      Guangzhou, China.
FAU - Zhu, Leying
AU  - Zhu L
AD  - Department of Rehabilitation, Guangdong Provincial Hospital of Chinese Medicine, 
      the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 
      Guangzhou, China.
FAU - Xu, Fanfeng
AU  - Xu F
AD  - Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese 
      Medicine, Guangzhou, China.
FAU - Wang, Yuan
AU  - Wang Y
AD  - Department of Rehabilitation, Guangdong Provincial Hospital of Chinese Medicine, 
      the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 
      Guangzhou, China.
FAU - Chen, Hongxia
AU  - Chen H
AD  - Department of Rehabilitation, Guangdong Provincial Hospital of Chinese Medicine, 
      the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 
      Guangzhou, China.
FAU - Zhan, Lechang
AU  - Zhan L
AD  - Department of Rehabilitation, Guangdong Provincial Hospital of Chinese Medicine, 
      the Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 
      Guangzhou, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Humans
MH  - *Shoulder Pain/etiology/therapy
MH  - Randomized Controlled Trials as Topic
MH  - Activities of Daily Living
MH  - *Acupuncture Therapy/methods
MH  - Upper Extremity
PMC - PMC10662925
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2023/07/21 19:10
MHDA- 2023/07/24 06:42
PMCR- 2023/07/21
CRDT- 2023/07/21 14:04
PHST- 2023/07/24 06:42 [medline]
PHST- 2023/07/21 19:10 [pubmed]
PHST- 2023/07/21 14:04 [entrez]
PHST- 2023/07/21 00:00 [pmc-release]
AID - 00005792-202307210-00034 [pii]
AID - 10.1097/MD.0000000000034266 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2023 Jul 21;102(29):e34266. doi: 
      10.1097/MD.0000000000034266.