To evaluate the effects and safety of electro-acupuncture (EA) for stroke patients with spasticity.
Five English (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and AMED) and four Chinese databases (CBM, CNKI, CQVIP and Wanfang) were searched from their inception to September 2016.
Randomized controlled trials were included if they measured spasticity with Modified Ashworth Scale in stroke patients and investigated the add-on effects of electro-acupuncture to routine pharmacotherapy and rehabilitation therapies.
Information on patients, study design, treatment details and outcomes assessing spasticity severity, motor function and activity of daily living were extracted.
In total, 22 trials met the search criteria and were included involving 1,425 participants. The estimated add-on effects of EA to reduce spasticity in upper limb measured by MAS (SMD: -0.57[-0.84, -0.29]) and improve overall motor function measured by FMA (MD: 10.60[8.67, 12.53]) were significant. It was also found that for spasticity in lower limb, lower-limb motor function and activity of daily living, significant add-on effects of EA were also shown (SMD: -0.88[-1.42, -0.35], MD:4.42[0.06, 8.78] and MD: 6.85[3.64, 10.05] respectively), though with high heterogeneity. For upper-limb motor function, no significant add-on effects of EA was received.
Electro-acupuncture combined with conventional routine care has the potential of reducing spasticity in upper and lower limb and improving overall and lower extremity motor function and activity of daily living for spasticity patients within 180 days post stroke. Further studies of high methodological and reporting quality are needed to confirm the effects and safety of electro-acupuncture, and to explore the adequate and optimal protocol of EA for post-stroke spasticity incorporating a group of comprehensive outcome measures in different populations.