Efficacy of Acupuncture-based Treatment in Post-stroke Aphasia: an Overview of Systematic Reviews

Abstract

Background Stroke is one of the leading causes of death and disability worldwide. The incidence of aphasia resulting from first-ever ischemic stroke is about 30%. Current guideline-recommended therapy is often challenging to achieve a satisfactory outcome, but numerous studies have shown that the treatment benefit could be increased if acupuncture therapy is used in a combined approach. Objective To give an overview of systematic reviews/meta-analyses of acupuncture-based treatment for post-stroke aphasia (PSA) . Methods Systematic reviews/meta-analyses of the efficacy of acupuncture-based treatment in PSA were searched in databases of CNKI, Wanfang Data, VIP, SinoMed, Cochrane Library, PubMed and EMBase from inception to July 2021. Literature enrollment and data extraction were performed by two researchers, respectively. The AMSTAR 2, PRISMA statement, and GRADE classification were used to evaluate methodological quality, the quality of reporting and the quality of evidence for outcome indicators, respectively. The results of overview were analysed in a comprehensive manner. Results A total of 12 systematic reviews/meta-analyses were included. One was of moderate methodological quality, five were of low quality and six were of critically low. Mainly due to the absence of a description of the pre-design protocol, the quality of majority of studies was rated low or critically low. The 12 studies had PRISMA scores ranging from 17 to 25, 7 of which with scores of 20-25 were considered relatively complete, and 5 with scores of 17-19 were considered to have certain defects. Fifty-four pieces of evidence were summarized from the studies, 12 of which were rated as moderate by GRADE in terms of quality, 24 were rated as low, and 18 very low. Conclusion In accordance with the evidence of moderate quality, compared with speech rehabilitation alone, acupuncture with speech rehabilitation could better improve the speech impairment, auditory comprehension, repetition and reading ability, and acupuncture-based treatment could better improve the overall clinical response in patients with PSA, so acupuncture therapy is recommended for clinical use. However, the efficacy of acupuncture in PSA is needs to be verified further by clinical evidence derived from more high-quality original studies using a strict evidence development process.

Keywords

• post-stroke aphasia|acupuncture|traditional chinese medicine therapy|systematic review re-evaluation|amstar 2|prisma|grade