康复学报 (Dec 2023)
Meta-Analysis of Acupuncture on Physical and Activity Participation Related Functions of Children with Autism Spectrum Disorders
Abstract
ObjectiveWith reference to the theory and framework of the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), a meta-analysis was conducted to evaluate the effect of acupuncture on physical and activity participation functions of children with autism spectrum disorder (ASD).MethodsData were searched from Chinese and English databases such as Web of Science, Cochrane Library, Embase, PubMed, VIP, CBMdisc, Wanfang Data and CNKI. The randomized controlled trials (RCTs) of acupuncture for children with ASD were included, and the retrieval time was from inception to November 12, 2022. The primary outcome measures included autism behavior checklist (ABC) score, autism treatment evaluation checklist (ATEC) score, psycho educational profile-Third Edition (PEP-3) score, children's sleep habits questionnaire (CSHQ) score, Gesell developmental schedules (GDS) score, functional independence measure for children (WeeFIM) score, Reynell developmental language scales (RDLS) score and Arabic language testing (ALT) score. Two researchers independently conducted literature screening, data extraction and quality assessment, and the Cochrane Risk of Bias tool was used for quality assessment. Review Manager 5.4 software was used for meta-analysis, continuous variables were expressed with a 95% confidence interval (95% CI). Mean difference (MD) was used when the same scale was used for evaluation. Standardized mean difference (SMD) was used when different scales were used. The heterogeneity was determined according to the P value and I2 value. If P≥0.10 and I2≤50%, there was no heterogeneity or small heterogeneity among the studies, a fixed effect model would be used. If P<0.1 and I2>50%, a random effects model would be used.ResultsA total of 13 RCTs with 730 patients were included. Meta-analysis results showed that, (1) In terms of physical function: compared with the control group, the emotional function score of the experimental group was significantly higher [SMD=0.76, 95% CI (0.50, 1.03), P<0.000 01]; sleep function score was significantly lower [MD=-6.74, 95% CI (-8.31, -5.17), P<0.000 01], and cognitive function score was significantly higher [SMD=1.14, 95% CI (0.85, 1.42), P<0.000 01]. (2) In terms of activity participation: compared with the control group, the score of healthy behavior in the experimental group was significantly lower [MD=-2.63, 95% CI (-3.68, -1.59), P<0.000 01], the score of expression ability was significantly higher [SMD=0.81, 95% CI (0.55, 1.08), P<0.000 01], and the score of social ability was significantly lower [SMD=-0.70, 95% CI (-0.88, -0.53), P<0.000 01].ConclusionAcupuncture can significantly improve the physical and activity participation functions such as emotion, sleep, cognition, social interaction, and language expression of children with ASD, which is recommended for further clinical application.
