Is the addition of acupuncture and related therapies providing extra benefits to post-stroke patients with dysphagia who are receiving usual conventional care?
Date of publication of the systematic review: July 2008
Design
Systematic review of randomized controlled trials (RCTs).
Participants
66 patients with dysphagia within 30 days after the onset of ischaemic or haemorrhagic stroke (mean age: 62.1 years, age range: 41 to 79 years, male %: 62%).
Intervention
Manual and electro-acupuncture administered on scalp, neck and/or body (treatment session 30 minutes daily for 7 days. 3 treatment sessions required, at 2-day intervals)
Comparator
Comparison: Acupuncture and related therapies plus usual treatment versus usual treatment alone.
Major Outcomes
Outcome 1: Marked improvement (nearly complete resolution of dysphagia and dysarthria, i.e. resumption of normal feeding with occasional bucking and normal speech with slight dysarthria) at the end of treatment (25 days).
Settings
The included trials were conducted in both inpatient and outpatient settings in mainland China.
Comparison    Acupuncture and related therapies plus usual treatment versus usual treatment alone
Main Results
Compared to usual treatment alone, the combination of acupuncture and usual treatment significantly increased the rate of marked improvement (relative risk increment (RRI): 49%, 95% CI: 3% to 116%).
Comparison: Acupuncture and related therapies plus usual treatment versus usual treatment alone in patients with dysphasia
Outcomes (units) No. of studies (Total number pf participants) No. of events/No. of participants Heterogeneity test (I2) RRI (95% CI) Overall quality of evidence*
Intervention Comparator
1(NA) 1 (66) 27/34 17/32 Not applicable as there is only 1 study. 49% (3% to 116%) Moderate
Keys: RRI: relative risk increment; CI: confidence interval.
Comparison    Acupuncture and related therapies plus usual treatment versus usual treatment alone
Main Results
Compared to usual treatment alone, the combination of acupuncture and usual treatment significantly increased the rate of marked improvement (relative risk increment (RRI): 49%, 95% CI: 3% to 116%).
Comparison: Acupuncture and related therapies plus usual treatment versus usual treatment alone in patients with dysphasia
Outcomes (units) 1(NA)
No. of studies (Total number pf participants) 1 (66)
No. of events/No. of participants Intervention 27/34
Comparator 17/32
RRI (95% CI) 49% (3% to 116%)
Overall quality of evidence* Moderate
Keys: RRI: relative risk increment; CI: confidence interval.
Conclusion
Benefits
Compared to usual treatment alone, addition of acupuncture and related therapies significantly increased the rate of marked symptom improvement. For all outcomes, the overall quality of evidence is moderate. Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
Harms
No adverse events were recorded by the reviewer.
Link to Original Article
http://www.ncbi.nlm.nih.gov/pubmed/18646136
The synopsis is based on the following article:
Xie Y, Wang L, He J, Wu T. Acupuncture for dysphagia in acute stroke. Cochrane Database of Systematic Reviews. Chichester, UK: John Wiley & Sons, Ltd, 2008.


* Interpretation of quality assessment results:
• Very low: Further research is most likely to have an important impact on our confidence in this estimate of effect.
• Low: Further research is likely to have an important impact on our confidence in this estimate of effect.
• Moderate: Further research is fairly likely to have an important impact on our confidence in this estimate of effect.
• High: Further research is unlikely to have an important impact on our confidence in this estimate of effect.
• Very high: Further research is most unlikely to have an important impact on our confidence in this estimate of effect.

Details of assessment method can be found at Chung VC, Wu XY, Ziea ET, Ng BF, Wong SY, Wu JC. Assessing internal validity of clinical evidence on effectiveness of CHinese and integrative medicine: Proposed framework for a CHinese and Integrative Medicine Evidence RAting System (CHIMERAS). European Journal of Integrative Medicine. 2015 Aug 31;7(4):332-41.