Comment on: Acupuncture for acute stroke

Might acupuncture reduce mortality and disability or improve quality of life for persons affected by acute Stroke?

For centuries, acupuncture has been widely used in Traditional Chinese Medicine to treat many conditions, including stroke. Indeed, acupuncture has been shown to induce various biochemical effects, exerting influence on muscles and on several neural systems. Acupuncture generally is well accepted by patients and doctors in China and is gaining interest in Western countries. As current therapies for stroke have limited effects in controlling high stroke mortality and disability rates, the search for adjunctive therapies is of paramount importance.  In 2005, a Cochrane Review found no clear evidence of the benefits of acupuncture for acute stroke. However, growing evidence has prompted scientists to update the Review.  This Cochrane Review focused on the effects of acupuncture on stroke mortality and disability and on the quality of life of stroke survivors. Data were available from 22 randomized controlled trials with a total of 2,865 participants. Only 6 trials compared acupuncture to a sham procedure, while all other studies compared acupuncture to any control. Unfortunately, this turned out to be the main limitation of current evidence: At the end of the follow-up and over time (>3 months), none of the apparent, if small, gains in stroke mortality and disability, nor the uncertain improvements of global neurological score and motor function, reported in trials comparing acupuncture with any control were confirmed in the generally more reliable trials comparing acupuncture with a sham procedure.On the other hand, the good news is that reported adverse events were minor overall and rarely resulted in discontinuing treatment.So, if we now can say that acupuncture for acute stroke is reasonably safe, we cannot be as confident as to its effectiveness. As most of the evidence was low quality, only future studies that are more rigorous as to randomization and double-blind controls will enable us to confirm or refute any short- or long-term effects of acupuncture in acute stroke.


Comment by Francesca Cecchi