title: Acupuncture for functional recovery after stroke: a systematic review of sham-controlled randomized clinical trials.
abstract: BACKGROUND
  Acupuncture is frequently advocated as an adjunct treatment during stroke rehabilitation. The aim of this review was to assess its effectiveness in this setting.
  
  
  METHODS
  We searched 25 databases and 12 major Korean traditional medicine journals from their inception to October 2009. We included randomized controlled trials, with no language restrictions, that compared the effects of acupuncture (with or without electrical stimulation) with sham acupuncture. We assessed the methodologic quality of the trials using the Cochrane risk-of-bias criteria and the PEDro (Physiotherapy Evidence Database) scale.
  
  
  RESULTS
  Ten of 664 potentially relevant studies met our inclusion criteria. For acute and subacute stages after stroke, we included seven trials. A meta-analysis of the five studies that assessed functionality did not show a significant difference in favour of acupuncture, with high heterogeneity. A post-hoc sensitivity analysis of three trials with low risk of bias did not show beneficial effects of acupuncture on activities of daily living at the end of the intervention period (n = 244; standard mean difference 0.07, 95% confidence interval [CI] -0.18 to 0.32; I(2) = 0%) or after follow-up (n = 244; standard mean difference 0.10, 95% CI -0.15 to 0.35; I(2) = 0%). For the chronic stage after stroke, three trials tested effects of acupuncture on function according to the Modified Ashworth Scale; all failed to show favourable effects.
  
  
  CONCLUSIONS
  Our meta-analyses of data from rigorous randomized sham-controlled trials did not show a positive effect of acupuncture as a treatment for functional recovery after stroke.
authors.affiliation: Department of Oriental Rehabilitation Medicine, College of Oriental Medicine, Wonkwang University, Iksan, South Korea.
authors.forename: Jae Cheol
authors.initials: JC
authors.lastname: Kong
authors.forename: Myeong Soo
authors.initials: MS
authors.lastname: Lee
authors.forename: Byung-Cheul
authors.initials: BC
authors.lastname: Shin
authors.forename: Yung-Sun
authors.initials: YS
authors.lastname: Song
authors.forename: Edzard
authors.initials: E
authors.lastname: Ernst
mesh_terms: D000203:Activities of Daily Living; D015670:Acupuncture Therapy / Q000379:methods*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D020521:Stroke / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome