title: Effectiveness of acupuncture combined with rehabilitation for treatment of acute or subacute stroke: a systematic review.
abstract: OBJECTIVE
  To determine whether the combination of acupuncture and rehabilitation produces better results in the treatment of acute or subacute stroke sequelae than rehabilitation alone.
  
  
  METHODS
  A systematic review was carried out. A search was conducted in March 2014 using PubMed, Medline, the Cochrane Library, Chinese National Knowledge Infrastructure database (CNKI) and Wanfang databases. English and Chinese language articles published within 10 years of the search were reviewed for inclusion. Randomised control trials comparing combined treatment with acupuncture and rehabilitation and rehabilitation alone in patients with acute or subacute stroke (onset until 3 months after stroke) were included in this review. Three review authors independently checked the titles and abstracts of trials for inclusion based on selection criteria. Studies measuring changes of motor function, activities of daily living, neurological deficit or spasticity/range of motion during the treatment period and at the end of follow-up were included.
  
  
  RESULTS
  17 trials met the inclusion criteria, of which five were of good quality. 14 trials had results favourable to acupuncture combined with rehabilitation, compared with conventional rehabilitation treatment alone.
  
  
  CONCLUSIONS
  Acupuncture in combination with rehabilitation may have benefits for the treatment of acute and subacute stroke sequelae in comparison with rehabilitation alone. However, many of the studies were at risk of bias. Future studies should focus on reaching a consensus about the most appropriate modality of acupuncture intervention, and the appropriate length of treatment for both interventions, to maximise the potential synergistic outcomes.
authors.affiliation: Tianjin University of Traditional Chinese Medicine, Tianjin, China.
authors.forename: Larissa
authors.initials: L
authors.lastname: Vados
authors.affiliation: Tianjin University of Traditional Chinese Medicine, Tianjin, China.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ferreira
authors.affiliation: Tianjin University of Traditional Chinese Medicine, Tianjin, China.
authors.forename: ShouFa
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Laboratory of Pharmacology of Pain & Neuromodulation, Instituto de Ciências Básicas da Saúde-ICBS, Universidade Federal do Rio Grande do Sul-UFRGS, Porto Alegre, Brasil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Vercelino
authors.affiliation: First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Wang
mesh_terms: D015670:Acupuncture Therapy; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006801:Humans; D020521:Stroke / Q000628:therapy*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
keywords: ACUPUNCTURE; PHYSIOTHERAPY; STROKE