Advertisement

Wiener klinische Wochenschrift

, Volume 131, Issue 9–10, pp 221–232 | Cite as

Acupuncture is effective in improving functional communication in post-stroke aphasia

A systematic review and meta-analysis of randomized controlled trials
  • Binlong Zhang
  • Yi Han
  • Xing Huang
  • Zhaolan Liu
  • Shuren Li
  • Jingling ChangEmail author
  • Ying GaoEmail author
review article

Summary

Objective

In this meta-analysis the authors evaluated the effectiveness of acupuncture in improving functional communication and language function in post-stroke aphasia (PSA) patients.

Methods

Data sources: MEDLINE, EMBASE, CENTRAL, AMED, SinoMed, CNKI, VIP, and Wanfang databases, ICTRP, ISRCTN, EUCTR, ClinicalTrials.gov, and Stroke Trials Registries. A search was carried out for randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or placebo acupuncture on post-stroke aphasia (PSA). The searched records were independently screened by two authors, who extracted the data, and assessed risk of bias of the included RCTs. Data aggregation and risk of bias evaluation were conducted on Review Manager Version 5.3. The protocol was registered in the PROSPERO database (CRD42016037543).

Results

A total of 28 RCTs involving 1747 patients (883 patients in the treatment group and 864 patients in the control group) were included in the quantitative synthesis. The results demonstrated significant effects of acupuncture in improving PSA functional communication (P < 0.00001, standardized mean difference (SMD) = 1.01 [0.81, 1.20]), severity of impairment (P < 0.0001, SMD = 0.64 [0.45, 0.84]), spontaneous speech (P = 0.0002, SMD = 1.51 [0.71, 2.32]), auditory comprehension (P < 0.0001, SMD = 0.84 [0.43, 1.26]), repetition (P < 0.00001, SMD = 1.13 [0.75, 1.52]), naming (P = 0.03, SMD = 0.65 [0.08, 1.23]), reading (P < 0.0001, SMD = 1.56 [0.83, 2.29]), and writing (P = 0.009, SMD = 1.03 [0.25, 1.80]).

Conclusion

Acupuncture seems to be effective in improving PSA functional communication and language function.

Keywords

Alternative medicine Language impairment Rehabilitation Systematic review Meta-analysis 

Notes

Acknowledgements

We would like to thank Professor Jian Kong for his great help in improving this manuscript.

Funding

This project was supported by the Special Public Welfare Industry and Scientific Research from State Administration of Traditional Chinese Medicine (project No. 201407001-9) and the National Science Foundation of China (project No. 81473654).

Conflict of interest

B. Zhang, Y. Han, X. Huang, Z. Liu, S. Li, J. Chang and Y. Gao declare that they have no competing interests.

References

  1. 1.
    Vos T, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, GBD 2016 Disease and Injury Incidence and Prevalence Collaborators, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1211–59.CrossRefGoogle Scholar
  2. 2.
    Davis GA. Aphasiology: Disorders and clinical practice. 2nd ed. Boston: Pearson; 2006.Google Scholar
  3. 3.
    Gottesman RF, Hillis AE. Predictors and assessment of cognitive dysfunction resulting from ischaemic stroke. Lancet Neurol. 2010;9:895–905.CrossRefGoogle Scholar
  4. 4.
    Inatomi Y, Yonehara T, Omiya S, Hashimoto Y, Hirano T, Uchino M. Aphasia during the acute phase in ischemic stroke. Cerebrovasc Dis. 2008;25:316–23.CrossRefGoogle Scholar
  5. 5.
    Engelter ST, Gostynski M, Papa S, et al. Epidemiology of aphasia attributable to first ischemic stroke: Incidence, severity, fluency, etiology, and thrombolysis. Stroke. 2006;37:1379–84.CrossRefGoogle Scholar
  6. 6.
    Brady MC, Kelly H, Godwin J, Enderby P, Campbell P. Speech and language therapy for aphasia following stroke. Cochrane Database Syst Rev. 2016;  https://doi.org/10.1002/14651858.cd000425.pub4.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Elsner B, Kugler J, Pohl M, Mehrholz J. Transcranial direct current stimulation (tDCS) for improving aphasia in patients with aphasia after stroke. Cochrane Database Syst Rev. 2015;  https://doi.org/10.1002/14651858.cd009760.pub3.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Berthier ML, Pulvermuller F, Davila G, Casares NG, Gutierrez A. Drug therapy of post-stroke aphasia: A review of current evidence. Neuropsychol Rev. 2011;21:302–17.CrossRefGoogle Scholar
  9. 9.
    Zhang S, Wu B, Liu M, et al. Acupuncture efficacy on ischemic stroke recovery: Multicenter randomized controlled trial in China. Stroke. 2015;46:1301–6.CrossRefGoogle Scholar
  10. 10.
    Peng L, Zhang C, Zhou L, Zuo HX, He XK, Niu YM. Traditional manual acupuncture combined with rehabilitation therapy for shoulder hand syndrome after stroke within the Chinese healthcare system: A systematic review and meta-analysis. Clin Rehabil. 2018;32:429–39.CrossRefGoogle Scholar
  11. 11.
    Chang J, Gao Y, Li S, Wang J. Effect of acupuncture and speech rehabilitation on motor aphasia after stroke. Chin J Rehabil Theory Pract. 2010;16(1):58–9.Google Scholar
  12. 12.
    Jiang H, Zhou Y, Liang X. Integrative analysis of clinical efficacy in patients with motor aphasia and its impact on the quality of the language of daily life after stroke. Chin Arch Tradit Chin Med. 2015;33:1235–7.Google Scholar
  13. 13.
    Wang M. Combining scalp acupuncture, tongue acupuncture and language rehabilitation for post-acute-stroke aphasia. J Bethune Med Sci. 2016;14:740–1.Google Scholar
  14. 14.
    Glass GV. Research, primary secondary and Meta-analysis. Educ Res. 1976;5:3–8.CrossRefGoogle Scholar
  15. 15.
    Armstrong E, Ferguson A. Language, meaning, context, and functional communication. Aphasiology. 2010;24:480–96.CrossRefGoogle Scholar
  16. 16.
    Zhu D, Gao Y, Chang J, Kong J. Placebo acupuncture devices: Considerations for acupuncture research. Evid Based Complement Alternat Med. 2013;2013:1–9.  https://doi.org/10.1155/2013/628907.CrossRefGoogle Scholar
  17. 17.
    Gialanella B. Aphasia assessment and functional outcome prediction in patients with aphasia after stroke. J Neurol. 2011;258:343–9.CrossRefGoogle Scholar
  18. 18.
    Marini A, Andreetta S, del Tin S, Carlomagno S. A multi-level approach to the analysis of narrative language in aphasia. Aphasiology. 2011;25:1372–92.CrossRefGoogle Scholar
  19. 19.
    Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0. 2011. http://handbook-5-1.cochrane.org/..Google Scholar
  20. 20.
    Shi X, Wang H, Wang L, et al. Can tongue acupuncture enhance body acupuncture? First results from heart rate variability and clinical scores in patients with depression. Evid Based Complement Alternat Med. 2014.  https://doi.org/10.1155/2014/329746.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Wang WW, Xie CL, Lu L, Zheng GQ. A systematic review and meta-analysis of Baihui (GV20)-based scalp acupuncture in experimental ischemic stroke. Sci Rep. 2014;4(1)  https://doi.org/10.1038/srep03981.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Liu J, Song KH, You MJ, Son DS, Cho SW, Kim DH. The effect of oculo-acupuncture on recovery from ethylene glycol-induced acute renal injury in dogs. Am J Chin Med. 2007;35:241–50.CrossRefGoogle Scholar
  23. 23.
    Zhou Y. The clinical efficacy of scalp electro-acupuncture combined with aphasia (uygur) training system treating for the uygur patients with aphasia. Xinjiang: Xinjiang Medical University; 2015.Google Scholar
  24. 24.
    Li A, Xiao W, Wang Y. A follow-up study of poststroke aphasia recovery using acupuncture and donepezfil. J New Med. 2013;44:832–5.Google Scholar
  25. 25.
    Ren YL, Guo TP, Du HB, et al. A survey of the practice and perspectives of chinese acupuncturists on deqi. Evid Based Complement Alternat Med. 2015.  https://doi.org/10.1155/2015/684708.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Zhang H. Clinical treatment of apoplectic Aphemia with multi-needle puncture of scalp-points in combination with visual-listening-speech training. Chen Tzu Yen Chiu. 2007;32(3):190–4.PubMedGoogle Scholar
  27. 27.
    Lu Q, Kang B. Clinical observation of acupuncture combined with language rehabilitation for poststroke aphasia. 2010. pp. 179–81.Google Scholar
  28. 28.
    Zheng Q, Yu B, Li Y. Clinical study of acupuncture with language training for aphasia after stroke. J Liaoning Univ Tcm. 2011;13(1):105–7.Google Scholar
  29. 29.
    Xie Z. Clinical Research of acupuncture combined head and body language rehabilitation after stroke motor aphasia. Guangzhou: Guangzhou University of Chinese Medicine; 2014.Google Scholar
  30. 30.
    Hu X, Zhou W. Clinical Observation of puncturing meridians therapy for post stroke ganglion aphasia. Lishizhen Med Materia Medica Res. 2010;21:2084–2085.Google Scholar
  31. 31.
    Li Y. Clinical research on aphasia from apoplexy treated by acupuncture needling integrated with language training. Hunan: Hunan University of Chinese Medicine; 2009.Google Scholar
  32. 32.
    Sun Q, Ji X, Cui Z. Observation on the therapeutic effect of scalp acupuncture, plum-blossom needle combined with speech rehabilitation training on aphasia of ischemic apoplexy. World J Acupunct Moxibustion. 2010;20:13–8.Google Scholar
  33. 33.
    Wang G, Liu L, Li L, Dong B, Wang S. Clinic observation on motor aphasia after stroke by acupuncture and psychological intervention combined with rehabilitation training. J Liaoning Univ Tcm. 2015;17:5–8.CrossRefGoogle Scholar
  34. 34.
    Zhou Y, Song J, Li X, Li X. Sichong point Yinzhong Yinyang acupuncture combined with Schuell language training for aphasia after Ischemic stroke. J Clin Acupunct Moxibustion. 2015;32(7):26–8.Google Scholar
  35. 35.
    Yang L, Guo Y. Clinical study of scalp electroacupuncture combined with language training on post-stroke aphasia patients. Chin J Rehabil Med. 2017;32:305–8.Google Scholar
  36. 36.
    Tan J, Zhang H, Han G, Ai K, Deng S. Acupuncture for aphasia: A retrospective analysis of clinical literature. Zhongguo Zhen Jiu. 2016;36:431–6.PubMedGoogle Scholar
  37. 37.
    Zhang Y, Fu L, Zhu Y, Xue P. Acupuncture treatment for aphasia after stroke: A systematic review. J Clin Acupunct Moxibustion. 2014;31:62–5.Google Scholar
  38. 38.
    Pan D. A meta analysis of acupuncture for post stroke aphasia. Shandong Med J. 2013;53:87–9.Google Scholar
  39. 39.
    Sun Y, Xue SA, Zuo Z. Acupuncture therapy on apoplectic aphasia rehabilitation. J Tradit Chin Med. 2012;32:314–21.CrossRefGoogle Scholar
  40. 40.
    Pang Y, Wu LB, Liu DH. Acupuncture therapy for apoplectic aphasia: A systematic review. Zhongguo Zhen Jiu. 2010;30:612–6.PubMedGoogle Scholar
  41. 41.
    Li YF, Kurabayashi Y, Zhao SH, et al. Meta analysis on acupuncture treatment of aphasia. zhen Ci Yan Jiu. 2010;35:468–73.PubMedGoogle Scholar
  42. 42.
    Jiang Y, Zhou Y, Wang B, Tang S, Niu W. The efficacy of acupuncture on treating aphasia following stroke: A Meta-analysis. Xinjiang Med J. 2016;46:1237–41.Google Scholar
  43. 43.
    Gao S. Aphasia. Beijing: Peking University Medical Press; 2005.Google Scholar
  44. 44.
    Gao S, Zhe Y, Shi S. The research of the standardization of aphasia battery of Chinese. Chin Ment Health J. 1992;6(3):125–8.Google Scholar
  45. 45.
    Dong B. Study of the combination of scalp acupuncture and body acupuncture in treating acute ischemic stroke patients with Broca aphasia. Beijing: Beijing University of Chinese Medicine; 2011.Google Scholar
  46. 46.
    Gu Y. Clinical research on acupuncture in Jinjinyuye point with speech therapy for Broca aphasia following stroke. Fujian: Fujian University of Chinese Medicine; 2009.Google Scholar
  47. 47.
    Stroke Foundation. Clinical guidelines for stroke management 2017. 2017. https://informme.org.au/en/Guidelines/Clinical-Guidelines-for-Stroke-Management-2017..Google Scholar
  48. 48.
    Winstein CJ, Stein J, Arena R, et al. Guidelines for adult stroke rehabilitation and recovery: A guideline for Healthcare professionals from the American heart association/American stroke association. Stroke. 2016;47:e98–e169.CrossRefGoogle Scholar
  49. 49.
    Zhang T. Chinese guideline of stroke rehabilitation. Chin J Rehabil Theory Pract. 2012;18:301–18.Google Scholar
  50. 50.
    Wu Q, Hu X, Wen X, Li F, Fu W. Clinical study of acupuncture treatment on motor aphasia after stroke. Technol Health Care. 2016;24(Suppl 2):691–6.CrossRefGoogle Scholar
  51. 51.
    Tao J, Fang Y, Wu Z, et al. Community-applied research of a traditional Chinese medicine rehabilitation scheme on Broca’s aphasia after stroke: Study protocol for a randomized controlled trial. Trials. 2014;15:290.CrossRefGoogle Scholar
  52. 52.
    Chang J, Zhang H, Tan Z, Xiao J, Li S, Gao Y. Effect of electroacupuncture in patients with post-stroke motor aphasia: Neurolinguistic and neuroimaging characteristics. Wien Klin Wochenschr. 2017;129:102–9.CrossRefGoogle Scholar
  53. 53.
    Li G, Yang ES. An fMRI study of acupuncture-induced brain activation of aphasia stroke patients. complementary Ther Med. 2011;19(Suppl 1):S49–59.CrossRefGoogle Scholar
  54. 54.
    Chau AC, Fai Cheung RT, Jiang X, Au-Yeung PK, Li LS. An fMRI study showing the effect of acupuncture in chronic stage stroke patients with aphasia. J Acupunct Meridian Stud. 2010;3:53–7.CrossRefGoogle Scholar
  55. 55.
    Xian Y, Chen J. Effect of acupuncture plus language function training on language function in patients with post-stroke aphasia. J China Prescr Drug. 2016;14:1–2.Google Scholar
  56. 56.
    Wang N, Li Y. Therapeutic observation of cluster needling at anterior oblique line of vertex-temporal plus speech training for motor aphasia after cerebral infarction. shanghai J Acu-mox. 2015;34:412–4.Google Scholar
  57. 57.
    Shao B. Clinical research on acupuncture in root and end and appearance and substance of kidney meridian associated with language training for Broca aphasia following the stroke. Fujian: Fujian University of Chinese Medicine; 2012.Google Scholar
  58. 58.
    Wang L, Liu S, Liu M. Post-stroke speech disorder treated with acupuncture and psychological intervention combined with rehabilitation training: A randomized controlled trial. Chin Acupunct Moxibustion. 2011;31:481–6.Google Scholar
  59. 59.
    Luo W, Huang H, Zhu J. Clinical research on Broca aphasia from Ischemic apoplexy treated by acupuncture Associtated with language training. Chin Arch Tradit Chin Med. 2010;29:2451–4.Google Scholar
  60. 60.
    Mu J, Fu L, Lu Y. Clinical observation on the Xingnao Kaiqiao acupuncture plus language rehabilitation training for motor aphasia caused by cerebral infarction: A report of 30 cases. J Tradit Chin Med. 2010;30:428–31.Google Scholar
  61. 61.
    Wu F, Yang W, Zhao N. Influence of Tongli acupuncture combined with speech function rehabilitation training on speech Functionon in patients with motor aphasia after cerebral infarction. Chin J Integr Med Cardio-cerebrovascular Dis. 2010;8:290–2.Google Scholar
  62. 62.
    Luo W, Tan J, Huang H. Clinical observation on treatment of cerebral infarction-induced broca aphasia by Tiaoshen Fuyin acupuncture therapy combined with language training. Chin Acupunct Moxibustion. 2008;28(3):171–5.Google Scholar
  63. 63.
    Liu L, Guo R, Feng S. Clinical research of acupuncture combined with language rehabilitation for early stroke aphasia. Chin Arch Tradit Chin Med. 2006;24:2256–9.Google Scholar
  64. 64.
    Wang Y. Clinical research on aphasia from apoplexy treated by skull slot needling integrated with language training. Fujian: Fujian University of Chinese Medicine; 2006.Google Scholar
  65. 65.
    Zhang B. Treating Nonfluent aphasia following stroke by scalp acupuncture with speech therapy. Fujian: Fujian University of Chinese Medicine; 2005.Google Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Neurology, Dongzhimen HospitalBeijing University of Chinese MedicineBeijingChina
  2. 2.Key Laboratory of Encephalopathy Treatment of Chinese MedicineState Administration of Traditional Chinese Medicine of the Peoples Republic of ChinaBeijingChina
  3. 3.Center for Evidence-Based Chinese MedicineBeijing University of Chinese MedicineBeijingChina
  4. 4.Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided TherapyMedical University of ViennaViennaAustria

Personalised recommendations