Acupuncture not effective in stroke recovery

Acupuncture does not appear to aid in stroke recovery, according to a new study published in CMAJ (Canadian Medical Association Journal).

Acupuncture is often used to supplement traditional stroke rehabilitation, although its effectiveness is uncertain. It is necessary to have evidence of effectiveness from rigourous randomised clinical trials to recommend routine therapeutic use.

This study, perhaps the most comprehensive to date as it includes trials published in English language and Asian journals, was a systematic review conducted by researchers in South Korea and the United Kingdom. They included 10 studies (out of a potential 664) with a total of 711 patients who had had strokes.

'Few randomised, sham-controlled trials have tested the effectiveness of acupuncture during stroke rehabilitation,' writes Dr Edzard Ernst, Peninsula Medical School, Exeter, England with coauthors. 'The majority of the existing studies do not suggest that acupuncture is effective.' They note that the only two studies showing positive effect were highly biased and had poor reporting which made them less reliable that the others included.

The authors conclude that 'the evidence from rigourous studies testing the effectiveness of acupuncture during stroke rehabilitation is negative.'

In a related commentary, Dr Hongmei Wu of West China Hospital, Sichuan University in Chengdu, China writes 'the negative effects of true acupuncture for stroke recovery based on the systematic review of sham-controlled trials by Jae Cheol Kong and colleagues should be interpreted cautiously.' She cautions that the study included several weaknesses, such as many of the included studies had small samples sizes and that the quality of acupuncture which varied in the papers is related to effectiveness. Dr Wu calls for large, rigourous, well-designed trials to better understand the effects of acupuncture and stroke recovery.