Efficacy and safety of manual acupuncture for the treatment of upper limb motor dysfunction after stroke: Protocol for a systematic review and meta-analysis

Bibliometric Analysis: Research Trends and Performances of Stroke on Acupuncture

Purpose

This study aimed to apply the bibliometric analysis to summarize acupuncture therapy for stroke, demonstrated and evaluated the trends, major research hotspots and frontier areas.

Materials and Methods

Articles on acupuncture for stroke were selected from the Web of Science Core Collection (WoSCC) from the inception of the database up until 2023. CiteSpace software was performed to conduct the collaborative analysis of networks of countries, institutions, authors and cited authors, journals and cited journals, cited references, keywords clustering and burstiness analysis.

Results

A total of 1141 articles were retrieved. China was the most productive country (851) and had the greatest centrality (0.43). Beijing Univ Chinese Med (86) contributed to the most publications. Chen LD (31) and Tao J (31) were the most prolific authors, of which all from Fujian Univ Tradit Chinese Med. Wu P (124) from Canadian College of Naturopathic Medicine, Canada, was the most cited author. Evidence-based Complementary and Alternative Medicine (89) was the most productive journal, while Stroke (744) was first cited journals. Stimulation, recovery, ischemic stroke, electroacupuncture, rehabilitation were the most high-frequency keywords. Future research in this area will pay more attention to the evaluation of the effectiveness of acupuncture therapeutics in treating stroke, conducting the clinical research on cognitive ability, quality of life and partial function of stroke patients, and basic research related to mechanisms.

Conclusion

The publications on acupuncture in stroke have shown major development, but the international cooperation for academic exchange among researchers and institutions remained to be strengthened to promote interdisciplinary and academic innovation. Furthermore, except for the molecular mechanism of acupuncture in treating functional rehabilitation of stroke, exploring the more high-quality clinical studies may become a key point based on the evidence-based medicine.

Effect of auricular acupuncture on neuroplasticity of stroke patients with motor dysfunction: A fNIRS study

Cerebral Stroke is an acute cerebrovascular disease, a disease of brain tissue damage caused by the sudden rupture or blockage of blood vessels in the brain that prevents blood flow to the brain. Acupuncture has become a popular treatment for stroke, with auricular acupuncture providing a new idea for stroke treatment. However, the neuromodulatory mechanism of auricular acupuncture in the brain is still unclear. The aim of this study was to investigate the effect of auricular acupuncture in the treatment of upper limb dysfunction and the activation of specific brain regions in stroke patients. Forty patients with stroke hemiplegia who met the nerf criteria were included in the experiment and randomly assigned into two groups (20 patients in each group): the auricular acupuncture group and the control group. Fugl-Meyer score (FMA) assessment of upper limb motor function, motor evoked potential (MEP) measurement, and functional near-infrared brain function imaging (fNIRS) data acquisition in the primary motor M1 area of the brain at rest were performed before and after treatment, respectively. It was found that: 1) after auricular acupuncture treatment, the patients in the auricular acupuncture group showed significantly greater peak MEP and significantly higher oxyhemoglobin content in the M1 region of the brain compared with the control group, with a significant activation effect (MEP: P-value = 0.032, t = -2.22; HbO2; f = 4.225, p = 0.046); 2) in the clinical efficacy assessment, the FMA score in the auricular acupuncture group after treatment (p = 0.0122, t = 2.769). The results suggest that auricular acupuncture has an ameliorative effect on upper limb motor deficits after stroke and that activation of the M1 region of the brain may be a key node in auricular acupuncture for treating upper limb dysfunction in stroke patients, a finding that emphasizes the potential for clinical application of auricular acupuncture therapy for stroke patients with potential mechanisms influencing the outcome.

[Modern view on upper limb physical rehabilitation after stroke. Literature review]

Stroke is the world's second leading cause of death and the first cause of disability among all diseases. The most common complication of a stroke is a violation of the motor function of the limbs, which significantly worsens the quality of life and the level of self-care and independence of patients. Restoring the function of the upper limb is one of the priority tasks of rehabilitation after a stroke. A large number of factors, such as the location and size of the primary brain lesion, the presence of complications in the form of spasticity, impaired skin and proprioceptive sensitivity, and comorbidities, determine the patient's rehabilitation potential and the prognosis of ongoing rehabilitation measures. Of particular note are the timing of the start of rehabilitation measures, the duration and regularity of the treatment methods. A number of authors propose scales for assessing the rehabilitation prognosis, as well as algorithms for compiling rehabilitation programs for restoring the function of the upper limb. A fairly large number of rehabilitation methods and their combinations have been proposed, including special methods of kinesitherapy, robotic mechanotherapy with biofeedback, the use of physiotherapeutic factors, manual and reflex effects, as well as ready-made programs that include sequential and combined use of various methods. Dozens of studies have been devoted to comparative analysis and evaluation of the effectiveness of these methods. The purpose of this work is to review current research on a given topic and draw up our own conclusion on the appropriateness of using and combining these methods at various stages of rehabilitation in stroke patients.