Warm-needle moxibustion for spasticity after stroke: A systematic review of randomized controlled trials

Article

Yang, Liu, Tan, Jing-Yu, Ma, Haili, Zhao, Hongjia, Lai, Jinghui, Chen, Jin-Xiu and Suen, Lorna K.P.. 2018. "Warm-needle moxibustion for spasticity after stroke: A systematic review of randomized controlled trials." International Journal of Nursing Studies. 82, pp. 129-138. https://doi.org/10.1016/j.ijnurstu.2018.03.013
Article Title

Warm-needle moxibustion for spasticity after stroke: A systematic review of randomized controlled trials

ERA Journal ID14088
Article CategoryArticle
AuthorsYang, Liu, Tan, Jing-Yu, Ma, Haili, Zhao, Hongjia, Lai, Jinghui, Chen, Jin-Xiu and Suen, Lorna K.P.
Journal TitleInternational Journal of Nursing Studies
Journal Citation82, pp. 129-138
Number of Pages10
Year2018
PublisherElsevier
Place of PublicationUnited Kingdom
ISSN0020-7489
1873-491X
Digital Object Identifier (DOI)https://doi.org/10.1016/j.ijnurstu.2018.03.013
Web Address (URL)https://www.sciencedirect.com/science/article/pii/S0020748918300646?via%3Dihub
Abstract

Background: Spasticity is a common post-stroke complication, and it results in substantial deterioration in the quality of life of patients. Although potential positive effects of warm-needle moxibustion on spasticity after stroke have been observed, evidence on its definitive effect remains uncertain.

Objectives: This study aimed to summarize clinical evidence pertaining to therapeutic effects and safety of warm-needle moxibustion for treating spasticity after stroke.

Design: Randomized controlled trials were reviewed systematically on the basis of the Cochrane Handbook for Systematic Reviews of Interventions. The report follows the PRISMA statement.

Methods: Ten electronic databases (PubMed, CENTRAL, EMBASE, AMED, CINAHL, Web of Science, CBM, CNKI, WanFang, and VIP) were explored, and articles were retrieved manually from two Chinese journals (The Journal of Traditional Chinese Medicine and Zhong Guo Zhen Jiu) through retrospective search. Randomized controlled trials with warm-needle moxibustion as treatment intervention for patients with limb spasm after stroke were included in this review. The risk of bias assessment tool was utilized in accordance with Cochrane Handbook 5.1.0. All included studies reported spasm effect as primary outcome. Effect size was estimated using relative risk, standardized mean difference, or mean difference with a corresponding 95% confidence interval. Review Manager 5.3 was utilized for meta-analysis.

Results: Twelve randomized controlled trials with certain methodological flaws and risk of bias were included, and they involved a total of 878 participants. Warm-needle moxibustion was found to be superior to electroacupuncture or acupuncture in reducing spasm and in promoting motor function and daily living activities. Pooled results for spasm effect and motor function were significant when warm-needle moxibustion was compared with electroacupuncture or acupuncture. A comparison of daily living activities indicated significant differences between warm-needle moxibustion and electroacupuncture. However, no difference was observed between warm-needle moxibustion and acupuncture.

Conclusions: Warm-needle moxibustion may be a promising intervention to reduce limb spasm as well as improve motor function and daily living activities for stroke patients with spasticity. However, evidence was not conclusive. Rigorously designed randomized controlled trials with sample sizes larger than that in the included trials should be conducted for verification.

KeywordsSpasticity; Stroke; Warm-needle moxibustion; Systematic review; Meta-analysis
ANZSRC Field of Research 2020420599. Nursing not elsewhere classified
420899. Traditional, complementary and integrative medicine not elsewhere classified
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Byline AffiliationsFujian University of Traditional Chinese Medicine, China
Hong Kong Polytechnic University, China
Zhengzhou Railway Vocational & Technical College, China
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Ge, Li, Zheng, Qing-Xiang, Liao, Yan-Tan, Tan, Jing-Yu, Xie, Qiu-Lin and Rask, Mikael. 2017. "Effects of traditional Chinese exercises on the rehabilitation of limb function among stroke patients: A systematic review and meta-analysis." Complementary Therapies in Clinical Practice. 29, pp. 35-47. https://doi.org/10.1016/j.ctcp.2017.08.005
Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials
Li, Rong-Qing, Li, Zhuang-Miao, Tan, Jing-Yu, Chen, Gu-Lan and Lin, Wen-Ying. 2017. "Effects of motor imagery on walking function and balance in patients after stroke: A quantitative synthesis of randomized controlled trials." Complementary Therapies in Clinical Practice. 28, pp. 75-84. https://doi.org/10.1016/j.ctcp.2017.05.009
Auricular therapy for lactation: A systematic review
Chen, Melissa Li-Sha, Tan, Jing-Yu and Suen, Lorna Kwai-Ping. 2017. "Auricular therapy for lactation: A systematic review." Complementary Therapies in Clinical Practice. 29, pp. 169-184. https://doi.org/10.1016/j.ctcp.2017.09.006
Assessment of Breathlessness in Lung Cancer: Psychometric Properties of the Dyspnea-12 Questionnaire
Tan, Jing-Yu, Yorke, Janelle, Harle, Amelie, Smith, Jacky, Blackhall, Fiona, Pilling, Mark and Molassiotis, Alex. 2017. "Assessment of Breathlessness in Lung Cancer: Psychometric Properties of the Dyspnea-12 Questionnaire." Journal of Pain and Symptom Management. 53 (2), pp. 208-215. https://doi.org/10.1016/j.jpainsymman.2016.08.009
Effectiveness of disease-specific self-management education on health outcomes in patients with chronic obstructive pulmonary disease: An updated systematic review and meta-analysis
Wang, Tao, Tan, Jing-Yu, Xiao, Lily Dongxia and Deng, Renli. 2017. "Effectiveness of disease-specific self-management education on health outcomes in patients with chronic obstructive pulmonary disease: An updated systematic review and meta-analysis." Patient Education and Counseling. 100 (8), pp. 1432-1446. https://doi.org/10.1016/j.pec.2017.02.026
Acupoints Stimulation for Anxiety and Depression in Cancer Patients: A Quantitative Synthesis of Randomized Controlled Trials
Wang, Tao, Deng, Renli, Tan, Jing-Yu and Guan, Feng-Guang. 2016. "Acupoints Stimulation for Anxiety and Depression in Cancer Patients: A Quantitative Synthesis of Randomized Controlled Trials." Evidence-Based Complementary and Alternative Medicine. 2016. https://doi.org/10.1155/2016/5645632
Current evidence on traditional Chinese exercises for cancer-related fatigue: a quantitative synthesis of randomized controlled trials
Ma, Hai-Li, Tan, Jing-Yu, Yang, Liu, Huang, Tao and Liao, Qiao-Jing. 2016. "Current evidence on traditional Chinese exercises for cancer-related fatigue: a quantitative synthesis of randomized controlled trials." European Journal of Integrative Medicine. 8 (5), pp. 707-714. https://doi.org/10.1016/j.eujim.2016.05.007
Psychometric assessment of the Chinese version of the MASCC Antiemesis Tool (MAT) for measuring chemotherapy-induced nausea and vomiting
Tan, Jing-Yu, Suen, Lorna and Molassiotis, Alex. 2016. "Psychometric assessment of the Chinese version of the MASCC Antiemesis Tool (MAT) for measuring chemotherapy-induced nausea and vomiting." Supportive Care in Cancer. 24 (9), pp. 3729 - 3737. https://doi.org/10.1007/s00520-016-3181-7
Auricular therapy for chronic pain management in adults: A synthesis of evidence
Zhao, Hong-Jia, Tan, Jing-Yu, Wang, Tao and Jin, Lang. 2015. "Auricular therapy for chronic pain management in adults: A synthesis of evidence." Complementary Therapies in Clinical Practice. 21 (2), pp. 68-78. https://doi.org/10.1016/j.ctcp.2015.03.006
Interventions for cough in cancer
Molassiotis, Alex, Bailey, Chris, Caress, Ann and Tan, Jing-Yu. 2015. "Interventions for cough in cancer." Cochrane Database of Systematic Reviews. 2015 (5). https://doi.org/10.1002/14651858.CD007881.pub3
Nurse-led educational interventions on cancer pain outcomes for oncology outpatients: A systematic review
Zhou, L., Liu, X.-L., Tan, J.-Y., Yu, H.-P., Pratt, J. and Peng, Y.-Q.. 2015. "Nurse-led educational interventions on cancer pain outcomes for oncology outpatients: A systematic review." International Nursing Review. 62 (2), pp. 218-230. https://doi.org/10.1111/inr.12172
Sham acupressure controls used in randomized controlled trials: A systematic review and critique
Tan, Jing-Yu, Suen, Lorna K. P., Wang, Tao and Molassiotis, Alexander. 2015. "Sham acupressure controls used in randomized controlled trials: A systematic review and critique." PLoS One. 10 (7). https://doi.org/10.1371/journal.pone.0132989
Acupuncture-Point Stimulation for Postoperative Pain Control: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Liu, Xian-Liang, Tan, Jing-Yu, Molassiotis, Alex, Suen, Lorna and Shi, Yan. 2015. "Acupuncture-Point Stimulation for Postoperative Pain Control: A Systematic Review and Meta-Analysis of Randomized Controlled Trials." Evidence-Based Complementary and Alternative Medicine. 2015. https://doi.org/10.1155/2015/657809
Effectiveness of home-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials
Liu, Xian-Liang, Tan, Jing-Yu, Wang, Tao, Zhang, Qi, Zhang, Min, Yao, Li-Qun and Chen, Jin-Xiu. 2014. "Effectiveness of home-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials." Rehabilitation Nursing. 39 (1), pp. 36-59. https://doi.org/10.1002/rnj.112
Adverse events of auricular therapy: A systematic review
Tan, Jing-Yu, Molassiotis, Alexander, Wang, Tao and Suen, Lorna K. P.. 2014. "Adverse events of auricular therapy: A systematic review." Evidence-Based Complementary and Alternative Medicine. 2014 (2014). https://doi.org/10.1155/2014/506758
Current evidence on auricular therapy for chemotherapy-induced nausea and vomiting in cancer patients: A systematic review of randomized controlled trials
Tan, Jing-Yu, Molassiotis, Alexander, Wang, Tao and Suen, Lorna K. P.. 2014. "Current evidence on auricular therapy for chemotherapy-induced nausea and vomiting in cancer patients: A systematic review of randomized controlled trials." Evidence-Based Complementary and Alternative Medicine. 2014 (2014). https://doi.org/10.1155/2014/430796
Progress towards the development of animal models of chemotherapy-induced gastrointestinal mucositis
Zhang, Min, Chen, Jin-Xiu, Tan, Jing-Yu and Liu, Xian-Liang. 2012. "Progress towards the development of animal models of chemotherapy-induced gastrointestinal mucositis." World Chinese Journal of Digestology. 20 (8), pp. 649-655. https://doi.org/10.11569/wcjd.v20.i8.649