Efficacy of Auricular Therapy for Motor Impairment After Stroke: A Systematic Review and Meta-Analysis

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY

International Journal of Older People Nursing Pub Date : 2025-01-08 DOI:10.1111/opn.70006

Yingqi Mao, Donghan Xu, Peiyu Yan, Yu Li, Jiaan Du, Yi Zheng, Qibiao Wu, Lili Yu, Tao Qiu

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引用次数: 0

Abstract

Background

A high number of stroke patients cannot recover fully from motor impairment despite early rehabilitation. Auricular therapies, usually given by acupuncture doctors or nurses, have been widely used among these post-stroke patients. Potential benefits of auricular therapies were shown in recent clinical trials.

Objectives

The purpose of this review was to systematically evaluate the clinical effects of auricular therapy in the treatment of post-stroke motor impairment.

Methods

PubMed, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Chinese Biological Medicine (CBM), Chinese National Knowledge Infrastructure (CNKI) and Wanfang databases were searched from their inception to May 2023. Randomised controlled trials of auricular therapy for the treatment of post-stroke motor impairment met the screening criteria. The primary outcome was the Fugl-Meyer Assessment Scale (FMA). The secondary outcomes included the Fugl-Meyer Assessment Upper Extremity Scale (FMA-UE), Chinese Stroke Scale (CSS), clinical efficacy and the Barthel Index Scale (BI). Meta-analysis was carried out using RevMan software 5.3.

Results

Twenty-eight RCTs with 1993 patients were included. The meta-analysis results suggested that compared with conventional treatment, auricular therapy combined with conventional treatment significantly improved the FMA score (MD: 15.07, 95% CI, 12.56 to 17.59), the FMA-UE score (MD: 6.49, 95% CI, 5.54 to 7.45), the clinical efficacy (RR: 1.20, 95% CI, 1.12 to 1.29) and the BI score (MD: 10.26, 95% CI, 9.11 to 11.40), while the combination treatment significantly decreased the CSS score (MD: −2.98, 95% CI, −4.38 to −1.59).

Conclusion

Auricular therapy, as an adjunctive treatment to the conventional treatment, improved post-stroke motor impairment and self-care ability. Early auricular therapy of the patients in the early disease stage may lead to better improvement. Further well-designed, large-size clinical studies are needed.

Implications for Practice

This study suggested that auricular therapy could be used as a complementary therapy with conventional treatment for improving motor impairment and self-care ability among post-stroke patients with motor impairment in hospitals, long-term care facilities and homes.

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耳穴治疗脑卒中后运动障碍的疗效：一项系统综述和meta分析。

背景：大量脑卒中患者即使早期康复也不能完全从运动障碍中恢复。耳穴疗法，通常由针灸医生或护士给予，已广泛应用于这些中风后患者。最近的临床试验显示了耳穴治疗的潜在益处。目的：本综述的目的是系统评价耳穴疗法治疗脑卒中后运动障碍的临床效果。方法：检索PubMed、Embase、Web of Science、Chinese journal of Nursing and Allied Health Literature （CINAHL）、Cochrane Library （Cochrane Library）、Chinese Biological Medicine （CBM）、Chinese National Knowledge Infrastructure （CNKI）和万方数据库，检索时间为建站至2023年5月。耳穴疗法治疗脑卒中后运动障碍的随机对照试验符合筛选标准。主要评价指标为Fugl-Meyer评定量表（FMA）。次要指标包括Fugl-Meyer上肢评估量表（FMA-UE）、中国脑卒中量表（CSS）、临床疗效和Barthel指数量表（BI）。采用RevMan软件5.3进行meta分析。结果：纳入28项随机对照试验，1993例患者。meta分析结果显示，与常规治疗相比，耳穴联合常规治疗显著提高了FMA评分（MD: 15.07, 95% CI, 12.56 ~ 17.59）、FMA- ue评分（MD: 6.49, 95% CI, 5.54 ~ 7.45）、临床疗效（RR: 1.20, 95% CI, 1.12 ~ 1.29）和BI评分（MD: 10.26, 95% CI, 9.11 ~ 11.40），而联合治疗显著降低了CSS评分（MD: -2.98, 95% CI, -4.38 ~ -1.59）。结论：耳穴治疗作为常规治疗的辅助治疗，可改善脑卒中后运动功能障碍和生活自理能力。早期耳穴治疗可使病情得到较好的改善。需要进一步精心设计的大规模临床研究。实践意义：本研究提示耳穴疗法可作为常规治疗的补充疗法，用于改善医院、长期护理机构和家庭卒中后运动损伤患者的运动损伤和自我护理能力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Older People Nursing Nursing-Gerontology

CiteScore

3.60

自引率

9.10%

发文量

期刊介绍： International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.