The Impact of Acupuncture on Neurological Recovery in Spinal Cord Injury: A Systematic Review and Meta-Analysis

Ruijie Ma, Xin Liu, Justin Clark, Gail M Williams, Suhail A R Doi

Research output: Contribution to journalArticleResearchpeer-review

8 Citations (Scopus)
45 Downloads (Pure)

Abstract

Spinal cord injury (SCI) has become a significant social and economic burden for patients and their families. The effect of acupuncture on neurological recovery in individuals with SCI remains inconclusive despite previous studies and meta-analyses. The aim of the current study was to perform a more rigorous systematic review and bias-adjusted meta-analysis of studies so that the overall impact of acupuncture on neurological recovery in SCI can be determined. Randomized controlled trials (RCTs) only were included and were searched for in seven databases through to August 2014. Four key outcomes were assessed: neurological recovery, motor function, sensory function, and functional recovery. Several statistical approaches were compared, models were tested for robustness using sensitivity analysis, and results are presented as weighted mean difference (WMD) or standardized mean difference (SMD) for continuous outcomes and relative risk (RR) for binary outcomes. The included studies' susceptibility to bias was also assessed. A total of 12 studies were included after exclusions were applied. Heterogeneity was evident among the studies included. Pooled analyses showed that acupuncture may have a beneficial effect on neurological recovery (RRs: 1.28, 95% confidence interval [CI]: 1.12-1.50), motor function (WMD: 6.86, 95% CI: 0.41-13.31), and functional recovery (SMD: 0.88, 95% CI: 0.56-1.21) and all statistical approaches concurred. Sensitivity analyses suggested that the smaller studies (sample size <30), those with acute disease, and studies that used varying acupuncture sessions demonstrated a larger magnitude of effect. However, studies were generally of poor quality and publication bias favoring positive studies was evident. Therefore, the benefit of acupuncture we report is by no means definitive and well-designed future studies are recommended to confirm this.

Original languageEnglish
Pages (from-to)1943-1957
Number of pages15
JournalJournal of Neurotrauma
Volume32
Issue number24
DOIs
Publication statusPublished - 15 Dec 2015

Fingerprint

Acupuncture
Spinal Cord Injuries
Meta-Analysis
Confidence Intervals
Publication Bias
Recovery of Function
Acute Disease
Sample Size
Randomized Controlled Trials
Economics
Databases

Cite this

Ma, Ruijie ; Liu, Xin ; Clark, Justin ; Williams, Gail M ; Doi, Suhail A R. / The Impact of Acupuncture on Neurological Recovery in Spinal Cord Injury : A Systematic Review and Meta-Analysis. In: Journal of Neurotrauma. 2015 ; Vol. 32, No. 24. pp. 1943-1957.
@article{c3c41e1014bc4e78bb973b68a1cad4f5,
title = "The Impact of Acupuncture on Neurological Recovery in Spinal Cord Injury: A Systematic Review and Meta-Analysis",
abstract = "Spinal cord injury (SCI) has become a significant social and economic burden for patients and their families. The effect of acupuncture on neurological recovery in individuals with SCI remains inconclusive despite previous studies and meta-analyses. The aim of the current study was to perform a more rigorous systematic review and bias-adjusted meta-analysis of studies so that the overall impact of acupuncture on neurological recovery in SCI can be determined. Randomized controlled trials (RCTs) only were included and were searched for in seven databases through to August 2014. Four key outcomes were assessed: neurological recovery, motor function, sensory function, and functional recovery. Several statistical approaches were compared, models were tested for robustness using sensitivity analysis, and results are presented as weighted mean difference (WMD) or standardized mean difference (SMD) for continuous outcomes and relative risk (RR) for binary outcomes. The included studies' susceptibility to bias was also assessed. A total of 12 studies were included after exclusions were applied. Heterogeneity was evident among the studies included. Pooled analyses showed that acupuncture may have a beneficial effect on neurological recovery (RRs: 1.28, 95{\%} confidence interval [CI]: 1.12-1.50), motor function (WMD: 6.86, 95{\%} CI: 0.41-13.31), and functional recovery (SMD: 0.88, 95{\%} CI: 0.56-1.21) and all statistical approaches concurred. Sensitivity analyses suggested that the smaller studies (sample size <30), those with acute disease, and studies that used varying acupuncture sessions demonstrated a larger magnitude of effect. However, studies were generally of poor quality and publication bias favoring positive studies was evident. Therefore, the benefit of acupuncture we report is by no means definitive and well-designed future studies are recommended to confirm this.",
author = "Ruijie Ma and Xin Liu and Justin Clark and Williams, {Gail M} and Doi, {Suhail A R}",
year = "2015",
month = "12",
day = "15",
doi = "10.1089/neu.2014.3866",
language = "English",
volume = "32",
pages = "1943--1957",
journal = "Central Nervous System Trauma",
issn = "0897-7151",
publisher = "Mary Ann Liebert Inc",
number = "24",

}

The Impact of Acupuncture on Neurological Recovery in Spinal Cord Injury : A Systematic Review and Meta-Analysis. / Ma, Ruijie; Liu, Xin; Clark, Justin; Williams, Gail M; Doi, Suhail A R.

In: Journal of Neurotrauma, Vol. 32, No. 24, 15.12.2015, p. 1943-1957.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The Impact of Acupuncture on Neurological Recovery in Spinal Cord Injury

T2 - A Systematic Review and Meta-Analysis

AU - Ma, Ruijie

AU - Liu, Xin

AU - Clark, Justin

AU - Williams, Gail M

AU - Doi, Suhail A R

PY - 2015/12/15

Y1 - 2015/12/15

N2 - Spinal cord injury (SCI) has become a significant social and economic burden for patients and their families. The effect of acupuncture on neurological recovery in individuals with SCI remains inconclusive despite previous studies and meta-analyses. The aim of the current study was to perform a more rigorous systematic review and bias-adjusted meta-analysis of studies so that the overall impact of acupuncture on neurological recovery in SCI can be determined. Randomized controlled trials (RCTs) only were included and were searched for in seven databases through to August 2014. Four key outcomes were assessed: neurological recovery, motor function, sensory function, and functional recovery. Several statistical approaches were compared, models were tested for robustness using sensitivity analysis, and results are presented as weighted mean difference (WMD) or standardized mean difference (SMD) for continuous outcomes and relative risk (RR) for binary outcomes. The included studies' susceptibility to bias was also assessed. A total of 12 studies were included after exclusions were applied. Heterogeneity was evident among the studies included. Pooled analyses showed that acupuncture may have a beneficial effect on neurological recovery (RRs: 1.28, 95% confidence interval [CI]: 1.12-1.50), motor function (WMD: 6.86, 95% CI: 0.41-13.31), and functional recovery (SMD: 0.88, 95% CI: 0.56-1.21) and all statistical approaches concurred. Sensitivity analyses suggested that the smaller studies (sample size <30), those with acute disease, and studies that used varying acupuncture sessions demonstrated a larger magnitude of effect. However, studies were generally of poor quality and publication bias favoring positive studies was evident. Therefore, the benefit of acupuncture we report is by no means definitive and well-designed future studies are recommended to confirm this.

AB - Spinal cord injury (SCI) has become a significant social and economic burden for patients and their families. The effect of acupuncture on neurological recovery in individuals with SCI remains inconclusive despite previous studies and meta-analyses. The aim of the current study was to perform a more rigorous systematic review and bias-adjusted meta-analysis of studies so that the overall impact of acupuncture on neurological recovery in SCI can be determined. Randomized controlled trials (RCTs) only were included and were searched for in seven databases through to August 2014. Four key outcomes were assessed: neurological recovery, motor function, sensory function, and functional recovery. Several statistical approaches were compared, models were tested for robustness using sensitivity analysis, and results are presented as weighted mean difference (WMD) or standardized mean difference (SMD) for continuous outcomes and relative risk (RR) for binary outcomes. The included studies' susceptibility to bias was also assessed. A total of 12 studies were included after exclusions were applied. Heterogeneity was evident among the studies included. Pooled analyses showed that acupuncture may have a beneficial effect on neurological recovery (RRs: 1.28, 95% confidence interval [CI]: 1.12-1.50), motor function (WMD: 6.86, 95% CI: 0.41-13.31), and functional recovery (SMD: 0.88, 95% CI: 0.56-1.21) and all statistical approaches concurred. Sensitivity analyses suggested that the smaller studies (sample size <30), those with acute disease, and studies that used varying acupuncture sessions demonstrated a larger magnitude of effect. However, studies were generally of poor quality and publication bias favoring positive studies was evident. Therefore, the benefit of acupuncture we report is by no means definitive and well-designed future studies are recommended to confirm this.

UR - http://www.scopus.com/inward/record.url?scp=84949883479&partnerID=8YFLogxK

U2 - 10.1089/neu.2014.3866

DO - 10.1089/neu.2014.3866

M3 - Article

VL - 32

SP - 1943

EP - 1957

JO - Central Nervous System Trauma

JF - Central Nervous System Trauma

SN - 0897-7151

IS - 24

ER -