Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, October 11, 2022

Effect of acupuncture for disorders of consciousness in patients with stroke: A systematic review and meta-analysis

You have got to be kidding:

Impossible to have effects except as a placebo. Energy meridians have never been proven to exist.
No mechanism of action is possible. 

But you're also using appeal to antiquity  which is not scientific

But if you believe, have at it, recognizing these possible side effects;

 The latest here:

 

Effect of acupuncture for disorders of consciousness in patients with stroke: A systematic review and meta-analysis

Zhibin Huang1, Yuning Chen1, Qilan Xiao2,3, Weichuan Kuang1,4, Kun Liu1,4, Ye Jiang1,4, Xi Wen1,4, Weiting Qin5, Yue Liu1,4* and Tong Liu1,4*
  • 1Department of Acupuncture and Rehabilitation, The Fifth College of Clinical Medicine, Guangzhou University of Traditional Chinese Medicine, Guangzhou, China
  • 2Department of Rehabilitation, Equivalent Master's Degree Applicants of Guangzhou University of Chinese Medicine, Guangzhou, China
  • 3Department of Rehabilitation, The Sixth Affiliated Hospital of Jinan University, Dongguan, China
  • 4Department of Acupuncture and Rehabilitation, Guangdong Second Hospital of Traditional Chinese Medicine, Guangzhou, China
  • 5Department of Urinary Surgery, The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, China

Background: Disorder of consciousness (DOC) is frequent in patients with stroke, which is the second most common cause of death and a leading cause of disability. Acupuncture has been used as a curative method for DOC treatment in China. Nevertheless, no critical systematic review of acupuncture's effect on DOC has been published. This review aims to evaluate the present evidence regarding the efficacy of acupuncture for DOC after stroke.

Methods: Seven databases were searched from their inception to November 1, 2021, containing three English databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) and four Chinese databases (CNKI, CBM, VIP, and Wanfang Database). The primary outcomes comprise the Glasgow Coma Scale (GCS) and Glasgow Outcome Scale (GOS) before and after treatment. Secondary outcomes involve resuscitation rate, resuscitation time, and adverse events. Data synthesis was calculated by RevMan (V.5.4.1) software. According to the Cochrane Handbook, methodological quality was assessed with the risk of bias tool 2.0 (RoB2).

Results: Seventeen studies containing 1,208 patients were eventually included in our review. Overall, most trials were rated as high or had some concerns regarding the risk of bias. GCS was reported in 16 trials, and a meta-analysis showed that GCS improvement in the acupuncture group was greater than in the non-acupuncture group (MD 1.45, 95% CI 0.94–1.97, P < 0.0001). One trial reported that GOS improvement in the acupuncture plus medication group was greater than in the medication group (MD 0.58, 95% CI 0.11–1.05, P = 0.01). Another study reported that acupuncture plus medication was statistically more effective in shortening resuscitation time than medication alone (MD−0.89, 95% CI −1.53 to −0.25, P = 0.006). Four trials reported that the resuscitation rate in the acupuncture group was higher than without acupuncture intervention (RR 1.68, 95% CI 1.30–2.18, I2 0%, P = 0.39). Adverse events were reported in two studies, with one case in the acupuncture group suffering from subcutaneous hematoma.

Conclusion: Acupuncture may improve consciousness level, increase the resuscitation rate, and shorten resuscitation time for post-stroke patients with DOC. Adverse events from acupuncture were rare, tolerable, and recoverable. However, the results should be interpreted cautiously, and more rigorous RCTs with better methodology are warranted.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=289802, identifier 289802.

Introduction

Stroke, a common acute cerebrovascular accident, can be clinically divided into two types according to pathogenesis: ischemic stroke and hemorrhagic stroke—the former accounts for about 62.4% and the latter, 37.6% (1). High incidence, morbidity, mortality, and recurrence rate constitute the significant characteristics of stroke. From a global perspective, stroke, in particular, has imposed a ponderous burden on developing countries (2). In 2017, the total number of stroke deaths worldwide was 6.16 million, while China accounts for about one-third of the total, with 2.1 million (3). Besides, the overall lifetime risk of stroke in China is 39.9%, the highest in the world, which means that about two out of five people may suffer from a stroke during their lifetime. In 2017, the per capita hospitalization expenses for patients with ischemic and hemorrhagic strokes in China were 9,607 and 18,525 Chinese yuan (CNY), an increase of 60 and 118%, respectively, compared with 2007 (4). Therefore, more attention should be paid to strokes.

Several complications could be involved in stroke, such as consciousness disorder, depression, dysphagia, cognitive impairment, and so on (5). The sequelae of a stroke may lead to a lengthy recovery period, high medical expenses, and a poor prognosis for post-stroke patients (6). Among various sequelae, a disorder of consciousness (DOC) occurs frequently. According to an evidence-based practice guideline for stroke, nearly one out of every three stroke patients suffers from DOC to varying degrees (7). Moreover, it was also shown that 40% of patients with DOC have difficulty regaining normal consciousness (8). In a clinical randomized controlled study involving 6,336 people, the results indicated that the hospital mortality rate of stroke patients with DOC was higher than those without (35.9 vs. 2.6%) (9).

Currently, stroke treatment is based primarily on surgery and drug thrombolytic therapy (10, 11). In terms of stroke sequelae, it has been pointed out that multidisciplinary cooperative rehabilitation units could achieve superior outcomes (12). As a relatively well-recognized traditional therapy, acupuncture has broadly been used in post-stroke rehabilitation in China (13). Studies have indicated that acupuncture treatment for stroke can adjust the stability of the human body environment through the influence of the nerve-endocrine-immune network (14). Specific to stroke, acupuncture affects the neurovascular unit through multiple levels to promote cerebral blood perfusion in the focal area of stroke patients and improve the function of damaged brain cells (15, 16). Furthermore, with respect to the therapeutic method regarding post-stroke patients with impaired consciousness, acupuncture has been carried out in correspondent clinical study (17).

However, no systematic review assessing the effect of acupuncture for DOC has been carried out until now. Consequently, we performed this review to explore whether acupuncture was an efficacious therapy for DOC.

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