Neural Regeneration Research ›› 2018, Vol. 13 ›› Issue (6): 1107-1117.doi: 10.4103/1673-5374.233455

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Acupuncture for cerebral palsy: a meta-analysis of randomized controlled trials

Ling-Xin Li1, Ming-Ming Zhang2, Yin Zhang1, Jing He1   

  1. 1 Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
    2 Chinese Cochrane Center, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
  • Received:2018-05-18 Online:2018-06-15 Published:2018-06-15
  • Contact: Jing He, yeshj028@163.com.
  • Supported by:

    This work was financially supported by the Science and Technology Department of Sichuan Province of China, No. 2016SZ0039, 2016; and a grant from the Sichuan Province Medical Association in China, No. S15063, 2015.

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Abstract:

OBJECTIVE: To evaluate the efficacy and safety of acupuncture therapy for children with cerebral palsy.
DATA SOURCES: We conducted electronic searches of PUBMED (1950/2017), EMBASE (1974/2017), ScienceDirect (1986/2017), Academic Source Premier (1887/2017), the Cochrane Library (Issue 4, April 2017), Science Citation Index Expanded (1900/2017), China National Knowledge Infrastructure (1915/2017), China Biological Medicine (1990/2017-04), WanFang (1980/2017), VIP (1989/2017), and Chinese Science Citation Database (1989/2017).
DATA SELECTION: We included randomized controlled trials that aimed to compare the effect of acupuncture plus rehabilitation training versus rehabilitation training alone. Data about functional motor abilities, daily activity/social participation, effective rate, intellectual development, and adverse effects were included. We used Revman 5.2 software for statistical analysis.
OUTCOME MEASURES: The primary outcomes included functional motor abilities, daily activity, and effective rate. The secondary outcomes included intellectual development and adverse effects.
RESULTS: Twenty-one studies with a total of 1 718 participants met the inclusion criteria. The effect size of gross motor function (SMD = 0.64, 95% CI: 0.52 to 0.76, P < 0.00001;  I2 = 0%, P = 0.69; in 13 studies with 1 144 patients) and the total effective rate (RR = 1.28, 95% CI: 1.20 to 1.37, P < 0.00001;  I2 = 18%, P = 0.27; in 12 studies with 1 106 patients) suggested that acupuncture plus rehabilitation produced a significant improvement in gross motor function and a high total effective rate. The pooled fine motor function (SMD = 3.48, 95% CI: 2.62 to 4.34, P < 0.00001;  I2 = 64%, P = 0.10; in 2 studies with 193 patients), modified Ashworth scale scores (SMD = –0.31, 95% CI: –0.52 to –0.11, P = 0.003;  I2 = 74%, P = 0.004; in 5 studies with 363 patients) and activities of daily living (SMD = 1.45, 95% CI: 1.20 to 1.71, P < 0.00001; I2 = 78%, P = 0.004; in 4 studies with 313 patients) also indicated improvements in children with cerebral palsy. Publication bias was not observed. Only mild adverse events related to acupuncture were reported.
CONCLUSION: Acupuncture plus rehabilitation training improved gross motor function, reduced muscle spasms, and enhanced daily life activities in children with cerebral palsy. However, this conclusion should be interpreted with caution due to the small number of randomized controlled trials available and the small sample sizes. More high-quality and large-scale studies are needed.

Key words: nerve regeneration, acupuncture, rehabilitation, children, efficacy, safety, cerebral palsy, meta-analysis, randomized controlled trials, neural regeneration