Skip to main content

Table 1 Key data from RCTs comparing contralateral acupuncture (CAT) to ipsilateral acupuncture (IAT) in post-stroke hemiplegic patients

From: Contralateral acupuncture versus ipsilateral acupuncture in the rehabilitation of post-stroke hemiplegic patients: a systematic review

First author (Year)

Sample size/Severity/Diagnosis

Groups

Main outcomes

Intergroup difference

CAT group

IAT group

Co-interventions for both groups

Risk of bias*

Infarction

       

Pan (2009)

[13]

53

n.r.

CT scan or MRI

(A) CAT (n = 28)

(B) IAT (n = 25)

1) Response rate

2) NDS

1) RR, 1.16 [0.93, 1.45], NS

2) MD, 3.69 [1.43, 5.95], P = 0.001

PC6, LI4, ST36, LR3

de-qi elicited, manipulation at every 5 min, 20 min per session, once daily for 10 days, interval of 5 days after one course, three courses in total

Identical points and procedures as CAT group

None

U-U-U-U-Y-Y-Y

Chen (2007)

[14]

68

Mild to severe

CT scan or MRI

(A) EA CAT (n = 34)

(B) EA IAT (n = 34))

1) Response rate

2) NDS

1) RR, 1.07 [0.88, 1.31], NS

2) MD, 0.01 [-4.00, 4.02], NS

Points: LI15, LI11, LI10, TE5, LI4, ST31, GB31, GB34, ST36, ST41, GB36

1.7 Hz, for 30 min, once daily

Identical points and procedures as CAT group

Scalp acupuncture with manual twirling at 180-200 Hz, manipulation at every 10 min for 3 times, once daily for 30 days

U-U-U-U-U-Y-Y

Liu (2005)

[15]

60

Mild (shoulder pain)

CT scan or MRI

(A) Big size needle CAT (n = 30)

(B) IAT (n = 30)

Response rate

RR, 1.17 [0.95, 1.43], NS

Points: GB34 through GB39

0.4-1.6 mm × 150-500 mm, de-qi elicited, manipulation at every 10 min, for 30 min, once daily, days n.r.

Points: LI15, SI9, LI14, LI11, TE5

0.30 mm × 40 mm, de-qi elicited, manipulation at every 10 min, for 30 min, once daily, days n.r.

Active and passive exercises

U-U-N-N-Y-Y-U

Sun

(2000)

[16]

80

n.r.

CT scan or MRI

(A) CAT (n = 40)

(B) IAT (n = 40)

Response rate

RR, 1.19 [1.00, 1.41], P = 0.05

Basic points: GV20, GB20, LI15, LI11, TE5, LI4, GB34, ST36, GB39, ST41

Additional points: GV26, PC8, LR3, BL18, BL23, BL17, SP10, ST40, SP6

De-qi elicited

One course: 30 min, once daily for 10 sessions, interval of 2 days after one course

Three courses in total

Identical points and procedures as CAT group

None

U-U-N-N-Y-Y-Y

Infarction and hemorrhage mixed

      

Hong (2009)

[17]

60

Severe (post-stroke shoulder-hand syndrome)

CT scan or MRI

(A) CAT (n = 30)

(B) IAT (n = 30)

1) Response rate

2) FMA

3) ADL

4) Pain (VAS)

1) RR, 1.04 [0.89, 1.21], NS

2) MD, 1.10 [0.06, 2.14], P = 0.04

3) MD, 10.67 [2.44, 18.90], P = 0.01

4) MD, -10.60 [-16.83, -4.37], P = 0.0009

1st set of points: LI15, SI9, LI10, TE6, SI3, GB34, and most painful points

2nd set of points: TE14, LI14, LI11, TE5, LI4, ST38, and most painful points

1st and 2nd sets in turn, 0.38 mm × 40-65 mm, de-qi elicited,2 Hz manipulation at every 10 min,

One course: for 30 min, once daily for 10 sessions, interval of 2-3 days after one course

Two courses in total

Identical points and procedures as CAT group

None

Y-U-N-N-Y-Y-Y

Ni

(2009)

[18]

80

n.r.

CT scan or MRI

(A) CAT (n = 20)

(B) IAT (n = 20)

(C) CAT +CSS (n = 20) †

(D) CSS (n = 20) †

1) Response rate

2) FMA

1) RR, 1.33 [0.88, 2.03], NS

2) MD, 14.54 [9.42,

19.66], P < 0.0001

Points: PC6, LU5, LU4 for arms; ST36, GB34, LR3, GB40, GB31 for legs, taking turns every other day

20 min, once daily for 6 days, 4 weeks in total

Points: LI15, LI11, LI10, TE5, LI4 for difficult extension; LU5, PC3, PC6 for difficult flexion

Identical procedures as CAT

None

Y-U-N-Y-Y-Y-Y

Huang

(2008)

[19]

120

Mild to severe

CT scan or MRI

(A) CAT (n = 30) strong stimulation

(B) CAT (n = 30) weak stimulation

(C) IAT (n = 30) strong stimulation

(D) IAT (n = 30) weak stimulation

1) FMA

2) ADL

1) A vs. C,

MD, 2.50 [-2.43, 7.43], NS

B vs. D,

MD, -0.60[-5.78,4.58],

NS

2) A vs. C,

MD, 0.66[-7.14, 8.46], NS

B vs. D,

MD, -0.67[-5.46,4.12],

NS

LI15, LI14, TE10, TE9, TE5, LI5, LI6, TE3 for arms; BL37, LR9, ST36, GB39, BL62, GB40, GB41 for legs

30 min, once daily for 6 days, one day rest, for 4 weeks

Twisting and twirling to 180 and 90 degrees/lifting and thrusting to 5 and 3 mm for strong and weak stimulation, respectively

HT1, LU5, PC3, LI11, LI10, PC6, PC7, PC8 for arms; ST31, ST32, BL40, BL57, SP6, KI3, KI6, KI1 for legs

Identical procedures as CAT group

None

Y-U-N-N-Y-Y-Y

Seo

(2001)

[10]

13

Moderate

CT scan or MRI

(A) CAT (n = 7)

(B) IAT (n = 6)

MBI

MD, -3.60 [-29.96, 22.76], NS

Points: GV20, CV24, GB20, LI11, LI4, TE5, LI10, ST36, GB34, GB31, GB39, LR3, Bafeng, Baxie on unaffected side; LI11, LI4, ST36, LR3 on affected side

20 min, once daily for 3 weeks

Points: GV20, CV24, GB20, LI11, LI4, TE5, LI10, ST36, GB34, GB31, GB39, LR3, Bafeng, Baxie on affected side; LI11, LI4, ST36, LR3 on unaffected side

Rest of procedures identical as CAT group

None

U-U-N-Y-Y-Y-Y

  1. ADL: Activity of Daily Living Scale; AT: Acupuncture therapy; CAT: Contralateral acupuncture (needling the unaffected side); CSS: continual static stretch; CT: Computed tomography; FMA: Fugl-Meyer Assessment; IAT: Ipsilateral acupuncture (needling the affected side); min: minute; MBI: modified Barthel Index; MD: mean difference; n.a.: not applicable; MRI: Magnetic resonance imaging; NDS: Neurological Deficit Score; n.r.: not reported; NS: not significant; RR: response rate; VAS: visual analogue scale. † We excluded this group because it was not comparable to the other groups.
  2. *(1) Was the allocation sequence adequately generated? (2) Was allocation adequately concealed? (3) Was knowledge of the allocated interventions adequately prevented during the study (both to patient and outcome assessor)? (4) Were incomplete outcome data adequately addressed? (5) Are reports of the study free of suggestion of selective outcome reporting? (6) Was the study apparently free of other problems that could put it at a risk of bias?; (Y) indicates "Yes (low risk of bias)"; (U), "Unclear"; (N), "No (high risk of bias)".12