Table 1 |
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Key data from RCTs comparing contralateral acupuncture (CAT) to ipsilateral acupuncture (IAT) in post-stroke hemiplegic patients |
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First author (Year) |
Sample size/Severity/Diagnosis |
Groups |
Main outcomes |
Intergroup difference |
CAT group |
IAT group |
Co-interventions for both groups |
Risk of bias* |
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Infarction |
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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 |
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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 |
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Infarction and hemorrhage mixed |
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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 |
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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 |
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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. *(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 |
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Kim et al. BMC Complementary and Alternative Medicine 2010 10:41 doi:10.1186/1472-6882-10-41 |
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