[Effectiveness of acupuncture in spasticity of the post-stroke patient. Systematic review]. / Eficacia de la acupuntura en la espasticidad del paciente que ha padecido un ictus. Revisión sistemática.

OBJECTIVE: To determine the effectiveness of acupuncture for reducing spasticity in post-stroke patients. DESIGN: Literature review. DATA SOURCE: The literature search was performed using scientific databases from January 2000 to January 2013. SELECTION OF STUDIES: Out of the 110 studies that were found, nine random and controlled trials were included. Inclusion criteria were based on clinical trials in which participants were over 18 years old, who were suffering with post-stroke spasticity, and one of the experimental groups was treated with acupuncture. DATA EXTRACTION: The variables were the passive resistance to stretching of the affected limb, and the degree of personal dependence. The variables were assessed by the Modified Ashworth Scale and Barthel Index. METHODS: The search was performed in the PUBMED, COCHRANE Library, PEDro, Dialnet, CSIC, CINAHL, databases. Search terms included the combination of keywords "acupuncture"; "muscle spasticity"; "stroke". RESULTS: Passive resistance to stretching, the degree of personal dependence, and motor function of the affected limb showed statistically significant improvements in at least one study included; however, these improvements are not clinically relevant changes. Passive resistance improved in the elbow, ankle, knee, and wrist. An increased joint range was observed, except for the elbow, forearm, and thumb. Improved of the patient dependency was also observed. CONCLUSIONS: Although improvements relative to the reduction of spasticity are shown, the results have failed to demonstrate the effectiveness of the technique for this ailment. It would take a greater number of studies to calculate the size of the reported effects with homogeneous procedures in the design as well as in the duration, frequency, and measurement tools.

Eficacia de la acupuntura en la espasticidad del paciente que ha padecido un ictus. Revisión sistemática / Effectiveness of acupuncture in spasticity of the post-stroke patient. Systematic review

OBJETIVO: Determinar la eficacia de la acupuntura para la reducción de la espasticidad en el paciente que ha sufrido un ictus. DISEÑO: Revisión sistemática. Fuente de datos: Búsqueda sistemática en las principales bases de datos de los ensayos clínicos, publicados en español e inglés desde enero de 2000 a enero de 2013, en los que los participantes cursaran con espasticidad a consecuencia de un ictus. Selección de los estudios: Se seleccionaron 9 registros de los 110 localizados. Los criterios de inclusión fueron: ensayos clínicos en pacientes con una edad igual o superior a 18 años, con espasticidad post-ictus y que al menos uno de los grupos experimentales fuese tratado con acupuntura. EXTRACCIÓN DE DATOS: Las principales variables analizadas fueron la resistencia pasiva al estiramiento del miembro afecto y el grado de dependencia personal. Fueron valoradas mediante la escala modificada de Ashworth y el índice de Barthel, respectivamente. MÉTODO: Realizamos una búsqueda en las bases de datos PUBMED, COCHRANE Library, PEDro, Dialnet, CSIC, CINAHL. Se empleó la combinación de los términos «acupuntura», «espasticidad» e «ictus». RESULTADOS: La resistencia pasiva al estiramiento, el grado de dependencia personal y la función motora del miembro afecto mostraron mejoras estadísticamente significativas en al menos un estudio de los incluidos. Se observó una mejora de la resistencia pasiva al estiramiento en codo, tobillo, rodilla y muñeca, hubo un incremento del rango articular, excepto en codo, antebrazo y dedo pulgar, y una mejora de la dependencia de los pacientes. CONCLUSIÓN: Aunque se muestran mejoras respecto a la reducción de la espasticidad, la eficacia de la técnica no ha podido demostrarse para esta enfermedad. Son necesarios estudios que calculen el tamaño de los efectos reportados, aplicando procedimientos homogéneos en el diseño así como en la duración, frecuencia e instrumentos de medida utilizados

OBJECTIVE: To determine the effectiveness of acupuncture for reducing spasticity in post-stroke patients. DESIGN: Literature review. Data source: The literature search was performed using scientific databases from January 2000 to January 2013. SELECTION OF STUDIES: Out of the 110 studies that were found, nine random and controlled trials were included. Inclusion criteria were based on clinical trials in which participants were over 18 years old, who were suffering with post-stroke spasticity, and one of the experimental groups was treated with acupuncture. Data extraction: The variables were the passive resistance to stretching of the affected limb, and the degree of personal dependence. The variables were assessed by the Modified Ashworth Scale and Barthel Index. METHODS: The search was performed in the PUBMED, COCHRANE Library, PEDro, Dialnet, CSIC, CINAHL, databases. Search terms included the combination of keywords 'acupuncture'; 'muscle spasticity'; 'stroke'. RESULTS: Passive resistance to stretching, the degree of personal dependence, and motor function of the affected limb showed statistically significant improvements in at least one study included; however, these improvements are not clinically relevant changes. Passive resistance improved in the elbow, ankle, knee, and wrist. An increased joint range was observed, except for the elbow, forearm, and thumb. Improved of the patient dependency was also observed. CONCLUSIONS: Although improvements relative to the reduction of spasticity are shown, the results have failed to demonstrate the effectiveness of the technique for this ailment. It would take a greater number of studies to calculate the size of the reported effects with homogeneous procedures in the design as well as in the duration, frequency, and measurement tools