Effect of Acupuncture Intervention and Manipulation Types on Poststroke Dysarthria: A Systematic Review and Meta-Analysis
Table 1
Characteristics of randomized controlled trials of acupuncture treatments for dysarthria.
Author (year)
Number of cases (men/woman)
Average age or range of age (years)
Time since onset (days)
Regime (a)
Regime (b)
Outcome measurement
Results
Adverse events
Manipulation of acupuncture
Total no.
Location
Bleeding
Intensity
Depth
Repetition
Zeng (2011)
(a) 30 (18/12) (b) 30 (19/11)
(a) 60.5 (b) 62.7
Undocumented
(1). AT (PC6, GV26, SP6, GB20, GB12, TE17, bleeding AT of the EX-HN12 and EX-HN13; 5 sessions a week for 4 weeks). (2). The same regime using SLT in the control group (b)
(1). SLT (passive tongue and lip movement (severe), active tongue and lip movement training, articulation, and speech speed training (moderate); a total of 30 sessions)
FDA
Significant differences in effective rates
None
13
Broad
+
Strong
Deep
—
Hu (2011)
(a) 56; (b) 56
40–75
Undocumented
(1). AT (GV20, CV23, and two para-CV23 points, bleeding AT of the EX-HN12 and EX-HN13, 5 sessions a week for 4 weeks, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training, 5 sessions a week for 4 weeks)
FDA
Significant differences in effective rates
None
6
Local
+
Strong
Superficial
+
Lai (2011)
(a) 65 (44/22) (b) 63 (45/18)
(a) 61.8 (b) 59.9
(a) 114 (b) 105
(1). AT (GV20, CV23, and two para-CV23 points, bleeding AT of the EX-HN12 and EX-HN13; 5 sessions a week for 4 weeks, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training, 5 sessions a week for 4 weeks)
FDA
Significant differences in effective rates
None
6
Local
+
Strong
Superficial
—
Luo (2012)
(a) 32 (18/14) (b) 28 (17/11)
(a) 56.2 (b) 57.4
(a) 72.1 (b) 71.3
(1). AT (CV23 and two para-CV23 points, Kai Yin, GB20, GB12, GV15, BL10; a total of 30 sessions, 40 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (passive tongue and lip movement (severe), active tongue and lip movement training, articulation, and speech speed training (moderate), a total of 30 times)
SFG
Significant differences in effective rates
Pain on the AT-treated site (n = 1)
11
Local
+
Strong
Deep
—
Shi (2012)
(a) 30 (18/12) (b) 27 (16/11)
(a) 60.1 (b) 59.8
(a) 7.8 (b) 6.9
(1). AT (CV21, left and right EX-HN1 points, GB20, TE17, EX-HN10, CV23, bleeding AT of the EX-HN12 and EX-HN13; a total of 2 weeks, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training; a total of 2 weeks)
SFG
Significant differences in effective rates
None
11
Local
+
Strong
Deep
—
Liu (2012)
(a) 30 (18/12) (b) 30 (19/11)
(a) 56.0 (b) 55.4
(a) 71 (b) 72
(1). AT (GV26, PC6, HT5, LI4, GB20, GV15, CV23, Para-CV23, Upper-CV23, Han Xia, bleeding AT of the EX-HN12 and EX-HN13; 5 sessions a week for 90 days, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training; a total of 90 days, 30 min. per session)
SFG
Significant differences in effective rates
None
18
Broad
+
Strong
Deep
+
Liang (2014)
(a) 65 (b) 65
52.29
3–7
(1). AT (GV20, CV23, and two para-CV23 points, bleeding AT of the EX-HN12 and EX-HN13; 5 sessions a week for 4 weeks, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT including articulation, breathing, and relaxation, lip, and facial muscle training, 5 sessions a week for 4 weeks
FDA
Significant differences in effective rates
None
6
Local
+
Strong
Superficial
+
Han (2014)
(a) 30 (20/10) (b) 30 (18/12)
(a) 58.2 (b) 56.4
(a) 28 (b) 29
(1). AT (GB20 and two points 4 cm under the GB 20, EX-HN14, Zhi Qiang, Tun Yan, Fa Yin, EX-HN 10, bleeding AT of the EX-HN12 and EX-HN13; a total of 40 days, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training; a total of 40 days, 30 min. per session)
FDA
Significant differences in effective rates and the numbers of FDA-a values
Pain on the AT-treated site (n = 1)
13
Local
+
Weak
Superficial
—
Feng (2015)
(a) 72; (b) 72
(a) >18, (b) >18
Undocumented
(1). AT (TE17, GB20, GB12, GV15, CV 23, and two para-CV23 points, CV22, PC6; daily, a total of 20 sessions, 30 min. per session)
General management
FDA
Significant differences in the total scores and effective rates
None
13
Broad
—
Strong
Deep
+
Li (2015)
(a) 89; (b) 85
60.34
3.9
(1). AT (GV20, CV23, and two para-CV23 points, bleeding AT of the EX-HN12 and EX-HN13; 5 sessions a week for 4 weeks, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training; five sessions a week for four weeks, 20 min. per session)
FDA
Significant differences in effective rates
None
6
Local
+
Strong
Superficial
+
Wang (2016)
(a) 60; (b) 60
42–79
Undocumented
(1). AT (GV20, CV23, and two para-CV23 points, bleeding AT of the EX-HN12 and EX-HN13, 5 sessions a week for 4 weeks, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training, 5 sessions a week for 4 weeks, 20 min. per session)
SFG
Significant differences in effective rates
None
6
Local
+
Strong
Superficial
+
Guan (2016)
(a) 60 (36/24) (b) 60 (40/20)
(a) 60.36 (b) 61.57
6
(1). AT (CV23 and two para-CV23 points, GB20, Gong Xue, Ex-HN14, GB19; daily, a total of 20 sessions, 20 min. per session)
General management
FDA
Significant differences in effective rates
None
11
Local
—
Weak
Deep
—
Jia (2016)
(a) 30 (18/12) (b) 30 (18/12)
(a) 62.3 (b) 62.4
Undocumented
(1). Tongue AT (division into two of the entire tongue substance, based on the midline. After that, vertical division into three and finally determining six regions of the tongue; left-upper, right-upper, left-middle, right-middle, left-lower, and right-lower region. Quick pricking with bleeding, a total of 12 punctures on each region. 5 sessions a week for 4 weeks). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training; a total of 90 days, 30 min. per session)
FDA
Significant differences in effective rates
None
6
Local
+
Strong
Superficial
—
Yang (2017)
(a) 40 (26/14) (b) 40 (27/13)
(a) 57.7 (b) 57.0
(a) 73 (b) 73
(1). Scalp EA (acupuncturing of 1 needle from the top of the ear to the GV20, vertically. Addition of two needling, anterior and posterior to the 2.5 cm position of the first acupoint; 5 sessions a week for 4 weeks, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training; a total of 4 weeks, 30 min. per session)
FDA
Significant differences in effective rates
None
6
Local
—
Strong
Superficial
—
Kang (2017)
(a) 44 (23/21) (b) 44 (24/20)
(a) 53.6 (b) 53.9
(a) 6 (b) 5
(1). AT (GV20, CV23, and two para-CV23 points, bleeding AT of the EX-HN12 and EX-HN13, 5 sessions a week for 40 days, 30 min. per session). (2). The same regime using SLT in the control group (b)
(1). SLT (articulation, breathing, and relaxation, lip, and facial muscle training; a total of 40 days, 30 min. per session)
FDA
Significant differences in effective rates and the numbers of FDA-a values
None
6
Local
+
Strong
Superficial
+
Acupoint location: the two para-CV23 points are located 2.5 cm from the left and right sides of the CV23; the upper-CV23 point is located 2.5 cm over the CV23; the Kai Yin points are located 1.5 cm under the left and right mandibular angles; the Gong Xue points are located 4 cm under both GB 20 points; Zhi Qiang is located on the midline between the hyoid bone and the upper margin of the thyroid cartilage; Tun Yan is located 1.3 cm from the left and right sides of the midline point between the hyoid bone and Adam’s apple; Fa Yin points are located 0.5 cm from the left and right sides of the midline point between the thyroid and cricoid cartilages. In Shi’s study, the two left and right Ex-HN1 points were selected among the four EX-HN1 points; the Han Xia is located at the middle point of the line which goes from the mandibular angle to the midpoint of the lower jaw. AT: acupuncture treatment, FDA: Frenchay dysarthria assessment, SFG: speech function grading, SLT: speech-language therapy, Total no: total numbers of needles.
