Efficacy of acupuncture therapy for post-stroke fatigue: a systematic review and Meta-analysis

OBJECTIVE: To assess the effectiveness and safety of acupuncture for post-stroke fatigue(PSF). METHODS: Eight online databases were searched to collect relevant trials of acupuncture for PSF published before April 2021. Meta-analysis was performed by using RevMan 5.4 software. The Grading of Recommendations, Assessment, Development and Evaluation system was used to assess the certainty of evidence. RESULTS: Four randomized controlled trials involving 289 PSF patients were identified and included in the systematic review. The results of the Meta-analysis revealed that acupuncture group was significantly better than routine treatment group in improving the effective rate [risk ratio(RR) = 1.15, 95%CI(1.01, 1.33), P = 0.04], reducing the FSS score [mean difference(MD) =-4.71, 95% CI(-6.22,-3.20), P < 0.000 01] and FMA score [MD = 15.60, 95% CI(11.96, 19.23), P < 0.000 01]. Side effects of acupuncture were mild and rarely reported. The certainty of evidence of the outcomes based on the four trials was assessed as low. CONCLUSIONS: The existing evidence suggests acupuncture as an adjunct to routine treatment may benefit in managing fatigue in stroke patients. However, high-quality RCTs are needed to further confirm these findings.