Accupouncture for acute management and rehabilitation of traumatic brain injury.
ABSTRACT Traumatic brain injury (TBI) can be life threatening depending on the severity of the insult to the brain. It can also cause a range of debilitating sequelae which require cognitive, motor, communication, emotional, or behavioral rehabilitation of varying intensity and duration. A number of studies conducted and published in China have suggested that acupuncture may be beneficial in the acute treatment and rehabilitation of TBI. The aim of this paper was to determine the efficacy and safety of acupuncture in the acute management or rehabilitation (or both) of patients with a TBI, including cognitive, neurological, motor, communication, emotional, or behavioral complications, or a combination of such complications.
We searched the Cochrane Injuries Group Specialised Register, Cochrane Central Register of Controlled Trials 2008, Issue 2 (The Cochrane Library), MEDLINE, EMBASE, CINAHL, AMED, PsycINFO and others. We also searched the Chinese Acupuncture Studies Register, the Studies Register of the Cochrane Complementary Medicine Field, NCCAM, and NIH Clinical Studies Database. Three major Mainland Chinese academic literature databases (CNKI, VIP and Wang Fang Data) were also searched using keywords in simplified Chinese. Searches were completed in December 2009. Randomized controlled studies evaluating different variants of acupuncture and involving participants of any age who had suffered a TBI. Included trials compared acupuncture with placebo or sham treatment, or acupuncture plus other treatments compared with the same other treatments.We excluded trials that only compared different variants of acupuncture or compared acupuncture alone against other treatments alone, as they did not yield the net effect of acupuncture. Two review authors identified potential articles from the literature search and extracted data independently using a data extraction form. We performed methodological assessment of included studies using the Cochrane Collaboration's tool for assessing risk of bias. We were unable to perform quantitative data analysis due to insufficient included studies and available data.
Four RCTs, including 294 participants, reported outcomes specified by this review. Three investigated electro-acupuncture for TBI while one investigated acupuncture for acute TBI. The results seem to suggest that acupuncture is efficacious for these indications, however the low methodological quality of these studies renders the results questionable. No adverse effects of acupuncture were reported in any of the studies.
The low methodological quality of the included studies does not allow us to make conclusive judgments on the efficacy and safety of acupuncture in either the acute treatment and/or rehabilitation of TBI. Its beneficial role for these indications remains uncertain. Further research with high quality trials is required.
Article: EJPRM systematic continuous update on Cochrane reviews in rehabilitation: news from December 2011 to February 2012.[show abstract] [hide abstract]
ABSTRACT: In order to present to our readers the best available evidence in the field of Rehabilitation, we continuously perform systematic reviews of the articles regularly published in the Cochrane Library, being these considered the most reliable instruments of synthesis, reliable because based on a strict methodology. Moreover, according to the aim of the Cochrane Collaboration, in order to diffuse sound data, we invited Cochrane authors to republish their articles in the EJPRM. The aim of the present paper is to systematically review all the new rehabilitation papers published from December 2011 up to February 2012 from the Cochrane Library in order to provide to physicians involved in the field a summary of the best evidence nowadays available. The authors systematically searched all the new papers of rehabilitative interest from the 5th of December 2011 to the 27th of February 2012 in the Cochrane Library. The retrieved papers have been then divided in subgroups on the base of the topic and the Cochrane Groups. The number of included papers was 5, 4 new reviews and 2 updates reviews. A synthesis of abstracts is presented. The field of rehabilitation, being cross-sectional to the whole Medicine, can be of interest for many specialty. This was documented by the large number of Cochrane Group publishing reviews of Rehabilitative interest. Reviewing periodically the Cochrane reviews is a good way to remain up to date and to find solid bases for everyday clinical practice.European journal of physical and rehabilitation medicine 03/2012; 48(1):57-70. · 1.40 Impact Factor
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ABSTRACT: Acupuncture has had a successful story in Brazil. With its use in the public health system supported by legislation since 1988, its recognition as a medical specialty in 1995 enabled the introduction of an annual board examination and the creation of an official Medical Residency Programme. Since then, medical acupuncture has developed considerably, mostly through its massive spread into the Brazilian public health system. Brazil is the only country outside China that has created a Medical Residency Programme on Acupuncture. The 2-year programme consists of 5760 training hours, beginning with major clinical areas (internal medicine, neurology, orthopaedics and gynaecology) during 24 weeks in the first year. The residents study and practice acupuncture using the traditional Chinese Medicine approach and also the biomedical model. Specialists educated by this programme are therefore expected to have an optimum knowledge of both Western and Eastern medicine. Since it was first created, nine public health institutions have adopted the residency programme on acupuncture so, rather than being an alternative therapy, acupuncture has become an easily accessible and well-accepted conventional medical resource in Brazil.Acupuncture in Medicine 09/2012; · 1.19 Impact Factor