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Journal of Traditional Chinese Medicine >

2022 , Vol. 42 >Issue 3: 321 - 331

DOI: https://doi.org/10.19852/j.cnki.jtcm.2022.03.001

Systematic review

Efficacy of meridian massage for motor function after a stroke: a systematic review and Meta-analysis

  • Yunhui XIE ,
  • Hao GU ,
  • Qing ZHAO ,
  • Dejie LI ,
  • Ying GONG ,
  • Junxing XIE ,
  • Guofeng SHI
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  • 1 Nursing school, Guizhou University of Traditional Chinese Medicine, Guiyang 550000, China
    2 Graduate School, Guizhou Medical University, Guiyang 550000, China
    3 Guizhou Provincial People’s Hospital, Guiyang 550000, China
    4 Qiannan Medical College for Nationalities, Duyun 558000, China
    5 Nanjing Medical University, Nanjing 210029, China
SHI Guofeng, Nursing School, Guizhou University of Traditional Chinese Medicine, Guiyang 550000, China. Shiguofeng529@gzy.edu.cn, Telephone: +8613608556696

Received date: 2021-09-20

  Accepted date: 2021-11-12

  Online published: 2022-05-20

Supported by

National Natural Science Foundation of China(Based on the Regulation of MIR-206 on BDNF, to Explore the Mechanism of Meridian Massage on Motor Function Reconstruction in rats with Cerebral Infarction)(8166150430)

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Abstract

OBJECTIVE: To evaluate the efficacy of meridian massage on motor function after a stroke.

METHODS: This systematic review and Meta-analysis of randomised (RCTs) and quasi-randomised controlled trials (qRCTs) was performed to determine the effects of meridian massage on motor dysfunction following a stroke. Articles published until December 2020 related to stroke and meridian massage from National Library of Medicine, Cochrane Central Register of Controlled Trials, Embase, KoreaMed, Japan science and Technology Agency, China National Knowledge Infrastructure Database, Wanfang Database, Chinese Biomedical Literature Database and China Science and Technology Journal Database were searched. The primary outcomes included Fugl-Mayer Assessment (FMA), modified Barthel Index (mBI) and clinical efficiency, while the secondary outcomes included modified Ashworth (mAS) and Berg Balance Scale (BBS). Two authors independently selected the literature, extracted the data and assessed the risk of bias, after which Meta-analysis with subgroups and sensitivity analysis was conducted.

RESULTS: A total of 16 RCTs and 3 q-RCTs involved 1556 patients satisfied the inclusion. Meta-analysis showed that compared to conventional rehabilitation, meridian massage had significantly better FMA [mean difference (MD) = 1.16, 95% confidence interval (CI): 0.43, 1.89, P = 0.002], FMA-L (MD = 3.21, 95% CI: 1.97, 4.45, P = 0.000 01), mBI (MD = 8.87, 95% CI: 4.24, 13.49, P = 0.000 02), clinical efficiency [relative risk (RR) = 1.37,95% CI: 1.24, 1.51, P < 0.000 01], mAS (MD = -0.69, 95% CI: -1.26, -0.11, P = 0.02) and BBS (MD = 5.07, 95% CI: 2.22, 7.93, P = 0.0005). Subgroup analysis indicated no significant difference between meridian massage and control group when the intervention duration was >8 weeks (MD = 0.89, 95% CI: -0.64, 2.42, P = 0.25) but improving motor function in the meridian massage when the intervention duration was ≤ 8 weeks (< 4 weeks intervention duration MD = 0.84, 95% CI: 0.59, 1.10, P < 0.000 01; 4-8 weeks MD = 2.41, 95% CI: 0.80, 4.01, P = 0.003).

CONCLUSIONS: Meridian massage as an alternative and complementary therapy seems to have short-term benefits in improving post-stroke motor function (particularly in the lower limbs), quality of life, clinical efficiency, and balance stability and muscle spasms. The high heterogeneity of the included studies and the low methodological quality certainly limits the confidence placed in this systematic review and Meta-analysis, warranting future well-designed studies.

Key words： stroke; meridian massage; motor function; Meta-analysis; randomized controlled trial

Cite this article

Yunhui XIE , Hao GU , Qing ZHAO , Dejie LI , Ying GONG , Junxing XIE , Guofeng SHI . Efficacy of meridian massage for motor function after a stroke: a systematic review and Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2022 , 42(3) : 321 -331 . DOI: 10.19852/j.cnki.jtcm.2022.03.001

References

1 Roy OM, McCullough LD, Age and sex are critical factors in ischemic stroke pathology. Endocrinology 2018; 159:3120-31.
2 Hankey GJ. Stroke. Lancet 2017; 389:641-54.
3 Feigin VL, Mensah GA, Norrving B, et al. GBD 2013 stroke panel experts group. Atlas of the Global Burden of Stroke (1990-2013): The GBD 2013 Study. Neuroepidemiology 2015; 45:230-6.
4 Avan A, Digaleh H, Di Napoli M, et al. Socioeconomic status and stroke incidence, prevalence, mortality, and worldwide burden: an ecological analysis from the Global Burden of Disease Study 2017. BMC Med 2019; 17:191.
5 Tod E, McCartney G, Fischbacher C, et al. What causes the burden of stroke in Scotland? A comparative risk assessment approach linking the Scottish Health Survey to administrative health data. PLoS One 2019; 14:e0216350.
6 Howard G, Goff DC. Population shifts and the future of stroke: forecasts of the future burden of stroke. Ann N Y Acad Sci 2012; 1268:14-20.
7 Verberne DPJ, Post MWM, Köhler S, Carey LM, Visser-Meily JMA, van Heugten CM. Course of social participation in the first 2 years after stroke and its associations with demographic and stroke-related factors. Neurorehabil Neural Repair 2018; 32:821-33.
8 Sacco RL, Kasner SE, Broderick JP, et al. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association [published correction appears in Stroke. 2019 Aug; 50(8): e239]. Stroke 2013; 44:2064-89.
9 Wu S, Wu B, Liu M, et al. Stroke in China: advances and challenges in epidemiology, prevention, and management. Lancet Neurol 2019; 18:394-405.
10 Li L, Scott CA, Rothwell PM; Oxford Vascular Study. Trends in stroke incidence in high-income countries in the 21st century: population-based study and systematic review. Stroke 2020; 51:1372-80.
11 Brainin M. Stroke epidemiology in China: which are the next steps? Lancet Neurol 2019; 18:325-6.
12 Zhou M, Wang H, Zeng X, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017 [published correction appears in Lancet. 2020 Jul 4; 396(10243): 26]. Lancet 2019; 394:1145-58.
13 Valdés BA, Van der Loos HFM. Biofeedback vs game scores for reducing trunk compensation after stroke: a randomized crossover trial [published correction appears in Top Stroke Rehabil. 2018 Apr; 25(3): 239]. Top Stroke Rehabil 2018; 25:96-113.
14 Vickers A, Zollman C. ABC of complementary medicine: herbal medicine [published correction appears in BMJ 1999 Nov 27; 319(7222): 1422]. BMJ 1999; 319:1050-53.
15 Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report 2008: 1-23.
16 Goldstone LA. Massage as an orthodox medical treatment past and future. Complement Ther Nurs Midwifery 2000; 6:169-75.
17 Pandian J D, Liu M, Misbach J, et al. Alternative therapies for stroke treatment in Asia. Int J Stroke 2011; 6:541-3.
18 Kong LJ, Fang M, Zhan HS, et al. Tuina-focused integrative chinese medical therapies for inpatients with low back pain: a systematic review and Meta-analysis. Evid Based Complement Alternat Med 2012; 2012:578305.
19 Kania-Richmond A, Reece BF, Suter E, Verhoef MJ. The professional role of massage therapists in patient care in Canadian urban hospitals--a mixed methods study. BMC Complement Altern Med 2015; 15:20.
20 Lee JS, Lee MS, Min K, Lew JH, Lee BJ. Acupressure for treating neurological disorders: a systematic review. Int J Neurosci 2011; 121:409-14.
21 Di HY, Li WW. Effects of surface and surface massage on motor function and daily life activity of patients with upper limb spasm after stroke. Sichuan Zhong Yi 2016; 34:185-6.
22 Di HY. Effects of surface and surface massage on spasticity of upper limbs after stroke. Zhong Xi Yi Jie He Xin Nao Xue Guan Bing 2017; 14:690-2.
23 Di HY, Han SK, Du XL, et al. Applying tuina to exterior-interiorly connected meridians for post-stroke upper limb spasticity. J Acupunct Tuina Sci 2017, 15:27-30
24 Geng XD, Duan JQ, Zhang XN, et al. Effects of Shujing Tongdu massage and rehabilitation training on motor ability of hemiplegic limbs in stroke patient. Lin Chuang Yi Yao Wen Xian Za Zhi 2016, 5:61-2.
25 Yang GP. Effect of massage combined rehabilitation training on hemiplegic limb motor ability of stroke patients. Zhong Guo Min Kang Yi Xue 2015, 27:112-4.
26 Xu JJ. Effect of manipulation massage combined with emotional nursing on clinical rehabilitation of patients with stroke recovery. Sichuan: Chengdu University of Traditional Chinese Medicine, 2011: 1-3.
27 Kang H S, Sok S R, Kang JS. Effects of Meridian acupressure for stroke patients in Korea. J Clin Nurs 2009; 18:2145-52.
28 Lin JZ, Zheng WX, Chen JL, et al. Effect and mechanism of meridian massage combined rehabilitation training on motor function recovery in stroke patients. Shi Jie Zhong Yi Yao 2017; 4:899-902.
29 Liu J, Liu C, Hu GF. Clinical observation of meridian massage combined with modern rehabilitation for stroke hemiplegic patients. Jining Yi Xue Yuan Xue Bao 2015; 38:116-8.
30 Zhang MN, Effect of rehabilitation massage combined with functional exercise on limb motor function and muscle strength recovery of hemiplegic patients after stroke. Zhong Wai Yi Xue Yan Jiu 2018; 17:171-2.
31 Pan HP. Effects of Shujing Tongdu massage and rehabilitation training on motor ability of hemiplegic limbs in stroke patients, Jiangsu: Nanjing University of Traditional Chinese Medicine 2012: 1-3.
32 Wu PX. The Correlation of the Function Outcomes and the Effects of Rehabilition by Tuina with Rehabilition Training on the pa-tients of post-stroke. Shandong: Shangdong University 2012: 1-3.
33 Lee J S, Seo N S. Effects of the meridian massage on the hand edema, activities of daily living, and depression in stroke patients, Korean Journal of Adult Nursing 2010, 22:171-81.
34 Sun PP. Clinical electrophysiological study of massage therapy for spastic hemiplegia after stroke, Liao Ning Zhong Yi Za Zhi 2015; 10:1850-52.
35 Tang JL, Han SK. Effect of massage on upper limb spasm after stroke, Hu Li Yan Jiu 2011; 7:1839-40.
36 Wang XH. Effect of meridian massage on motor function of stroke hemiplegic patients, Hu Li Yan Jiu 2015; 29:4473-74.
37 Wu XL, Sun SJ, Yin GX. Clinical observation on relieving spastic hemiplegia after stroke by meridian massage. Zhong Yi Yao Lin Chuang Za Zhi 2018, 10:1920-22.
38 Yang M, Xiao MZ. Effect of rehabilitation massage therapy on motor function and daily life ability of stroke hemiplegic spastic patients, Chinese and foreign medical research. Zhong Wai Yi Xue Yan Jiu 2018; 16:16-7.
39 Yang YJ, Zhang J, Hou Y, et al. Effectiveness and safety of Chinese massage therapy (Tui Na) on post-stroke spasticity: a prospective multicenter randomized controlled trial. Clin Rehabil 2017; 31:904-12.
40 Wang YF. Effect of Traditional Chinese Medicine massage combined with modern rehabilitation training on spasticity of stroke hemiplegia, Beijing: Beijing University of Traditional Chinese Medicine 2003: 1-3.
41 Yue S, Jiang X, Wong T. Effects of a nurse-led acupressure programme for stroke patients in China. J Clin Nurs 2013; 22:1182-88.
42 Sanford J, Moreland J, Swanson LR, Stratford PW, Gowland C. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phys Ther 1993; 73:447-54.
43 Salter K, Jutai JW, Teasell R, Foley NC, Bitensky J. Issues for selection of outcome measures in stroke rehabilitation: ICF body functions. Disabil Rehabil 2005; 27:191-207.
44 Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol 1989; 42:703-09.
45 Salter K, Jutai JW, Teasell R, Foley NC, Bitensky J. Issues for selection of outcome measures in stroke rehabilitation: ICF body functions. Disabil Rehabil 2005; 27:121-41.
46 Salter K, Jutai JW, Teasell R, Foley NC, Bitensky J. Issues for selection of outcome measures in stroke rehabilitation: ICF body functions. Disabil Rehabil 2005; 27:507-28.
47 Salter K, Jutai JW, Teasell R, Foley NC, Bitensky J. Issues for selection of outcome measures in stroke rehabilitation: ICF body functions. Disabil Rehabil 2005; 27:315-40.
48 Downs S. The Berg Balance Scale. J Physiother 2015; 61:46.
49 Higgins J P, Sterne J A, Savovic J, et al. A revised tool for assessing risk of bias in randomized trials, Cochrane Database Syst Rev 2016; 2016: CD010820.
50 Pollock A, Farmer SE, Brady MC, et al. Interventions for improving upper limb function after stroke. Cochrane Database Syst Rev 2014; 2014: CD010820.
51 Dohle C. Rehabilitation nach Schlaganfall [Rehabilitation after stroke]. Dtsch Med Wochenschr 2021; 146:809-17.
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