Stroke, by whatever cause, is a serious event as most anyone knows, and surviving it is both blessing and challenge. Strokes are generally completely unanticipated, unless one has experienced one already (which puts one at high risk for future strokes), and even if anticipated, they occur with little or no immediate warning. And of course, the potential outcome of stroke is quite concerning to say the least. So, surviving one is in itself fortunate. Surviving stroke is a challenge because of all the possible sequelae: as mentioned, the heightened risk of stroke in the future, as well as the changes that may result from an attack, whether to motor skills, speech, thinking, etc.
One main after-event of stroke is Post-Stroke Depression (PSD), which affects up to 35% of stroke survivors. As with depression by any cause, this condition can be seriously debilitating on many levels. As stated in the study, “PSD negatively affects social activities, cognitive function, and stroke rehabilitation, which is closely associated with increased mortality,” as failing to return the individual’s health to a state of relative normalcy means increased risk of recurrence.
Biomedical (pharmaceutical) interventions can be effective treating PSD, but very often bring undesirable side effects as well, including low blood pressure, insomnia, visual disturbance, sexual dysfunction and urinary problems.
This meta-study (a study analyzing the results of several individual studies, which reveals the overall trend of those results) began as a search for as many pertinent trials as could be found, narrowed that list down to 158 which dealt directly with the question of whether acupuncture was effective therapy for PSD, and then filtered those trials in turn to eliminate ones conducted with poor scientific method, loose standards of the therapies’ effectiveness, or which tested too many different therapies at once (example given: acupuncture with music.) The final list of seven trials gave good scientific data and a reasonably large number of trial participants.
If you’re not familiar with scientific testing, the goals of these tests are to give factual knowledge as solid as can be found, by using methods to produce evidence that can be reproduced, and which enable reliable and accurate predictions according to the theory being tested. Most of us know someone who has had acupuncture, or reiki, or used herbal medicine, for some specific ailment or another, and of course their stories can be very influential in our decision making process. Still, if you go to your MD for a recommendation to get alternative care, and to make your point, tell them about your aunt who got great results using acupuncture to treat her hypertension, your doctor could likely say that your aunt’s story alone is not much of a reason to think it would work for your own complaint. This is why a meta-study like this one is so valuable. Acupuncture is notoriously hard to prove with good scientific method for various reasons, and yet it can be done, and to condense the results of multiple tests to show their overall trend can help patients and providers with a good handle in their own decision-making.
The results are in! --what the meta-study showed:
From the seven trials analyzed, it was demonstrated that, on average, acupuncture did better than the control group (mainly meaning patients given pharmaceuticals or placebos) by a good margin. Only in one test did the participants’ average fall in favor of the control group, but not by a dramatic margin. A couple of the studies looked at what happened when patients were treated with both acupuncture and drugs together, or with drugs alone, and interestingly, there was not a cumulative advantage to both therapies used in tandem. However, acupuncture alone compared to drugs alone showed significantly in favor of acupuncture. On top of that, acupuncture was shown to cause fewer adverse side-effects than anti-depressants and SSRI’s.
The flipside of the article’s findings is that, considering how many tests had to be eliminated from the meta-study, it’s clear that as definitive as the results discussed in the article are, there is still vast room for careful scientific studies of acupuncture’s effectiveness. In the closing of the article, the authors point this out, saying that there was still not enough evidence to support recommending acupuncture for PSD by the biomedical community.
Hopefully this review can give readers interested in learning about this kind of research something to think about, and maybe some understanding of what to look for when making decisions about health care in their own lives.
