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. 2016 Aug 26;2016(8):CD004131. doi: 10.1002/14651858.CD004131.pub3

Zhou 2014.

Methods RCT
 Method of randomisation: closed envelopes
 Blinding: Investigators but not participants blinded
 Adverse effects: 20
ITT analysis: not stated
 Losses to FU: none
Participants Country: China
 Number of participants included: 147 (75/72)
 Demographics: aged 35‐80 years, 54% male
 Type of stroke: ischaemic only
 Diagnosis: WHO definition and all confirmed by CT/MRI
 Severity on entry: not stated
 Time from stroke onset: 1‐3 months
 Setting: inpatient
 Comparability: no significant difference in age or time post onset
Interventions Comparison: acupuncture + daily PT versus daily PT
Acupuncture treatment
  • Acupuncture rationale: not stated

  • Needling details

    • Points used: both body and scalp acupoints

    • Numbers of points used: 8 scalp acupoints and 9 body acupoints

    • Depths of insertion: 1.18‐1.38 inches

    • Deqi elicited: not stated

    • Needle stimulation: manual and electrical

    • Needle retention time: 6‐8 hours/30 minutes

    • Needle type: hua tuo brand, length 1.57 inches

  • Treatment regimen

    • Number of treatment sessions: 40 sessions

    • Frequency of treatment: 5 sessions/week

    • Total course: 8 weeks

  • Practitioner background: not stated

  • Co‐intervention: PT


Control interventions: PT
Outcomes
  • Improvement of depression (HAMD)

  • Improvement of neurological function (NIHSS)

  • Improvement of independence (Barthel Index)

  • Improvement of motor function (Fugl‐Meyer scale)

  • Adverse event: bleeding, haematoma, and pain

Notes
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Randomisation by using closed envelopes
Allocation concealment (selection bias) Low risk Randomisation by using closed envelopes
Blinding (performance bias and detection bias) 
 All outcomes Low risk Investigators blinded
Blinding of participants and personnel (performance bias) 
 All outcomes Unclear risk Details not given
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Outcome assessors blinded
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Treatment: no participants lost to follow‐up
Control: 3 participants lost to follow‐up
Selective reporting (reporting bias) Unclear risk Some patient‐related outcomes were not reported, such as information on quality of life or all‐cause mortality
Other bias Unclear risk No information provided