Non-Traditional Chinese and non-Ayurvedic complementary and alternative medicine in Southeast Asian post-stroke care: A systematic review

Abstract

Background and Purpose: Stroke has a particularly high incidence and mortality in the Association of Southeast Asian Nations (ASEAN) region. Complementary and alternative medicine (CAM) usage is widespread in this region, including Traditional Chinese Medicine (TCM) and Ayurvedic medicine, but also other forms of traditional medicine. This study aims to systematically review the prevalence, type and effectiveness of non-TCM non-Ayurvedic CAM in post-stroke patients in the ASEAN region.

Methods: PubMed, Embase and Scopus databases were searched from inception to 27 July 2024. Studies with patients from the ASEAN region who were diagnosed with stroke and used any CAM that was not TCM or Ayurvedic medicine were included. Two independent authors screened through relevant articles, extracted data and assessed risk of bias.

Results: Sixteen studies from four countries were included. The use of massages, herbs, spiritual and energy healing methods were widely adopted for post-stroke patients in the ASEAN region. Evidence for CAM improving neurological and physical stroke outcomes were limited. Despite this, studies have been largely unanimous in reporting improved psychological and quality of life outcomes following CAM use.

Conclusions: There is a severe paucity of published literature on non-TCM and non-Ayurvedic CAM use in stroke patients in the ASEAN region despite likely widespread use. There is some evidence of potential benefit but these are limited to subjective patient-reported outcomes. More research is needed to understand its impact and how best to complement conventional stroke care without compromising outcomes.