STROKE RESEARCH (© JCM Ltd)
ACUPUNCTURE IMPROVES BALANCE IN STROKE PATIENTS
Investigators in Taiwan have found that acupuncture has an immediate effect on improving balance in stroke patients. In a single-blinded, randomised, controlled study, 30 stroke patients were allocated to experimental and control groups. All participants had needles inserted at Baihui DU-20 and at four surrounding points (1.5 cun anterior, posterior and lateral to Baihui DU-20) for 20 minutes. In the experimental group the needles were manipulated to obtain deqi, while in the control group the needles were not manipulated. Balance functions, measured as the time taken to reach a standing from a seated position and the time taken to walk six metres decreased equally in both experimental and control groups, although the experimental group showed a greater reduction in the displacement areas of their centres of gravity compared with the control group. In addition, the strength of hip flexor and knee extensor muscles were increased on both paralysed and non-paralysed sides of patients in the experimental group, but not in the control group. (Acupuncture stimulation improves balance function in stroke patients: a single-blinded controlled, randomized study. Am J Chin Med. 2009;37(3):483-94).
ELECTROACUPUNCTURE FOR MOTOR RECOVERY IN CHRONIC STROKE
A US pilot study has compared improvement in upper-limb motor function in chronic stroke survivors who received a combination of acupuncture and strength training, with that of subjects who received strength training alone. Ten chronic stroke patients with moderate or severe wrist muscle spasticity were recruited for the study, which used a crossover design with a random order of either combined electroacupuncture and strength training or strength training alone. Each subject received one of the two types of treatment twice a week for the first six weeks and then switched to the other treatment for another six weeks. After the combined treatment, quantitative spasticity level, active wrist extension range of motion and Fugl-Meyer upper-limb motor score changed significantly, but no significant changes were noted in isometric wrist strength. Strength training alone resulted in no significant changes to any measured variable. (Electroacupuncture may help motor recovery in chronic stroke survivors: a pilot study. J Rehabil Res Dev. 2008;45(4):587-95).
LOW FREQUENCY ELECTROACUPUNCTURE BETTER FOR STROKE RECOVERY
A Korean study suggests that low frequency electroacupuncture (EA) may be more helpful for motor recovery after stroke than high frequency EA. Sixty-two patients with motor dysfunction, hospitalised one week to one month from onset of ischaemic stroke, were treated with 2Hz or 120Hz EA over a two week period. Motor evoked potentials (MEPs, measurements of electrical potential recorded in muscles following transcranial magnetic stimulation) were recorded in patients before and after treatment. After two weeks of treatment, the 2Hz group showed significantly more improvement in MEP parameters on the affected side than the 120 Hz group. This suggests that low frequency EA activates the central motor conduction system better than high frequency EA, and could therefore be more helpful in stimulating motor recovery after stroke. (The effect of low versus high frequency electrical acupoints stimulation on motor recovery after ischemic stroke by motor evoked potentials study. Am J Chin Med. 2008;36(1):45-54).
ELECTROACUPUNCTURE FOR STROKE
The effects of electroacupuncture for patients with ischaemic stroke have been examined in a randomised controlled study. Sixty-three patients with first-ever ischaemic stroke were divided into study and control groups. Both groups underwent a conventional rehabilitation program and the study group received an additional eight sessions of electroacupuncture over a period of one month. Motor performance and functional independence were assessed at two and four weeks after treatment, and three months and six months after stroke. Motor performance in the study group was significantly improved, relative to the control group, at two and four weeks after treatment, and at three months after the stroke. Particular improvement was seen in upper-limb motor function. There was no statistically significant difference found between the groups in terms of functional independence. (Additional therapeutic effects of electroacupuncture in conjunction with conventional rehabilitation for patients with first-ever ischaemic stroke. J Rehabil Med. 2007 Apr;39(3):205-11).
ELECTRO-ACUPUNCTURE REDUCES POST-STROKE SPASTICITY
A combination of electro-acupuncture and muscle strengthening exercises can significantly reduce the spasticity of the wrist joint in stroke survivors. In a crossover trial, seven chronic stroke subjects (average age 63) received two six-week treatment regimens: combined electro-acupuncture and strengthening twice a week, and strengthening twice a week only. Wrist spasticity was reduced significantly in the combined treatment group after the six-week period, but not in the strengthening-only group. (The effect of electro-acupuncture on spasticity of the wrist joint in chronic stroke survivors. Arch Phys Med Rehabil. 2007 Feb;88(2):159-66).
ACUPUNCTURE & STROKE
A Hong Kong study has cast doubt on the benefits of acupuncture for stroke recovery. All 106 patients in the study (3-15 days after stroke) received standard stroke care (physiotherapy, occupational and speech therapy and medical and nursing care) whilst a randomised subgroup also received Chinese manual acupuncture (35 treatment sessions using manual acupuncture on 10 main acupoints over 10 weeks). There were no significant differences between the two groups in any measures. (Stroke 2002; 33:186-94).
ELECTRO-ACUPUNCTURE & STROKE
A Taiwanese study compared rehabilitation therapy plus non-needling electro stimulation of acupuncture points with rehabilitation therapy alone in the treatment of post-CVA hemiplegia. Electro-acupuncture was given 5 times per week. Patients who received electro-acupuncture had shorter hospital stays and better neurological and functional outcomes. The authors report that this study contrasts with previous studies suggesting that needling to obtain deqi is a requisite (American Journal of Physical Medicine & Rehabilitation 1999; 78(2); 117-122).
ACUPUNCTURE & STROKE
The aim of this study carried out at the Sunnaas Rehabilitation Hospital in Norway was to investigate whether acupuncture treatment, if given to stroke patients in the subacute phase (within 40 days of the stroke) in addition to rehabilitation would influence motor function, activity of daily living (ADL) and quality of life. 45 patients (median age 57 years) were randomised into a control group and an acupuncture group. When included and six weeks later all patients were evaluated by three measurement systems: the Motor Assessment Scale for stroke patients, Sunnaas Index of ADL and Nottingham Health Profile. All patients underwent individually adapted rehabilitation therapy. The patients in the treatment group were given classical acupuncture three to four times a week for six weeks, each session lasting 20-30 minutes. Both groups improved significantly in motor function and ADL. However, improvement was significantly greater among the acupuncture group than among the controls. Only the acupuncture group rated a significantly improved quality of life. Our results indicate that acupuncture gives an additive therapeutic benefit when given to stroke patients during their rehabilitation programme in the subacute phase. (Tidsskrift for Den Norske Laegeforening. 1995 ;115(23):2884-7).
