A Randomized Controlled Trial on the Treatment for Acute Partial Ischemic Stroke with Acupuncture

Abstract

The effectiveness of acupuncture in acute stroke remains largely untested and unproved. A randomized, controlled trial was carried out to study the feasibility of acupuncture in combination with conventional supportive treatment for acute stroke patients. A total of 30 patients, aged 46-74, with the onset of symptoms within 36 h were enrolled into the study after appropriate screening. All patients gave informed consent. Basing on the same supportive treatment, patients were randomly assigned to a treatment with or without acupuncture. The procedure and acupoint selection were discussed and decided through several meetings of a group of senior acupuncture doctors in Taiwan. Acupuncture was applied 3 times/ week for 4 weeks. During the study period, there were no problems in conducting this trial in terms of patient availability and acceptance, and physician cooperation. A significantly better neurologic outcome was observed in the acupuncture group on day 28 and day 90. The improvement in neurologic status was greatest in patients with a poor neurologic score at baseline. There were no important side effects except for one episode of dizziness related to acupuncture treatment. The data and results of this study will be used as a guideline for planning a full-scale clinical trial, e.g. sample size calculation, method of randomization with stratification of prognostic factors, choosing acupuncture points and technique of acupuncture.

Acupuncture Efficacy on Ischemic Stroke Recovery

“…[7][8][9][10] However, randomized controlled trials have yet to show convincing evidence of benefit in acute and subacute ischemic stroke. [11][12][13] In the earlier trials conducted outside China, 2 studies showed that acupuncture can improve motor function and independence in activities of daily living (ADL), 14,15 whereas 2 trials using sham treatment as control did not find evidence of benefit. 16,17 Although, by contrast, many Chinese trials reported positive results, the conclusions were not regarded as robust, as a result of small sample size and methodological weaknesses as follows: the use of outcome measures that were not internationally recognized; unclear methods of randomization and allocation concealment; the lack of long-term follow-up; and publication bias.…”

A Meta-Analysis of Acupuncture Use in the Treatment of Cognitive Impairment After Stroke

“…10,11 The utility of acupuncture treatment remains under investigation, even with many lines of evidence supporting its use across diseases. Numerous studies [12][13][14][15] support the clinical efficacy of acupuncture in stroke rehabilitation, especially in China; nevertheless, some conflicting evidence exists. 16 Systematic reviews of trials of acupuncture in stroke rehabilitation have been conducted, 13,[17][18][19][20][21] including trials on stroke patients in acute, subacute, or chronic stages.…”

Does Acupuncture Have Additional Value to Standard Poststroke Motor Rehabilitation?

“…All 12 trials showed that the acupuncture group was better in functional recovery than the control group, although none had sample size calculation or used intention-to-treat analysis. Among the 12 trials, only 1 4 compared the efficacy of acupuncture plus PT and OT with that of PT and OT alone, whereas in the English literature, 10 RCTs were found [5][6][7][8][9][10][11][12][13][14] between 1966 and March 2001, using the same inclusion criteria. Excluding 2 long-term follow-up studies 13,14 of the same sample of previously reported trials, 5,9 2 6,12 of the remaining 8 RCTs reported negative results and 2 7,9 reported positive results in both impairment and disability measures.…”