Needle acupuncture in chronic poststroke leg spasticity. Combination of log relative risk in retrospective studies of disease. Effects of electroacupuncture on acute cerebral infarction. Randomized trials published in some Chinese journals: how many are randomized? Acupuncture and Transcutaneous Nerve Stimulation in Stroke Rehabilitation: A Randomized, Controlled Trial Effects of Acupuncture Treatment on Poststroke Motor Recovery and Physical Function: A Pilot Study Effects of acupuncture treatment on daily life activities and quality of life: a controlled, prospective, and randomized study of acute stroke patients. Does Acupuncture Have Additional Value to Standard Poststroke Motor Rehabilitation? Additional therapeutic effects of electroacupuncture in conjunction with conventional rehabilitation for patients with first-ever ischaemic stroke. Do certain countries produce only positive results? A systematic review of controlled trials. Clinical observation on therapeutic effects of the point-penetrating method in acupuncture treatment of spastic hemiparalysis due to cerebrovascular disorders. Acupuncture for subacute stroke rehabilitation: a Sham-controlled, subject- and assessor-blind, randomized trial. Evaluating the efficacy of acupuncture in defined aspects of stroke recovery [Clinical study on effect of scalp-acupuncture in treating acute cerebral hemorrhage]. [A randomized controlled trial of acupuncture treatment of acute ischemic stroke]. A randomized controlled trial on the treatment for acute partial ischemic stroke with acupuncture. Can sensory stimulation improve the functional outcome in stroke patients? [Long-term effect of acupuncture on quality of life in patients with early stage of stroke]. Chinese authors do need CONSORT: reporting quality assessment for five leading Chinese medical journals. Standards for reporting interventions in controlled trials of acupuncture: The STRICTA recommendations. STandards for Reporting Interventions in Controlled Trails of Acupuncture. EFFECTIVENESS OF COMBINED ACUPUNCTURE THERAPY AND CONVENTIONAL TREATMENT ON SHOULDER RANGE OF MOTION AND MOTOR POWER IN STROKE PATIENTS WITH HEMIPLEGIC SHOULDER SUBLUXATION: A PILOT STUDY Clinical trial of electrical acupuncture on hemiplegic stroke patients. Factors That Influence the Applicability of Sham Needle in Acupuncture Trials: Two Randomized, Single-Blind, Crossover Trials With Acupuncture-Experienced Subjects A one year follow-up study on the effects of acupuncture in the treatment of stroke patients in the subacute stage: a randomized, controlled study
OBJECTIVE To determine whether needle acupuncture may be useful in the reduction of leg spasticity in a chronic state . DESIGN Single-blind , r and omized , placebo-controlled trial . SETTING Neurologic outpatient department of a medical school in Germany . PARTICIPANTS Twenty-five patients ( 14 women ) suffering from chronic poststroke leg spasticity with pes equinovarus deformity ( Modified Ashworth Scale [ MAS ] score , > /=1 ) , aged 38 to 77 years ( mean + /- st and ard deviation , 58.5+/-10.4 y ) , were enrolled in the study . The mean time from stroke to inclusion in the study was approximately 5 years ( mean , 65.4+/-48.3 mo ; range , 7 - 180 mo ) . INTERVENTIONS Participants were r and omly assigned to placebo treatment ( n=12 ) by using a specially design ed placebo needling procedure , or verum treatment ( n=13 ) . MAIN OUTCOME MEASURES MAS score of the affected ankle , pain ( visual analog scale ) , and walking speed . RESULTS There was no demonstrated beneficial clinical effects from verum acupuncture . After 4 weeks of treatment , mean MAS score was 3.3+/-0.9 in the placebo group versus 3.3+/-1.1 in the verum group . The neurophysiologic measure of H-reflex indicated a significant increase of spinal motoneuron excitability after verum acupuncture ( H-response/M-response ratio : placebo,.39+/-.19 ; verum,.68+/-.41 ; P<.05 ) . CONCLUSIONS This effect might be explained by afferent input of A delta and C fibers to the spinal motoneuron . The results from our study indicate that needle acupuncture may not be helpful to patients with chronic poststroke spasticity . However , there was neurophysiologic evidence for specific acupuncture effects on a spinal ( segmental ) level involving nociceptive reflex mechanisms I SHALL discuss the combination of estimates of relative prevalence or incidence , commonly referred to as relative risk , obtained from retrospective 2 X 2 tables . Barnet Woolf ' described the method in 1954 and J. B. S. Haldane2 introduced some modifications shortly afterward in the Annals of Human Genetics . Figure 1 shows how  retrospective case and control data  may be classified . There are usually some background classes based on age , sex , race , occupation , and the like . Within each such class , individuals are further classified into a 2 X 2 table according to the presence or absence of the disease being studied and the presence or absence of a defined characteristic of focal interest . For any single 2 X 2 table , Cornfield3 has shown a simple way to estimate the risk of disease among those wvith the characteristic , relative to the risk of disease among those without the characteristic . This is done , as illustrated below Figure 1 , by taking the ratio of diagonal products of the cell frequencies . This is a maximum likelihood estimate of the relative risk of disease in the parent population , provided that it is assumed that the cases and controls have been selected at r and om and that cases comprise a negligible portion of the population . It is also possible to obtain a combined , unconditioned , maximum likelihood estimate of relative risk based on all of the 2 X 2 tables . However , the method is time-consuming , involving the iterative solution of sets of quadratic equations . Unless such a method is programed for the computer , I feel that the less tedious procedure to be described is adequate for most practical purpose s. Strictly speaking , the maximum likelihood estimate just described has infinite bias and it is positively skewed . To help remedy these defects , the number , 1/2 , is added to each cell frequency before obtaining the ratio of diagonal products ; furthermore , the natural logarithm of this ratio is taken . The result ing value is an estimate of natural log relative risk . Woolf pointed out that the logarithmic transformation tends to remove skew and Haldane showed that of all possible numbers which might be added to or subtracted from the cell frequencies , 1/2 is the number which reduces the bias of the estimate to a minimum . This estimate of log relative risk is shown in the first column of Figure 2 . The estimated The present paper is to study the effects of electroacupuncture ( EA ) on acute ischemic stroke patient and acute cerebral ischemic rat . In clinic , 42 acute ischemic stroke patients were r and omly divided into 2 therapeutic groups : drug group and EA+ drug group . Neurological deficits of patients were evaluated before and after the treatment by Chinese Stroke Scale . The results showed that the acute ischemic stroke patients treated by drug or EA+ drug were all partially recovered , but the clinical functional recovery in EA+ drug group was significantly better than in the drug group ( P < 0.01 ) . In laboratory , the model of reversible middle cerebral artery occlusion ( MCAO ) was used in rats . The somatosensory evoked potential ( SEP ) was recorded before and after MCAO . EA was applied one hour after cerebral ischemia and once a day after reperfusion for 7 days in EA+ MCAO group . It was shown that the amplitude of P1-N1 wave of SEP before MCAO was 100 % . After MCAO 30 min the P1-N1 wave of SEP on the ipsilateral side of MCAO was decreased to 2.2 + /- 3 % ( MCAO group ) , 1.9 + /- 2 % ( MCAO+ EA group ) ; and then recovered to 25.5 + /- 14.1 % ( MCAO group ) , 58.6 + /- 27.2 % ( MCAO+ EA group ) after 7 days of reperfusion following MCAO 2 hours . The above results indicated that EA could promote the recovery of neurological function in acute ischemic stroke patients and SEP on MCAO rats Background The approximately 1100 medical journals now active in China are publishing a rapidly increasing number of research reports , including many studies identified by their authors as r and omized controlled trials . It has been noticed that these reports mostly present positive results , and their quality and authenticity have consequently been called into question . We investigated the adequacy of r and omization  of clinical trials published in recent years in China to determine how many of them met acceptable st and ards for allocating participants to treatment groups . Methods The China National Knowledge Infrastructure electronic data base was search ed for reports of r and omized controlled trials on 20 common diseases published from January 1994 to June 2005 . From this sample , a subset of trials that appeared to have used r and omization methods was selected . Twenty-one investigators trained in the relevant knowledge , communication skills and quality control issues interviewed the original authors of these trials about the participant r and omization methods and related quality -control features of their trials . Results From an initial sample of 37,313 articles identified in the China National Knowledge Infrastructure data base , we found 3137 apparent r and omized controlled trials . Of these , 1452 were studies of conventional medicine ( published in 411 journals ) and 1685 were studies of traditional Chinese medicine ( published in 352 journals ) . Interviews with the authors of 2235 of these reports revealed that only 207 studies adhered to accepted methodology for r and omization and could on those grounds be deemed authentic r and omized controlled trials ( 6.8 % , 95 % confidence interval 5.9–7.7 ) . There was no statistically significant difference in the rate of authenticity between r and omized controlled trials of traditional interventions and those of conventional interventions . R and omized controlled trials conducted at hospitals affiliated to medical universities were more likely to be authentic than trials conducted at level 3 and level 2 hospitals ( relative risk 1.58 , 95 % confidence interval 1.18–2.13 , and relative risk 14.42 , 95 % confidence interval 9.40–22.10 , respectively ) . The likelihood of authenticity was higher in level 3 hospitals than in level 2 hospitals ( relative risk 9.32 , 95 % confidence interval 5.83–14.89 ) . All r and omized controlled trials of pre-market drug clinical trial were authentic by our criteria . Of the trials conducted at university-affiliated hospitals , 56.3 % were authentic ( 95 % confidence interval 32.0–81.0 ) . Conclusion Most reports of r and omized controlled trials published in some Chinese journals lacked an adequate description of r and omization . Similarly , most so called ' r and omized controlled trials ' were not real r and omized controlled trials owing toa lack of adequate underst and ing on the part of the authors of rigorous clinical trial design . All r and omized controlled trials of pre-market drug clinical trial included in this research were authentic . R and omized controlled trials conducted by authors in high level hospitals , especially in hospitals affiliated to medical universities had a higher rate of authenticity . That so many non-r and omized controlled trials were published as r and omized controlled trials reflected the fact that peer review needs to be improved and a good practice guide for peer review including how to identify the authenticity of the study urgently needs to be developed Background and Purpose — In small trials with control groups that receive no intervention , acupuncture has been reported to improve functional outcome after stroke . We studied effects of acupuncture and transcutaneous electrical nerve stimulation on functional outcome and quality of life after stroke versus a control group that received subliminal electrostimulation . Methods — In a multicenter r and omized controlled trial involving 7 university and district hospitals in Sweden , 150 patients with moderate or severe functional impairment were included . At days 5 to 10 after acute stroke , patients were r and omized to 1 of 3 intervention groups : ( a ) acupuncture , including electroacupuncture ; ( b ) sensory stimulation with high-intensity , low-frequency transcutaneous electrical nerve stimulation that induces muscle contractions ; and ( c ) low-intensity ( subliminal ) high-frequency electrostimulation ( control group ) . A total of 20 treatment sessions were performed over a 10-week period . Outcome variables included motor function , activities of daily living function , walking ability , social activities , and life satisfaction at 3-month and 1-year follow-up . Results — At baseline , patients in each group were closely similar in all important prognostic variables . At 3-month and 1-year follow-ups , no clinical ly important or statistically significant differences were observed between groups for any of the outcome variables . The 3 treatment modalities were all conducted without major adverse effects . Conclusions — When compared with a control group that received subliminal electrostimulation , treatment during the subacute phase of stroke with acupuncture or transcutaneous electrical nerve stimulation with muscle contractions had no beneficial effects on functional outcome or life satisfaction This pilot study obtained preliminary data on the effects of acupuncture treatment combined with a st and ard inpatient stroke rehabilitation program on poststroke motor recovery and physical function .  Thirty-two patients with acute stroke were recruited and r and omized to 1 of 2 treatment arms : st and ard rehabilitation ( control group ) or a combination of acupuncture and st and ard rehabilitation ( acupuncture group ) . Baseline and discharge assessment s were obtained on motor recovery as measured by the Fugl-Meyer ( FM ) Assessment and on physical function as measured by the Functional Independence Measure ( FIM ) . Comparisons were made between the acupuncture and control group in total FM and FIM as well as for each subscale of the FM and FIM . No differences between treatment groups were found in the total FM or the total FIM . However , statistically significant benefit due to acupuncture was observed for the FM lower extremity motor function subscale ( P = 0.01 ) and the tub/shower transfer mobility subscale of the FIM ( P = 0.03 ) . Marginally significant benefit due to acupuncture was noted for the toilet transfer mobility subscale of the FIM ( P = 0.09 ) . The effectiveness of acupuncture as an adjunct to st and ard poststroke rehabilitation programs may be demonstrated when more specific measures of stroke motor recovery and physical function are used BACKGROUND AND PURPOSE A number of studies have indicated that acupuncture might improve the functional recovery of stroke patients . These studies vary in inclusion criteria , sample size , and evaluation methods . The present study was design ed to investigate whether electroacupuncture treatment favorably affects stroke patients ' ability to perform daily life activities , their health-related quality of life , and their use of health care and social services . METHODS One hundred four consecutive patients > 40 years of age admitted to hospital because of an acute stroke were r and omized to 3 groups : deep , superficial , and no acupuncture treatment . The acupuncture treatment given by 4 physiotherapists started 4 to 10 days after r and omization and was given twice a week for 10 weeks . All patients underwent conventional stroke rehabilitation as well . Two occupational therapists , blinded regarding the patients ' allocation , evaluated the treatment effects . The assessment s were performed 4 times during the first year after r and omization by means of interviews and observations . RESULTS There were no differences between the groups with reference to changes in the neurological score and the Barthel and Sunnaas activities of daily living index scores after 3 and 12 months . Regarding the Nottingham Health Profile , the no acupuncture group had somewhat fewer mobility problems . No differences in health care and social services were found between the groups . CONCLUSIONS The present study does not give support to the previous studies , which indicates that acupuncture treatment may have a beneficial effect on acute stroke patients ' ability to perform daily life activities , their health-related quality of life , and their use of health care and social services Background and Purpose — A significant number of patients remain severely disabled after stroke despite rehabilitation with st and ard treatment modalities . Acupuncture has been reported as an alternative modality . This study aims to examine whether acupuncture has additional value to st and ard poststroke motor rehabilitation . Methods — A prospect i ve r and omized controlled trial ( RCT ) was carried out in a stroke rehabilitation unit in Hong Kong . One hundred six Chinese patients with moderate or severe functional impairment were included at days 3 to 15 after acute stroke . They were stratified into the moderate and the severe groups before r and omization into the control arm receiving st and ard modalities of treatment , which included physiotherapy , occupational and speech therapy , and skilled medical and nursing care , and the intervention arm receiving in addition traditional Chinese manual acupuncture . A mean of 35 acupuncture sessions on 10 main acupoints were performed over a 10-week period . Outcome measures included Fugl-Meyer assessment , Barthel Index , and Functional Independence Measure , respectively , at weeks 0 , 5 , and 10 , performed by blinded assessors . Results — At baseline , patients in each arm were comparable in all important prognostic characteristics . No statistically significant differences were observed between the 2 arms for any of the outcome measures at week 10 or outcome changes over time . Conclusions — Traditional Chinese manual acupuncture on the body has no additional value to st and ard poststroke motor rehabilitation OBJECTIVE This study examined the additional therapeutic effects of electroacupuncture for patients with first-ever ischaemic stroke . DESIGN R and omized controlled study . SUBJECTS A total of 63 patients with first-ever ischaemic stroke . METHODS The study and control groups underwent a conventional rehabilitation program , with the former receiving an additional 8 courses of electroacupuncture over a period of one month . Therapeutic effects were assessed by the Fugl-Meyer Assessment for motor performance and the Functional Independence Measure ( FIM ) for the independence of functional performance at 2 and 4 weeks after treatment , and 3 months and 6 months after stroke . RESULTS For total Fugl-Meyer Assessment score , improvement was more significant for the study group relative to the control group at 2 weeks ( 16.2 vs 10.6 ; p = 0.047 ) and 4 weeks after treatment ( 27.4 vs 17.1 ; p = 0.005 ) , and at 3 months after the stroke ( 34.7 vs 21.8 ; p = 0.009 ) . The Fugl-Meyer Assessment scores improved significantly , especially in upper-limb motor function for the study group . There was no statistically significant between-group difference in total FIM score improvement . CONCLUSION Electroacupuncture can improve motor function , especially in upper-limb motor function , for patients with first-ever ischaemic stroke OBJECTIVE To determine whether clinical trials originating in certain countries always have positive results . DATA SOURCES Abstract s of trials from Medline ( January 1966-June 1995 ) . STUDY SELECTION Two separate studies were conducted . The first included trials in which the clinical outcome of a group of subjects receiving acupuncture  was compared to that of a group receiving placebo , no treatment , or a nonacupuncture intervention . In the second study , r and omized or controlled trials of interventions other than  acupuncture  that were published in China , Japan , Russia/USSR , or Taiwan were compared to those published in Engl and . DATA EXTRACTION Blinded review ers determined inclusion and outcome and separately classified each trial by country of origin . DATA SYNTHESIS In the study of acupuncture  trials , 252 of 1085 abstract s met the inclusion criteria . Research conducted in certain countries was uniformly favorable to acupuncture ; all trials originating in China , Japan , Hong Kong , and Taiwan were positive , as were 10 out of 11 of those published in Russia/USSR . In studies that examined interventions other than acupuncture , 405 of 1100 abstract s met the inclusion criteria . Of trials published in Engl and , 75 % gave the test treatment as superior to control . The results for China , Japan , Russia/USSR , and Taiwan were 99 % , 89 % , 97 % , and 95 % , respectively . No trial published in China or Russia/USSR found a test treatment to be ineffective . CONCLUSIONS Some countries publish unusually high proportions of positive results . Publication bias is a possible explanation . Research ers undertaking systematic review s should consider carefully how to manage data from these countries OBJECTIVE To observe the therapeutic effects of different acupuncture methods for spastic hemiparalysis due to cerebrovascular disorders . METHODS 90 cases of spastic hemiparalysis after wind-stroke were r and omly divided into a control group of 30 cases , a body acupuncture group of 30 cases and a point-penetrating acupuncture group of 30 cases . All the patients were given 4 courses of treatment , with 7 sessions constituting one therapeutic course and with a one-day interval between courses . The evaluations were made 3 times , i.e. once before treatment and once every 15 days during the treatment . RESULTS The therapeutic effects in the point-penetrating acupuncture group were obviously superior to those of both the control group and the body acupuncture group . CONCLUSION The point-penetrating acupuncture is an effective therapy for treating spastic hemiparalysis due to cerebrovascular disorders BACKGROUND Any adjunctive therapy that may reduce persistent disability after stroke should be considered . Acupuncture is used for this purpose , but there is conflicting evidence on its effectiveness . METHODS Patients with a recent ( < 4 weeks ) episode of stroke were r and omized to receive 12 sessions of either real or sham acupuncture during 2 weeks . The primary outcome was the change in Barthel activities of daily living score at the end of treatment . Secondary outcome measures included National Institutes of Health Stroke Scale score , motoricity index , and quality of life ( EQ-5D [ EuroQoL-5 Dimensional form ] and EQ-VAS [ EuroQoL-Visual Analog Scale ] ) . Assessment s were carried out by blinded physicians . RESULTS A total of 116 patients ( 56 in the real acupuncture group and 60 in the sham group ) were r and omized , and 98 ( real , 48 ; sham , 50 ) completed treatment and the 2-week assessment . Patient blinding by means of the sham acupuncture device was successful . Acupuncture was well tolerated except for 1 seizure during a real acupuncture session . The improvements in the Barthel scores were 4 points ( interquartile range [ IQR ] , 0 - 8 ) vs 3 points ( IQR , 0 - 7 ) in the real and sham acupuncture groups , respectively ( P = .38 ) . The secondary outcome measures also essentially showed no significant effect of acupuncture . Post hoc analysis by baseline severity showed a greater improvement in leg function in the subgroup with baseline Barthel score less than the median ( median score , 6 ) : 22 points ( IQR , 0 - 37 ) vs 0 [ corrected ] points ( IQR , 0 - 4 ) in the acupuncture and sham control groups , respectively ( P = .02 ) . CONCLUSIONS Acupuncture is not superior to sham treatment for recovery in activities of daily living and health-related quality of life after stroke , although there may be a limited effect on leg function in more severely affected patients Objective To investigate the efficacy of acupuncture on stroke recovery compared to an inert placebo . Design Placebo-controlled , r and omised , clinical trial . Setting Post-stroke rehabilitation wards in five NHS hospitals in the UK.Subjects Patients between 4 and 10 days after their first stroke . Interventions and outcome measures The patients received 12 acupuncture or placebo treatments over four weeks . Acupuncture with electrical stimulation was compared with mock TENS , and assessment s continued for 12 months after entry . Primary outcome was the Barthel Index ( BI ) . Secondary outcomes were muscle power , Motricity Index ( MI ) , mood , Nottingham Health Profile ( NHP ) and treatment credibility . Results 92 patients completed data sets . Data were analysed using both t tests and a structural equation based on longitudinal analysis of both BI and MI , using generalised estimating equations with an exchangeable correlation structure . While both acupuncture and placebo ( mock TENS ) appeared to have had an equal effect on stroke recovery , there is no significant difference between the two interventions at 12 ( p = 0.737 , 95 % CI –2.00 to 2.81 ) and 52 weeks ( p = 0.371 , 95 % CI –3.48 to1.32 ) . An apparently accelerated improvement in the MI scores in the acupuncture group at 3 weeks ( p = 0.009 , 95 % CI 1.55 to 10.77 ) is interesting . Conclusions Acupuncture did not demonstrate specific efficacy over placebo and both groups did as well as normally expected with this condition OBJECTIVE To study the therapeutic effect of scalp-acupuncture in treating acute cerebral hemorrhage and its mechanism . METHODS Sixty-four patients were divided into two groups , the acupuncture group and the control group . All were treated with mannitol and furosemide to reduce intracranial pressure , p-aminomethyl benzoic acid for hemostasis . The acupuncture group received scalp-acupuncture additionally .  Neurofunction deficit scoring ( NDS ) , hemorheology , thromboxane , prostacyclin , endothelin and transcranial Doppler ( TCD ) ultrasonic examination were taken before and after treatment . RESULTS NDS of the acupuncture group was markedly better than that of the control group , especially in function recovering of limbs and speech . Blood viscosity , thromboxane and endothelin level of the acupuncture group lowered obviously , as compared with the control group , the difference was significant , P < 0.05 . TCD showed that the cerebral blood flow was markedly improved in the acupuncture group . CONCLUSION Scalp-acupuncture is safe and effective in treating acute cerebral hemorrhage , it is particularly effective in recovering limb paralysis and speech disturbance caused by cerebral hemorrhage OBJECTIVE To explore effects of acupuncture on ability of daily living ( ALD ) and the incidence rate of disability and mortality of the patient of acute ischemic stroke . METHODS Forty patients with acute ischemic stroke were r and omly assigned to an acupuncture group and a control group , 20 cases in each group . The treatment group were treated with acupuncture for 3 - 4 weeks , 5 times each week , and routine therapy . The control group were treated with routine therapy alone . RESULTS No statistically significant differences between the two groups in the score of neurological defection , and the incidence rate of disability and mortality at following survey of 3 and 6 months were found . CONCLUSION Acupuncture is safe and feasible for stroke at early stage The effectiveness of acupuncture in acute stroke remains largely untested and unproved . A r and omized , 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 r and omly 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 r and omization with stratification of prognostic factors , choosing acupuncture points and technique of acupuncture After obtaining informed consent , we r and omized 78 patients with severe hemiparesis of the left or right side within 10 days of stroke onset : 40 to a control group receiving daily physiotherapy and occupational therapy , and 38 to a group that , in addition , we treated with sensory stimulation ( acupuncture ) twice a week for 10 weeks . The median age was 76 years for both groups .  Motor function , balance , and ADL ( Barthel 's Index ) were assessed before the start of treatment and at 1 and 3 months after stroke onset ; ADL was also assessed after 12 months . We assessed the quality of life ( QL ) using the Nottingham Health Profile 3 , 6 , and 12 months after stroke onset . Patients given sensory stimulation  recovered faster and to a larger extent than the controls , with a significant difference for balance , mobility , ADL , QL , and days spent at hospitals/nursing homes . Whether acupuncture per se is responsible for the differences requires further study OBJECTIVE To study the long-term effects of acupuncture on quality of life in patients with early stage of stroke . METHODS Eighty patients were r and omly assigned to the acupuncture group and the control group , 40 in each . All received conventional Western medical treatment , but for patients in the acupuncture group , acupuncture was applied additionally immediately from 48 h after patients ' life signs were stabilized . Curative effects were evaluated with scores of SF-36 , function independent measure ( FIM ) and NIHSS . RESULTS Effect evaluated immediately after acupuncture operation showed that all the scores in the acupuncture group , except score of recognition function in FIM , and scores of body pain and physical function in SF-36 , were improved more significantly than those in the control group ( P < 0.05 ) . The effectiveness improved continuously in the 6-month period after stroke in both groups , but more superiority was shown in the acupuncture group in aspects of emotional function , social function and mental health by SF-36 ( P < 0.05 ) . CONCLUSION Early applying acupuncture could raise the physical , social , and psychological functions of stroke patients . Although the effects might decrease to some extent later , acupuncture still showed markedly effect on patients ' psychological and social functions as well as on their life satisfaction OBJECTIVE Only a few Chinese medical journals have recommended CONSORT in their " Instruction for authors or Guide for authors " . This study aims to evaluate the reporting quality of r and omized  controlled trials ( RCTs ) published in the five leading Chinese medical journals indexed by MEDLINE . METHODS We identified RCTs published from 2004 to January 2007 in five leading Chinese medical journals by search ing three important Chinese data bases systematic ally , namely CNKI ( China National Knowledge Infrastructure/Chinese Academic Journals full text Data base ) , VIP ( a full text data base of China ) and CBM disc ( China Biomedicine Data base Disc ) and assessed the quality of each RCT by using the Consoli date d St and ards for Reporting of Trials ( CONSORT ) and the 5-point Jadad scale . RESULTS One hundred and forty two RCTs were included . Based on the items in the revised CONSORT statement , 130 ( 91.55 % ) of the 142 RCTs mentioned " r and omization " in the title or abstract , but only 38 ( 26.76 % ) RCTs described the method to generate the r and om sequence ; only 6 RCTs had adequate allocation concealment ; 24 ( 17.61 % ) RCTs mentioned " masking " , but only 7 described the process of masking . Three out of 40 items were reported clearly in all included trials , while five items were not mentioned at all . The quality of RCTs was low as assessed by the Jadad scale and 22 RCTs were high- quality research ( > /=3 points ) . CONCLUSIONS The reporting quality of RCTs published in the five leading Chinese medical journals is low . Chinese journals should adopt the CONSORT statement to improve the reporting quality of Chinese r and omized controlled trials Acupuncture treatment and control group interventions in parallel-group r and omised trials of acupuncture are not always precisely reported . In an attempt to improve st and ards , an international group of experienced acupuncturists and research ers devised a set of recommendations , design ating them STRICTA : ST and ards for Reporting Interventions in Controlled Trials of Acupuncture . In a further consensus-building round , the editors of several journals helped redraft the recommendations . These follow the Consoli date d St and ards for Reporting Trials ( CONSORT ) format , acting as an extension of the CONSORT guidelines for the specific requirements of acupuncture studies . Participating journal editors are publishing the STRICTA recommendations and requesting prospect i ve authors to adhere to them when preparing reports for publication . Other journals are invited to adopt these recommendations . The intended outcome is that interventions in controlled trials of acupuncture  will be more adequately reported , thereby facilitating an improvement in critical appraisal , analysis and replication of trials The aim of this study was to eluci date the effects of combined conventional rehabilitation therapy and acupuncture on the active shoulder range of motion ( ROM ) and motor power in stroke patients with hemiplegic shoulder subluxation . Twenty-one patients received a combination of acupuncture and rehabilitation treatment  at a hospital , and their active shoulder ROM and motor power were assessed at admission and discharge . The therapy produced significant improvements in joint mobility , such as in flexion , extension , internal rotation , external rotation , abduction , and adduction ( p < .001 ) , and in motor power ( p < .05 ) in stroke patients with hemiplegic shoulder subluxation To assess the efficacy of electrical acupuncture in the rehabilitation of patients with hemiplegia in stroke , we r and omized 128 patients within 2 wk of stroke onset to receive either comprehensive rehabilitation plus electrical acupuncture  ( n = 59 ) or comprehensive rehabilitation only  ( n = 59 ) . Electrical acupuncture was administered by electrical stimulation of acupuncture points through adhesive surface electrodes five times per week . Neurological status ( Brunnstrom 's stage ) and the Chinese version of the Functional Independence Measure were assessed before treatment and at discharge . Patients treated with electrical acupuncture had a shorter duration of hospital stay for rehabilitation and better neurological and functional outcomes than the control group had , with a significant difference in scores for self-care and locomotion ( P = 0.02 ) . This result did not postulate the previous study that acupuncture therapy for stroke patients should depend on needle manual and " de qi " response . We suggest that electrical acupuncture through adhesive surface electrodes in conjunction with current optimal rehabilitation programs is a convenient and effective therapy for stroke patients Objectives In recent years the retractable type of sham needle has been anticipated to be a possible solution for masking patients in acupuncture research . However , this needle has been intended mainly for acupuncture-naïve subjects . The authors ’ goal in this study was to assess the validity of the retractable type of sham needle . Methods The authors conducted two r and omized , single-blind , crossover trials with acupuncture-experienced subjects . Different acupuncture points were used in each trial ( a LI-4 trial and a BL-23 trial ) . The subjects received two sessions of different stimulations in each trial . A Park Sham Needle was used in one session , a genuine acupuncture needle in the other . Results In the LI-4 trial , all of the 21 subjects ( 100 % ) felt penetration with the genuine needle , but only 7 of the 20 subjects ( 35 % ) felt a similar sensation with the sham needle ( P=0.0002 ) . Fifteen of the 21 subjects ( 71 % ) felt a dull sensation with the genuine needle , but only 4 of the 20 subjects ( 20 % ) felt a similar sensation with the sham needle ( P=0.01 ) . In the BL-23 trial , 14 of the 20 subjects ( 70 % ) felt penetration with the genuine needle and 10 of the 20 subjects ( 50 % ) felt “ penetration ” with the sham needle ( P=0.39 ) . Eight of the 20 subjects ( 40 % ) felt a dull sensation with the genuine needle and 2 of the 20 subjects ( 10 % ) did with the sham needle ( P=0.109 ) . Conclusions Potential factors that influence the applicability of “ placebo ” needling include not only intertester variability but also the patient 's knowledge and experience of acupuncture , acupuncture point selection , the visual impact of needling , and so on Objective : We recently reported that acupuncture treatment of stroke patients in the subacute stage gave additive therapeutic benefit . The purpose of the present study was to determine , approximately one year after discharge from the rehabilitation hospital , whether the group differences still remained . Design : The patients were r and omized into two groups : one acupuncture group and one control group , considering gender and side of hemispheral localization of lesion . With regard to the main parameters the groups were comparable at baseline . Setting : Initially , 45 stroke patients admitted to Sunnaas Rehabilitation Hospital were included in the study : median 40 days post stroke . Subjects : Forty-one of the patients were available one year after the treatment period : 21 patients in the acupuncture group and 20 controls .  Intervention : All subjects received an individually adapted , multidisciplinary rehabilitation programme . The acupuncture group received additional treatment with classical acupuncture for 30 min three to four times weekly for six weeks . Main outcome measures : The patients were evaluated at inclusion , after six weeks and approximately 12 months after discharge from the rehabilitation hospital . The Motor Assessment Scale ( MAS ) for stroke patients , Sunnaas Index of Activity of Daily Living ( ADL ) and Nottingham Health Profile ( NHP ) were used . In addition , the social situations of the patients were recorded at one year follow-up . Results : The results show that the acupuncture group improved significantly more than the controls , both during the treatment period of six weeks , and even more during the following year , both according to MAS , ADL , NHP and the social situation . Conclusion : Although the mechanism of the effects is debatable , there seems to be a positive long-term effect of acupuncture given in the subacute stage post stroke
BACKGROUND AND PURPOSE Acupuncture is a low-risk treatment with purported cl aims of effectiveness for poststroke rehabilitation .
To comprehensively assess the efficacy of acupuncture in poststroke rehabilitation , we conducted a systematic review and meta- analysis of all r and omized clinical trials of acupuncture for poststroke rehabilitation .