Sensory Stimulation Promotes Normalization of Postural Control After Stroke Effects of electroacupuncture on acute cerebral infarction. 52 cases of apoplexy treated with scalp acupuncture by the slow-rapid reinforcing-reducing method. Puncturing the empirical point shengen in treatment of 101 cases of apoplectic hemiplegia. Effects of acupuncture treatment on daily life activities and quality of life: a controlled, prospective, and randomized study of acute stroke patients. [Acupuncture therapy in stroke during the subacute phase. A randomized controlled trial]. A randomized controlled trial on the treatment for acute partial ischemic stroke with acupuncture. Can sensory stimulation improve the functional outcome in stroke patients? [Comparative study of cerebral infarction treated with acupuncture at 6 acupoints of yang meridian and calan]. [Clinical observation on treatment of 40 cases of apoplexy hemiplegia complicated shoulder-hand syndrome with electro-acupuncture]. Introducing a placebo needle into acupuncture research Clinical trial of electrical acupuncture on hemiplegic stroke patients. [The changes of vasoactive intestinal peptide somatostatin and pancreatic polypeptide in blood and CSF of acute cerebral infarction patients and the effect of acupuncture on them]. 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
Background and Purpose In a r and omized study of hemiparetic stroke patients with a median age of 75 years , functional recovery was significantly better in those who received additional  sensory stimulation  ( n=38 ) , including electrostimulation , than in control patients ( n=40 ) given the same physiotherapy and occupational therapy ; group differences for balance , mobility , and activities of daily living were significant . The present study was design ed to investigate postural control in patients who survived more than 2 years after stroke onset . Methods The 48 survivors ( mean , 2.7 years ; range , 2.0 to 3.8 years ) , 22 from the treatment group and 26 from the control group , were compared with 23 age-matched healthy subjects . Subjects were perturbed by vibrators applied to calf muscles or with galvanic vestibular stimulation . We evaluated postural control in terms of sway variances or sway velocities and the dynamics of postural control as a feedback system using system identification with a model previously vali date d for human postural control . Results Significantly more patients of the treatment group than of the control group maintained stance during perturbations ( P<.01 ) . Among patients capable of maintaining stance during perturbation , the control patients were characterized by significant divergence from normal values in two of the three characteristic parameters of dynamic postural control ( ie , swiftness and stiffness ; P<.05 ) compared with the treatment subgroup or age-matched subjects . Conclusions The course of sensory stimulation enhanced recovery of postural function , an enhancement still significant 2 years after the lesion and treatment . The differences and near normalization of characteristic parameters of dynamic postural control among treated patients suggest that improved recovery after sensory stimulation may be achieved by patients regaining normal or near normal dynamics of human postural control 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 85 cases of apoplexy were treated with scalp acupuncture , including 52 cases by the method of slow-rapid reinforcing-reducing and 33 cases by the method of flat twisting . The total effective rates differed insignificantly between the 2 methods . However , in respects of improving the myodynamia and motile functional disturbances of the limbs , the method of slow-rapid reinforcing-reducing was markedly superior to the method of flat twisting By needling chiefly an empirical point Shengen with the penetration method , a total effective rate of 96.04 % was obtained in 101 cases of apoplectic hemiplegia . In comparison with 38 controls , either the therapeutic effects and courses or other indices observed in the needling group were shown to be encouraging 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 The aim of this study was to investigate whether acupuncture treatment , if given to stroke patients in subacute phase in addition to rehabilitation would influence motor function , activity of daily living ( ADL ) and quality of life . After obtaining informed consent , 45 patients ( median age 57 years ) were r and omised into a control group ( n = 21 ) and an acupuncture group ( n = 24 ) . Median time from onset of stroke to inclusion in the study was 40 days . The inclusion criterion was hemiparesis following a first-ever stroke . 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 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 UNLABELLED This article reports the curative effects of acupuncture on 6 acupoints of Yang meridian in treating 32 cases of cerebral infa rct ion in comparison with another 31 cases treated with calan tablets  55 out of 63 patients have been diagnosed as cerebral infa rct ion by computer tomography . Diagnosis of 8 cases relied on history , symptoms , signs together with cerebrospinal fluid examination . Patients were divided r and omly into two treatment groups : acupuncture group and calan tablet group . Therapeutic method : ( 1 ) For acupuncture group , main acupoints consisted of Jianyu ( L.I. 15 ) , Quchi ( I. I. 11 ) , Hegu ( L. I.4 ) in the upper extremity and Huantiao ( G. B. 30 ) , Yanglingquan ( G. B. 34 ) , Guangming ( G. B. 37 ) in the lower extremity . According to the syndrome differentiation , Taichong ( Liv . 3 ) , Fengchi ( G. B. 20 ) , Tianshu ( St. 25 ) , Fenglong ( St. 40 ) , Zusanli ( St. 36 ) , Sanyinjiao ( Sp . 6 ) , Taixi ( K. 3 ) were added . The lifting and thrusting was manipulated . The needles were retained for 30 minutes after the patient felt local sourness , distension and heaviness .  Acupuncture was carried out every day for 6 weeks . ( 2 ) For calan tablet group , calan tablet 5 mg was administered 3 times a day for the same treatment session as the former group . RESULT The total effective rates were 93 . 75 % and 83.87 % respectively . The therapeutic effect in the acupuncture group was much better than that in the calan tablet group ( P less than 0.05 ) . The majority of hemorheological indices of patients in two groups were obviously higher than those of the normal in the same age group . ( ABSTRACT TRUNCATED AT 250 WORDS The authors treated 40 cases of shoulder-h and syndrome of apoplexy hemiplegia with electro-acupuncture ( EA ) and filiform needle acupuncture ( FNA ) respectively . The results showed that EA had better results in treating h and back swelling , h and skin temperature elevating and the bending finger caused pain than that with FNA ( P < 0.05 ) . The finger joint and shoulder joint improvement ( the functional scoring increased for 3 points or more ) in EA was also better than that of FNA ( P < 0.05 ) . The total marked effective rate was higher in EA group ( 75 % ) than that in FNA ( 50 % ) , P < 0.05 ) . It suggested that EA produced rhythmic muscle contraction which had a " shoulder-h and pump " like action , and is significant in eliminating h and back swelling and preventing atrophy of h and muscles BACKGROUND A problem acupuncture research has to face is the concept of a control group . If , in control groups , non-acupoint needling is done , physiological acupuncture effects are implied . Therefore the effects shown in this group are often close to those shown in the acupuncture group . In other trials , control groups have received obviously different treatments , such as transcutaneous electrical nervous stimulation or TENS-laser treatment ; it is not clear if the effects of acupuncture are due only to the psychological effects of the treatment . METHODS We developed a placebo acupuncture needle , with which it should be possible to simulate an acupuncture procedure without penetrating the skin . In a cross-over experiment with 60 volunteers we tested whether needling with the placebo needle feels any different from real acupuncture . FINDINGS Of 60 volunteers , 54 felt a penetration with acupuncture  ( mean visual analogue scale [ VAS ] 13.4 ; SD 10.58 ) and 47 felt it with placebo ( VAS 8.86 ; SD 10.55 ) , 34 felt a dull pain sensation ( DEQI ) with acupuncture and 13 with placebo . None of the volunteers suspected that the needle may not have penetrated the skin . INTERPRETATION The placebo needle is sufficiently credible to be used in investigations of the effects of acupuncture 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 VIP , SS and PP which exist in gastrointestinal tract and CNS might be to play an important role in nervous system as neurotransmitters of neuromediaters . There have been a few of reports about their changes in plasma and CSF in ICVD . The effects of acupuncture , which was used in treatment of ICVD with good efficiency , on VIP , SS and PP have not been known . For research ing their changes in ICVD and effects of electro-acupuncture on them , and finding the mechanism of acupuncture in treatment of ICVD , the study was performed . The levels of VIP , SS and PP in 64 patients with acute cerebral infa rct ion were determined . The points of acupuncture were Quchi ( LI 12 ) , Waiguan ( SJ 5 ) , Huantiao ( BG 30 ) , and Zusanli ( ST 36 ) . The routine treatment included dextran , nicotinic acid , aspirin , dipyridamole and radix salviae miltiorrhizae composita . The CSF and blood were taken before the begining of treatments and after a course of treatment . The level of VIP , SS and PP were measured by radiommunoassay . Results showed the level of CSF VIP in the patients was significantly lower as compared with controls . The level of plasma SS in the patients was lower , but the difference was not significant as compared with controls , and level of plasma PP in the patients was significantly increased when it was compared with controls . After electro-acupuncture treatment , in patients with good efficiency , CSF VIP recovered to normal level and the levels of plasma and CSF SS were significantly increased , while the level of plasma PP had no significant change . The results suggest that acupuncture might regulate the disturbances of metabolism of VIP and SS in CNS 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 Acupuncture has been suggested as a treatment for stroke rehabilitation , but the question whether it is effective has not been answered satisfactorily .
Purpose To summarise and critically review all r and omised controlled trials of the effectiveness of acupuncture as a treatment for stroke .