Acupuncture in Stroke Rehabilitation

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Abstract
This paper summarises earlier published data on acupuncture and electroacupuncture in stroke patients and discusses possible mechanisms behind the enhanced recovery obtained. Severely hemiparetic patients were entered into a randomised trial within 10 days of their stroke. Acupuncture, including electroacupuncture, was given twice a week for ten weeks to half of the patients, in addition to the daily physiotherapy and occupational therapy given to all. Patients given acupuncture recovered faster and more fully than the control stroke patients, with a significant difference in balance, mobility, activity of daily living and quality of life, an effect that persisted one year after stoke onset. In a follow-up 2 to 3.8 years after the stroke, the postural control of stroke survivors was compared with that of 23, age-matched, healthy subjects. Only half of the control stroke patients could perform the test, and the postural control pattern in those who could take part was significantly different from the healthy controls and acupuncture treated stroke patients, whereas there was no significant difference between acupuncture treated patients and healthy controls. The possible psychological effects of a greater expectation in patients given acupuncture has to be considered. Other studies have shown that special attention given to stroke patients in the early rehabilitation period can accelerate their recovery, but that the difference is usually lost at follow-up. Our results need confirmation, but we have hypothesised that sensory stimulation in the form of acupuncture may release substances that enhance brain plasticity after stroke, an hypothesis than can be tested in experimental studies. Whether or not the effects are specific for acupuncture, or can be obtained also by other kinds of sensory stimuli such as transcutaneous nerve stimulation is currently being investigated.