Acupuncture for Subacute Stroke Rehabilitation: A Sham-Controlled, Subject- and Assessor-Blind, Randomized Trial

University of Exeter, Exeter, England, United Kingdom
Archives of Internal Medicine (Impact Factor: 17.33). 10/2005; 165(17):2026-31. DOI: 10.1001/archinte.165.17.2026
Source: PubMed


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.
Patients with a recent (<4 weeks) episode of stroke were randomized 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]). Assessments were carried out by blinded physicians.
A total of 116 patients (56 in the real acupuncture group and 60 in the sham group) were randomized, 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).
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.

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Available from: Martin A James, Jul 19, 2014
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    • "One meta-analysis has shown that acupuncture has only a small positive effect on disability and no effect on motor recovery (Sze et al., 2002). One study has reported that real acupuncture is not superior to sham acupuncture (without penetrating the skin) for stroke recovery (Park et al., 2005). In consideration of these findings, the present study was designed to examine rats that were not treated with acupuncture and rats that were treated with invasive non-acupoint acupuncture in a nonchannel and nonpoint location. "
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    • "Since the original validation studies, the Park device has been used in several acupuncture RCTs as a placebo acupuncture control [31–34]. For instance, in one RCT [35], the authors compared the efficacy of verum acupuncture (56 stroke patients) and the Park device (60 stroke patients) and they found that verum acupuncture was not superior to placebo treatment in terms of improvements in health-related quality of life after suffering a stroke. "
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    • "Sham acupuncture will be applied to the same nine acupuncture points as in the standard acupuncture group. This Parksham acupuncture device has been used in several previous clinical research studies [28-30]. "
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