Acupuncture and transcutaneous nerve stimulation in stroke rehabilitation: a randomized, controlled trial.
OBJECTIVE
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 randomized 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 randomized 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 clinically 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.
Department of Neurology, Lund University Hospital, Lund.
B B
BB
Johansson
E
E
Haker
M
M
von Arbin
M
M
Britton
G
G
Långström
A
A
Terént
D
D
Ursing
K
K
Asplund
D000203:Activities of Daily Living; D015670:Acupuncture Therapy; D000368:Aged; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009119:Muscle Contraction; D011788:Quality of Life; D012720:Severity of Illness Index; D000071939:Stroke Rehabilitation; D015996:Survival Rate; D013548:Sweden; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods; D016896:Treatment Outcome