title: Acupuncture for upper-extremity rehabilitation in chronic stroke: a randomized sham-controlled study.
abstract: OBJECTIVE
  To compare the effects of traditional Chinese acupuncture with sham acupuncture on upper-extremity (UE) function and quality of life (QOL) in patients with chronic hemiparesis from stroke.
  
  
  METHODS
  A prospective, sham-controlled, randomized controlled trial (RCT).
  
  
  METHODS
  Patients recruited through a hospital stroke rehabilitation program.
  
  
  METHODS
  Thirty-three subjects who incurred a stroke 0.8 to 24 years previously and had moderate to severe UE functional impairment.
  
  
  METHODS
  Active acupuncture tailored to traditional Chinese medicine diagnoses, including electroacupuncture, or sham acupuncture. Up to 20 treatment sessions (mean, 16.9) over a mean of 10.5 weeks.
  
  
  METHODS
  UE motor function, spasticity, grip strength, range of motion (ROM), activities of daily living, QOL, and mood. All outcomes were measured at baseline and after treatment.
  
  
  RESULTS
  Intention-to-treat (ITT) analyses found no statistically significant differences in outcomes between active and sham acupuncture groups. Analyses of protocol-compliant subjects revealed significant improvement in wrist spasticity (P<.01) and both wrist (P<.01) and shoulder (P<.01) ROM in the active acupuncture group, and improvement trends in UE motor function (P=.09) and digit ROM (P=.06).
  
  
  CONCLUSIONS
  Based on ITT analyses, we conclude that acupuncture does not improve UE function or QOL in patients with chronic stroke symptoms. However, gains in UE function observed in protocol-compliant subjects suggest traditional Chinese acupuncture may help patients with chronic stroke symptoms. These results must be interpreted cautiously because of small sample sizes and multiple, unadjusted, post hoc comparisons. A larger, more definitive RCT using a similar design is feasible and warranted.
authors.affiliation: Research Department, New England School of Acupuncture, Watertown, MA 02472, USA.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Wayne
authors.forename: David E
authors.initials: DE
authors.lastname: Krebs
authors.forename: Eric A
authors.initials: EA
authors.lastname: Macklin
authors.forename: Rosa
authors.initials: R
authors.lastname: Schnyer
authors.forename: Ted J
authors.initials: TJ
authors.lastname: Kaptchuk
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Parker
authors.forename: Donna Moxley
authors.initials: DM
authors.lastname: Scarborough
authors.forename: Chris A
authors.initials: CA
authors.lastname: McGibbon
authors.forename: Judith D
authors.initials: JD
authors.lastname: Schaechter
authors.forename: Joel
authors.initials: J
authors.lastname: Stein
authors.forename: William B
authors.initials: WB
authors.lastname: Stason
mesh_terms: D000203:Activities of Daily Living; D026881:Acupuncture; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009128:Muscle Spasticity / Q000534:rehabilitation; D010291:Paresis / Q000534:rehabilitation*; D011446:Prospective Studies; D011788:Quality of Life; D016059:Range of Motion, Articular; D000071939:Stroke Rehabilitation; D034941:Upper Extremity