Acupuncture for upper-extremity rehabilitation in chronic stroke: a randomized sham-controlled study.
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.
Wayne
Peter M
PM
Research Department, New England School of Acupuncture, Watertown, MA 02472, USA.
Krebs
David E
DE
Macklin
Eric A
EA
Schnyer
Rosa
R
Kaptchuk
Ted J
TJ
Parker
Stephen W
SW
Scarborough
Donna Moxley
DM
McGibbon
Chris A
CA
Schaechter
Judith D
JD
Stein
Joel
J
Stason
William B
WB
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