title: Prospective, randomized controlled trial of physiotherapy and acupuncture on motor function and daily activities in patients with ischemic stroke.
abstract: OBJECTIVE
  To assess the value of acupuncture for promoting the recovery of patients with ischemic stroke and to determine whether the outcomes of combined physiotherapy and acupuncture are superior to those with physiotherapy alone.
  
  
  METHODS
  Prospective randomized controlled trial.
  
  
  METHODS
  Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, P. R. China.
  
  
  METHODS
  120 inpatients and outpatients (84 men and 36 women).
  
  
  METHODS
  Acupuncture, physiotherapy, and physiotherapy combined with acupuncture.
  
  
  METHODS
  Motor function in the limbs was measured with the Fugl-Meyer assessment (FMA). The modified Barthel index (MBI) was used to rate activities of daily living. All evaluations were performed by assessors blinded to treatment group.
  
  
  RESULTS
  On the first day of therapy (day 0, baseline), FMA and MBI scores did not significantly differ among the treatment groups. Compared with baseline, on the 28th day of therapy the mean FMA scores of the physiotherapy, acupuncture, and combined treatment groups had increased by 65.6%, 57.7%, and 67.2%, respectively; on the 56th day, FMA scores had increased by 88.1%, 64.5%, and 88.6%, respectively (p<0.05). The respective MBI scores in the three groups increased by 85.2%, 60.4%, and 63.4% at day 28 and by 108.0%, 71.2%, and 86.2% at day 56, respectively (p<0.05). However, FMA scores did not significantly differ among the three treatment groups on the 28th day. By the 56th day, the FMA and MBI scores of the physiotherapy group were 46.1% and 33.2% greater, respectively, than those in the acupuncture group p<0.05). No significant differences were seen between the combined treatment group and the other groups. In addition, the FMA subscores for the upper extremities did not reflect any significant improvement in any group on the 56th day. Although the FMA subscores for the upper and lower extremities and the MBI score in the combined treatment group were higher than those in the acupuncture group, the differences were not statistically significant.
  
  
  CONCLUSIONS
  Acupuncture is less effective for the outcome measures studied than is physiotherapy. Moreover, the therapeutic effect of combining acupuncture with physiotherapy was not superior to that of physiotherapy alone. A larger-scale clinical trial is necessary to confirm these findings.
authors.affiliation: Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: Bai
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.forename: Yong-Shan
authors.initials: YS
authors.lastname: Hu
authors.forename: Yi
authors.initials: Y
authors.lastname: Wu
authors.forename: Pei-Jing
authors.initials: PJ
authors.lastname: Xie
authors.forename: Song-Wei
authors.initials: SW
authors.lastname: Wang
authors.forename: Ming
authors.initials: M
authors.lastname: Yang
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Xu
authors.forename: Bing
authors.initials: B
authors.lastname: Zhu
mesh_terms: D000203:Activities of Daily Living; D015670:Acupuncture Therapy; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005121:Extremities / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome