title: Additional effects of acupuncture on early comprehensive rehabilitation in patients with mild to moderate acute ischemic stroke: a multicenter randomized controlled trial.
abstract: BACKGROUND
  Acupuncture is not considered a conventional therapy for post-stroke sequelae but it might have some additional positive effects on early rehabilitation. We conducted this trial to determine whether acupuncture has additional effects in early comprehensive rehabilitation for acute ischemic stroke and dysfunctions secondary to stroke.
  
  
  METHODS
  Two hundred fifty patients were randomized into two groups: acupuncture (AG) or no acupuncture (NAG). Eighteen acupuncture treatment sessions were performed over a 3-week period. The primary outcome was blindly measured with National Institutes of Health Stroke Scale (NIHSS) at week 1, week 3, and week 7. Secondary outcomes included: Fugl-Meyer Assessment (FMA) for motor function, bedside swallowing assessment (BSA) and videofluoroscopic swallowing study (VFSS) for swallowing function, the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) for cognitive function, and the adverse reaction of acupuncture for safety assessment.
  
  
  RESULTS
  Significant improvements from acupuncture treatment were observed in NIHSS (p < 0.001), VFSS (p < 0.001), MMSE (p < 0.001), MoCA (p = 0.001), but not obtained from FMA (p = 0.228). Changes from baseline of all above variables (except FMA) also had the same favorable results. A significant improvement in FMA lower extremity subscale appeared in AG (p = 0.020), but no significant difference was found for the upper extremity subscale (p = 0.707). More patients with swallowing disorder recovered in AG (p = 0.037). Low incidence of mild reaction of acupuncture indicated its safety.
  
  
  CONCLUSIONS
  This trial showed acupuncture is safe and has additional multi-effect in improving neurologic deficits, swallowing disorder, cognitive impairment, and lower extremity function, but has no significant improvement for upper extremity function during this short-term study period.
  
  
  BACKGROUND
  Chictr.org ChiCTR-TRC -12001971 (March 2012).
authors.affiliation: Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, 219 Moganshan Road, Xihu District, Hangzhou City, Zhejiang Province, 310005, China.
authors.forename: Lifang
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, 219 Moganshan Road, Xihu District, Hangzhou City, Zhejiang Province, 310005, China. fangjianqiao7532@163.com.|The Third Clinical Medical College, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou City, Zhejiang Province, 310053, China. fangjianqiao7532@163.com.
authors.forename: Jianqiao
authors.initials: J
authors.lastname: Fang
authors.affiliation: Department of Acupuncture, The Third Affiliated Hospital of Zhejiang Chinese Medical University, 219 Moganshan Road, Xihu District, Hangzhou City, Zhejiang Province, 310005, China.
authors.forename: Ruijie
authors.initials: R
authors.lastname: Ma
authors.affiliation: Department of Rehabilitation, The Second Hospital of Jiaxing, 1518 North Huancheng Road, Jiaxing, Zhejiang Province, 314000, China.
authors.forename: Xudong
authors.initials: X
authors.lastname: Gu
authors.affiliation: Department of Rehabilitation, Hangzhou First People's Hospital, 261 Huansha Road, Hangzhou, Zhejiang Province, 310006, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Rehabilitation, Sir Run Run Shaw Hospital College of Medicine Zhejiang University, No. 3 East Qingchun Road, Hangzhou, Zhejiang Province, 310016, China.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Li
authors.affiliation: The Third Clinical Medical College, Zhejiang Chinese Medical University, 548 Binwen Road, Binjiang District, Hangzhou City, Zhejiang Province, 310053, China.
authors.forename: Shouyu
authors.initials: S
authors.lastname: Xu
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000628:therapy*; D000071939:Stroke Rehabilitation / Q000379:methods*; D016896:Treatment Outcome
keywords: Acupuncture; Randomized controlled trial; Rehabilitation; Stroke