Effect of acupuncture and Chinese herbal medicine on subacute stroke outcomes: a single-centre randomised controlled trial
Objective To determine whether integrative medicine, combining acupuncture and Chinese herbal medicine with conventional rehabilitation during subacute stroke, is an effective comprehensive rehabilitation strategy for daily life activities, neurological deficits, motor dysfunction, cognitive impairment and depression.
Design Randomised controlled trial: patients were randomly assigned to a conventional rehabilitation (CR) group or an integrative medicine rehabilitation (IMR) group with CR plus acupuncture and Chinese herbal medicine.
Setting Single-centre inpatient teaching hospital, China
Participants 120 Patients aged 35–80 years, with a recent first incidence of subacute ischaemic stroke
Main outcome measures Measured at baseline (week 0), mid-point (week 4), week 8 and follow-up (week 20).
Primary outcome measurement Modified Barthel Index (MBI)
Secondary outcome measurements The National Institutes of Health Stroke Scale; Fugl-Meyer Assessment; the Mini-Mental State Examination; Montreal Cognitive Assessment; depression, Hamilton’s Depression Scale; Self-Rating Depression Scale.
Results The primary outcome measurement, MBI, showed significant improvement in the IMR group compared with the CR group. The IMR group also showed significant improvement across all of the secondary outcome measures (repeated-measures analysis of variance group*time; independent Student’s t test).
Limitations A small placebo bias may exist, but measures were undertaken to limit it. Sample sizes for cognitive impairment and depression in this study were small. Results cannot be generalised to one type of treatment only.
Conclusion This trial, evaluating a treatment protocol commonly used in clinical practice, demonstrates that comprehensive rehabilitation including acupuncture and Chinese herbal medicine may comprehensively improve subacute stroke outcomes.
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