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(Stroke. 2001;32:707.)
© 2001 American Heart Association, Inc.
Original Contributions |
Acupuncture and Transcutaneous Nerve Stimulation in Stroke Rehabilitation
A Randomized, Controlled Trial
From the Department of Neurology (B.B.J.), Lund University Hospital, Lund; Department of Physiotherapy (E.H.), Karolinska Institutet; Department of Medicine at Danderyd Hospital (M. von A.), Stockholm; Swedish Council for Technology Assessment in Health Care (M.B.), Astra Hässle AB (G.L.), Mölndal; Departments of Medicine at Uppsala University Hospital (A.T.), Uppsala; Ängelholm Hospital (D.U.), Ängelholm; and Umeå University Hospital (K.A.), Umeå, Sweden.
Correspondence to Prof Kjell Asplund, Department of Medicine, University Hospital, SE-901 85 Umea, Sweden. E-mail kjell.asplund{at}medicin.umu.se
Background and Purpose—In small trials with control groups that receive no intervention, acupuncture has been reported to improve functional outcome after stroke. We studied effects of acupuncture and transcutaneous electrical nerve stimulation on functional outcome and quality of life after stroke versus a control group that received subliminal electrostimulation.
Methods—In a multicenter randomized controlled trial involving 7 university and district hospitals in Sweden, 150 patients with moderate or severe functional impairment were included. At days 5 to 10 after acute stroke, patients were randomized to 1 of 3 intervention groups: (a) acupuncture, including electroacupuncture; (b) sensory stimulation with high-intensity, low-frequency transcutaneous electrical nerve stimulation that induces muscle contractions; and (c) low-intensity (subliminal) high-frequency electrostimulation (control group). A total of 20 treatment sessions were performed over a 10-week period. Outcome variables included motor function, activities of daily living function, walking ability, social activities, and life satisfaction at 3-month and 1-year follow-up.
Results—At baseline, patients in each group were closely similar in all important prognostic variables. At 3-month and 1-year follow-ups, no clinically important or statistically significant differences were observed between groups for any of the outcome variables. The 3 treatment modalities were all conducted without major adverse effects.
Conclusions—When compared with a control group that received subliminal electrostimulation, treatment during the subacute phase of stroke with acupuncture or transcutaneous electrical nerve stimulation with muscle contractions had no beneficial effects on functional outcome or life satisfaction.
Key Words: acupuncture • trancutaneous electric nerve stimulation • activities of daily living • quality of life • outcome
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