Abstract
We have explored the potential of auricular intradermal acupuncture (AIA) in standard rehabilitation and acupuncture treatment for motor recovery in poststroke patients. This was a randomized, controlled preliminary clinical study in which the patients were randomly assigned to the CT group (conventional treatment, standard rehabilitation, and routine acupuncture) or AIA group (AIA combined with conventional treatment) and underwent 6 sessions in 1 week (6 days). Standard procedures and previously reported acupuncture points were used. Clinical outcomes were measured by the Fugl-Meyer motor assessment (FMA) of flexor and extensor synergy movement (FSM and ESM) of the upper and lower extremities (UE and LE) at days 0, 3, and 6. The assessment was performed by blinded assessors. The AIA group showed a significant increase in FMA-UE/FMA-LE scores on day 3 (P=0.012 and 0.001, respectively) and day 6 (P=0.041 and P < 0.001, respectively), but this was not observed in the CT group. Furthermore, unlike the CT group, the AIA group exhibited a significant increase in the FMA-LE score on day 3 (P=0.004) and the FMA-UE scores on day 6 (P=0.048). Finally, the correlation between ESM and FMA-UE/FMA-LE was higher than that between FSM and FMA-UE/FMA-LE after treatment: for ESM and UE, r = 0.759, P=0.007; for ESM and LE, r = 0.697, P=0.003; for FSM and UE, r = 0.604, P=0.049; for FSM and LE, r = 0.347, P=0.188. AIA is useful for motor rehabilitation in poststroke patients, particularly in terms of improving extensor synergy. This trial is registered with CHiCTR1800020150.
Highlights
Stroke was one of the leading causes of death and disabilityadjusted life years (DALYs) in China in 2017 [1]
Transcutaneous auricular branch vagus nerve stimulation, a noninvasive alternative therapy, has similar benefits to invasive vagus nerve stimulation in terms of Evidence-Based Complementary and Alternative Medicine enhancing the effects of physiotherapy for upper limb motor recovery after stroke [7]. ese findings indicate that poststroke motor rehabilitation could benefit from more direct neural pathway stimulation, the stimulation of nuclei in the brainstem that are concerned with motor control
Based on computer-generated random numbers that were assigned to participants according to their order of enrollment, those with an even number were allocated to the auricular intradermal acupuncture (AIA) group and the others were allocated to the CT group
Summary
Stroke was one of the leading causes of death and disabilityadjusted life years (DALYs) in China in 2017 [1]. Ese findings indicate that poststroke motor rehabilitation could benefit from more direct neural pathway stimulation, the stimulation of nuclei in the brainstem that are concerned with motor control. Transcutaneous auricular branch vagus nerve stimulation (taVNS), a noninvasive alternative therapy, has similar benefits to invasive vagus nerve stimulation in terms of Evidence-Based Complementary and Alternative Medicine enhancing the effects of physiotherapy for upper limb motor recovery after stroke [7]. In this regard, the craniofacial pathway may prove to be effective as a target neural pathway. Considering the role of taVNS in motor rehabilitation [7], acupuncture of the afferent nerve of the external ear may trigger the brainstem network to regulate the supraspinal neural pathways of motor control. In order to explore this possibility, we conducted a randomized controlled clinical preliminary study of AIA combined with rehabilitation and routine acupuncture [11] for the treatment of motor dysfunction after stroke
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