Abstract
Acupuncture therapies were used to treat spinal cord injury (SCI) and its complications. To assess the effect of a specific acupuncture therapy combined with rehabilitation training for inpatients with incomplete SCI, we conducted an assessor-blinded, randomized controlled clinical trial in the Department of Rehabilitation Medicine Center in West China Hospital, Sichuan University. Seventy-two participants diagnosed with incomplete SCI were randomly assigned into 3 groups of 24 patients each, with data collection completed in December, 2019. Participants were randomly assigned (1 : 1 : 1) to 3 groups to receive treatment for 4 weeks, 5 times/week of acupuncture for Continuous Acupuncture Treatment (CAT) group, 3 times/week for Intermittent Acupuncture Treatment (IAT) group, and no acupuncture for Control group; all 3 groups received routine rehabilitation training. The primary outcome was the change of American Spinal Injury Association (ASIA) motor score from baseline to week 4. Secondary outcomes included sensory score, Modified Barthel Index (MBI). At week 4, CAT group had a higher motor score and MBI score increase than the control group (mean difference 10.52, 17.36; p < 0.001, p < 0.01, respectively). CAT group had more increase in motor score and MBI than IAT group (mean difference 5.55, 14.77; p < 0.05, p < 0.05, respectively). But the difference among groups in the increase of sensory score was not statistically significant. Acupuncture resulted in a higher motor score and MBI after 4 weeks. And the dosage of 5/week led to more improvement in motor score and MBI than that of 3/week. The results suggested that a dosage of 5/week of acupuncture is safe and more effective for SCI than 3/week. But further research is needed to determine the best intervention dosage, long-term efficacy, and underlying mechanism. This trial is registered with ChiCTR1900021530.
Highlights
Spinal cord injury (SCI) is a neurological condition that is common in the clinic but is often severe; most of the patients ended up with quadriplegia or paraplegia
Acupuncture has a wide range of applications, and acupuncture treatments for SCI have been studied across the world, but there have been only a few randomized controlled trials reporting treatment effects on neural function in English [3,4,5,6]
To help solve the problem of dosage, this study aimed to investigate the intervention frequency of acupuncture therapy on incomplete SCI
Summary
Spinal cord injury (SCI) is a neurological condition that is common in the clinic but is often severe; most of the patients ended up with quadriplegia or paraplegia. Acupuncture has a wide range of applications, and acupuncture treatments for SCI have been studied across the world, but there have been only a few randomized controlled trials reporting treatment effects on neural function (motor and sensory) in English [3,4,5,6]. Most of the existing literature regarding the clinical effect of acupuncture on SCI only reported other outcomes such as pain scale or molecular indicators [3,4,5,6,7,8,9]. The acupoints used in most of Evidence-Based Complementary and Alternative Medicine the studies investigating acupuncture treatment for SCI were mainly on the abdomen, the back, and the lower extremities [3,4,5,6]. Acupuncture relies on mobilizing the energy within the human body itself, but because of the stagnation of Qi and blood below the damaged segment after SCI, it is difficult to obtain a satisfactory result using treatments consisting mostly of acupoints below the injured segment
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