Acupuncture of Motor-Implicated Acupoints on Subacute Stroke Patients: An fMRI Evaluation Study

摘要

Background: Motor impairment is common after stroke. Along with classic integrated physical and occupationaltherapy, acupuncture is also suggested as an adjunctive therapy.Objective: To evaluate the effectiveness of acupuncture on upper limb motor recovery of patients with subacute stroke. Design, Setting, and Patients: Eighteen subacute stroke patients, transferred from a regional acute hospital to a convalescent hospital for rehabilitation in Hong Kong, from March 2005 to November 2007. Two clinical and behavioral evaluations for motor function were given to each participant along with 2 functional magnetic resonance imaging (fMRI) scans. Intervention: Patients were treated with acupuncture 3 times a week over 8 weeks. The intervention set of 3 acupoints is known to influence the motor system, while a second control set does not. Physical and occupational therapy were also used as treatment (parallel to the interventions with acupuncture). Main Outcome Measures: The primary outcome measure was fMRI, and the secondary measures were clinical and behavioral parameters, concentrating on motor function and disability using reliable and validated scales. Results: Data on hand grip demonstrated reappearance of brain activations in the motor-related areas of the lesioned hemisphere in both groups after intervention. As with clinical and behavioral evaluations, the fMRI data on hand grip demonstrated no statistically significant differences between the groups. Conclusions: These preliminary results suggest that acupuncture may be beneficial to motor recovery in subacute stroke patients. However, the application of control acupuncture points did not result in a different recovery. The supplemental effect of acupuncture to physical and occupational therapy needs to be explored in further studies.