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Acupuncture for recovery of stroke

Stroke is one of the leading causes of long-term disability worldwide. In general, stroke requires immediate medical attention, for instance, recombinant tissue plasminogenactivator (rtPA), as the only Food and Drug Administration-approved thrombolytic for treating ischemic stroke must be administered within 4.5 hours of stroke onset to be effective, and it has risk of causing intracranial hemorrhage. These factors largely restrict the clinical use of rtPA and other remedies. Thus, given its widespread occurrence and devastating impact of sufferers and their caregivers, better treatment of stroke is urgently needed.

Typical post-stroke care in the USA starts with seven days of hospital stay followed by one to two weeks of physical therapy, occupational therapy and speech therapy in a rehabilitation facility. After three or more weeks of outpatient rehabilitation, the treatment comes to an end, but the patient's recovery is far from complete.

Regenerative strategies, particularly with regard to neurogeneisis, offer long-term hope for many patients who have suffered a stroke.

Acupuncture is a kind of classical traditional Chinese medicine (TCM) that has been used for patients with stroke and post-stroke rehabilitation for thousands of years.[1] One systematic review of preclinical study indicates that acupuncture decreases infarct volume, ameliorates neurological impairment and plays a neuroprotective role in experimental models with acute ischemia. Recent reports suggest that acupuncture can enhance stroke recovery through neurogenesis.[2] The underlying mechanisms mostly involved with enhancing endogenous neurogenesis including proliferation, migration and differentiation of neural progenitor cells (NSCs).

A recent systematic review paper suggests that conventional acupuncture and electroacupuncture could be effective treatments for survivors with Poststroke shoulder pain (PSP), with regard to reducing pain and improving upper extremity function and physical function.[3] Acupuncture or electroacupuncture also reported be effective in decreasing the spasticity after stroke.[4]

In summary, acupuncture can be a major benefit to stroke rehabilitation when administered correctly. Results are most remarkable in the acute stage. First, start acupuncture treatment in time is critical. Earlier intervention promises fewer deficits. Second, an effective acupuncture system should be employed. Scalp acupuncture excels over body acupuncture in treating neurological conditions such as strokes. After insertion, needles should be manipulated to ensure qi flow. Additionally, appropriate acupuncture needs to be emphasized; acupuncture is not simply an act of inserting needles at certain points, psychological counseling, encouragement, building the patient’s confidence to heal, helping the patient to relax, and teaching the patient how to talk and to move must be carried out simultaneously. Finally, treatments have to be repeated frequently for reinforcement. In this manner a stroke patient will achieve a faster and more complete recovery.

As a classical TCM art for post-stroke rehabilitation, we hope that acupuncture treatments for stroke can be emphasized and let more stroke patients know what’s acupuncture is and how acupuncture may benefit them.

1. Wu, P.; Mills, E.; Moher, D.; Seely, D.. Stroke 2010, 41, e171-9. 2. Nam, M. H.; Yin, C. S.; Soh, K. S.; Choi, S. H. Journal of acupuncture and meridian studies 2011, 4, 153-8. 3. Chau, J. P. C.; Lo, S. H. S.; Yu, X.; Choi, K. C.; Lau, A. Y. L.; Wu, J. C. Y.; Lee, V. W. Y.; Cheung, W. H. N.; Ching, J. Y. L.; Thompson, D. R. Frontiers in neurology 2018, 9, 30. 4. Lim, S. M.; Yoo, J.; Lee, E.; Kim, H. J.; Shin, S.; Han, G.; Ahn, H. S., Evidence-based complementary and alternative medicine : eCAM 2015, 2015, 870398.

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