Acupuncture and transcutaneous nerve stimulation in stroke rehabilitation - A randomized, controlled trial

Background and Purpose-In small trials with control groups that receive no intervention, acupuncture has been reported to improve functional outcome a fter stroke. We studied effects of acupuncture and transcutaneous electrica l 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 fun ctional impairment were included. At days 5 to 10 after acute stroke, patie nts were randomized to 1 of 3 intervention groups: (a) acupuncture, includi ng electroacupuncture; (b) sensory stimulation with high-intensity, low-fre quency transcutaneous electrical nerve stimulation that induces muscle cont ractions; and (c) low-intensity (subliminal) high-frequency electrostimulat ion (control group). A total of 20 treatment sessions were performed over a 10-week period. Outcome variables included motor function, activities of d aily living function, walking ability, social activities, and life satisfac tion at 3-month and 1-year follow-up. Results-At baseline, patients in each group were closely similar in all imp ortant prognostic variables. At 3-month and 1-year follow-ups, no clinicall y important or statistically significant differences were observed between groups for any of the outcome variables. The 3 treatment modalities were al l conducted without major adverse effects. Conclusions-When compared with a control group that received subliminal ele ctrostimulation, treatment during the subacute phase of stroke with acupunc ture or transcutaneous electrical nerve stimulation with muscle contraction s had no beneficial effects on functional outcome or life satisfaction.