Category: Stroke; Complementary Integrative Rehabilitation Medicine
Evaluate the effect of acupuncture by measuring the amplitude of motor evoked potential (MEPs) elicited by single Transcranial Magnetic Stimulation (sTMS) on acute stroke patients with flaccid hemiparesis before and after five days of treatment in Inpatient Rehabilitation setting.
Patients with acute hemiplegic stroke within 5-15 days were selected to participate in a randomized controlled trial. Participants in the experimental group received five daily consecutive acupuncture sessions of 45 minutes duration, and two sessions sTMS, prior and after treatment to evaluate MEPS. Control group received two sessions of sTMS, 5 days apart. sTMS was given at an intensity of 120% of the motor threshold. The MEPs were measured with EMG of the abductor pollicis brevis and the mean of the amplitudes of 10 pulses was calculated for both sessions.
Setting : Inpatient rehabilitation unit at community hospital
Participants (or Animals, Specimens, Cadavers) : Random sample of patients with acute hemiplegic stroke
Interventions : Five daily consecutive acupuncture treatment, 45 min/session
Main Outcome Measure(s) : MEPs elicited by sTMS
Two participants were enrolled. The first subject, who received acupuncture obtained a MEP average of 1187.8 mV with stdev of 3.97 prior and 1076.6 mV with stdevof38.03 after the treatment. The second participant, who did not receive acupuncture, obtained a MEP average are 930.0 mV with stdev of 296.79 in the first sTMS session and 1177.1 mV with stdev 53.73 in the second session.
The present case series shows the feasibility of this study in acute inpatient rehabilitation setting. The difference in MEP amplitude was not significant in either case. The variability of stroke recovery pattern has been considered, however, further research is needed to fully evaluate effectiveness of acupuncture stimulation on neuroplasticity in stroke patients.