Stroke is the second most common cause of death (after coronary heart disease) and the leading cause of adult disability in the US today. Approximately 700,000 strokes occur each year in the US leaving 500,000 survivors with residual disability. Forty percent of those survivors have moderate impairment and functional limitations related to motor function and basic mobility, while 15-30% are severely disabled. Physical therapists and other professionals focus recovery on relearning normal patterns of movement or facilitating a rebalance of muscle tone. In an attempt to further improve outcomes of stroke rehabilitation alternative treatments such as acupuncture or electroacupuncture (EA) are being evaluated for their efficacy in improving functional recovery after stroke. Acupuncture/EA has been used in eastern medicine for thousands of years to enhance stroke recovery. It has only been in the last decade that studies of brain function with computed tomography (CT) scan and magnetic resonance imaging (MRI) has substantially expanded our understanding of neuronal recovery and their modulation by various rehabilitation interventions.
The mechanism by which acupuncture increases cerebral blood flow is not fully understood but immunohistochemical analysis in animals suggests an enhanced expression of vascular endothelial growth factor. Clearly, post stroke outcome is dependent on stroke severity in the acute phase and that patients with intact cortical function have an advantage to better participate with motor recovery. The location of the lesion site plays a significant role in the responsiveness to any therapeutic intervention as does the type of stroke: ischemic vs. hemorrhagic. During the functional reorganization of neural pathways following a stroke, therapeutic techniques rely on the neuroplasticity of the brain to achieve improved motor abilities and functional outcomes
Current evidence for clinical efficacy of acupuncture/EA for stroke recovery is promising but still controversial; it's efficacy as an adjunct to standard post-stroke rehabilitation programs can be demonstrated with accurate treatment intervention using electrical stimulation over acupuncture points, proper selection of patient and functional outcomes measures. Additionally, acupuncture/EA may be helpful in treating pain, sleep disturbance, anxiety, depression, or other conditions which are common in stroke and often a barrier to recovery.
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