Research: JOHANSSON and colleagues,

Listed in Issue 66

Abstract

JOHANSSON and colleagues, Department of Neurology, Lund University Hospital, Lund, Sweden investigated the effects of acupuncture and transcutaneous electrical nerve stimulation (TENS) on functional outcome and quality of life after stroke .

Background

In limited design small studies, acupuncture has been reported to improve functional outcome after stroke.

Methodology

In this multicentre, randomized, controlled trial involving 7 university and district hospitals in Sweden, the investigators studied the effects of acupuncture and TENS on functional outcome and quality of life in 150 patients with moderate to severe functional impairment after stroke. At 5-10 days after stroke, patients were randomized to receive: 1) acupuncture, including electroacupuncture; 2) sensory stimulation with high-intensity, low-frequency TENS that induces muscle contraction; or 3) low-intensity (subliminal), high-frequency electrostimulation (control group). 20 treatment sessions were performed over a 10-week period. Outcome measures included: motor function; activities of daily living function; walking ability; social activities; and life satisfaction, at 3-month and 1-year follow-up.

Results

Patients in each group were similar at baseline in all important prognostic variables. No clinically important or statistically significant differences between treatment groups were seen at 3-month and 1-year follow-ups. No major adverse effects were reported for any of the 3 treatment modalities.

Conclusion

In comparison with a control group that received subliminal electrostimulation, no beneficial effects of acupuncture or TENS with muscle contraction during the subacute phase of stroke were seen on functional outcome or life satisfaction .

References

Johansson BB et al. Acupuncture and transcutaneous nerve stimulation in stroke rehabilitation: a randomized, controlled trial. Stroke 32 (3): 707-13. Mar 2001.

Comment

A superficial reading of this research provides the conclusion that neither acupuncture nor TENS confer any objective benefit in stroke patients. However, the control group in this trial consisted of patients given low-intensity, high-frequency electrostimulation. These results would have been more meaningful, in my opinion, if the control group had not been provided with any electrical stimulation treatment, i.e. standard medical treatment, in order to truly see the benefits, if any, of acupuncture and/or electrical stimulation.

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