OBJECTIVE: To analyze how acupuncture therapy affects balance in patients experiencing their first stroke and to identify the stroke group with greatest improvement in balance after acupuncture intervention. DESIGN: Retrospective case-control study. SETTING:Ward of a medical university hospital. PARTICIPANTS: A total of 629 stroke patients were enrolled initially; 345 patients met the study criteria and 132 were analyzed (66 each in the study and control groups). INTERVENTIONS: The study group received physiotherapy combined with acupuncture and the control group received only physiotherapy. MAIN OUTCOME MEASURES: The Postural Assessment Scale for Stroke patients (PASS) was used to evaluate balance. This balance scale system can be subdivided into static balance (PASS-MP, maintain posture) and dynamic balance (PASS-CP, change posture). RESULTS: This study revealed no statistically significant improvement of balance in the study group (t test). When patients with high Brunnstrom stage (Br stage) and low Br stage were analyzed separately, once again no statistical difference was detected between the study and control groups of those with high Br stage. However, among low-Br stage patients, the study group showed significant improvement in static balance (mean PASS-MP score±standard deviation: 4.7±3.7) compared with the control group (PASS-MP score: 2.8±2.7) (p<0.05). CONCLUSIONS: In first-ever stroke patients with a low Br stage, acupuncture therapy can improve static balance during rehabilitation. However, the effect on balance was limited among high-Br stage patients. This study provides information valuable to patients with hemiplegic stroke because it suggests that acupuncture can be used to improve balance. A prospective double-blind, randomized, controlled study design is recommended for future studies in patients with hemiplegic stroke.
RCT Entities:
OBJECTIVE: To analyze how acupuncture therapy affects balance in patients experiencing their first stroke and to identify the stroke group with greatest improvement in balance after acupuncture intervention. DESIGN: Retrospective case-control study. SETTING: Ward of a medical university hospital. PARTICIPANTS: A total of 629 strokepatients were enrolled initially; 345 patients met the study criteria and 132 were analyzed (66 each in the study and control groups). INTERVENTIONS: The study group received physiotherapy combined with acupuncture and the control group received only physiotherapy. MAIN OUTCOME MEASURES: The Postural Assessment Scale for Strokepatients (PASS) was used to evaluate balance. This balance scale system can be subdivided into static balance (PASS-MP, maintain posture) and dynamic balance (PASS-CP, change posture). RESULTS: This study revealed no statistically significant improvement of balance in the study group (t test). When patients with high Brunnstrom stage (Br stage) and low Br stage were analyzed separately, once again no statistical difference was detected between the study and control groups of those with high Br stage. However, among low-Br stage patients, the study group showed significant improvement in static balance (mean PASS-MP score±standard deviation: 4.7±3.7) compared with the control group (PASS-MP score: 2.8±2.7) (p<0.05). CONCLUSIONS: In first-ever strokepatients with a low Br stage, acupuncture therapy can improve static balance during rehabilitation. However, the effect on balance was limited among high-Br stage patients. This study provides information valuable to patients with hemiplegic stroke because it suggests that acupuncture can be used to improve balance. A prospective double-blind, randomized, controlled study design is recommended for future studies in patients with hemiplegic stroke.