Article

Objectives: To determine whether adding electrical stimulation of upper limb
acupoints to conventional rehabilitation during acute stroke could produce
greater and longer lasting motor improvements of the arm.
Design: Double-blind,
randomized, placebo-controlled trial. Setting: Acute stroke wards, followed by
rehabilitation hospitals and subjects' residences. Participants: Seventy-three
patients </= 46 hours post stroke onset with moderate to severe weakness in the
arm contralateral to the side of stroke. Intervention: All subjects received
conventional rehabilitation. Twenty-nine received additional electrical
stimulation, 21 received additional placebo-electrical stimulation and 23
received conventional rehabilitation only, as control. Electrical stimulation or
placebo-electrical stimulation was applied to acupoints GB20, LI15, LI11, LI10
and LI4, 60 minutes a day, five days a week, for four weeks. Measurements:
Primary outcome measures were hand grip and pinch strength, with Action Research
Arm Test (ARAT) as secondary outcome measure. These were assessed on the affected
arm at recruitment, then 4 (W4), 12 (W12) and 24 weeks (W24) afterwards. Results:
Post-hoc analysis showed that the electrical stimulation group had greater
improvements than the control group in hand grip (P = 0.015) and pinch strength
(P = 0.007) at W4, with the gains maintained at W12 and W24. In contrast, the
placebo-electrical stimulation group did not differ from either the control or
the electrical stimulation group. Between-group improvements in ARAT scores from
baseline to W24 (by 16.8 in control, 27.6 in placebo-electrical stimulation group
and 26.3 in electrical stimulation group) were not significant. Conclusions:
Adding four weeks of electrical stimulation during acute stroke appears to
produce greater and longer lasting hand grip and pinch strength improvements than
administering conventional rehabilitation alone.

Langue : ANGLAIS