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Acupuncture for a first episode of acute ischaemic stroke: an observer-blinded randomised controlled pilot study
  1. Ching-Hsiung Liu1,2,
  2. Yu-Ting Hsieh3,
  3. Hung-Pin Tseng1,
  4. Hung-Chih Lin1,
  5. Chun-Liang Lin1,
  6. Tai-Yi Wu3,
  7. Shu-Hua Lin3,
  8. Szu-Hung Tsao3,
  9. Hong Zhang4
  1. 1Department of Neurology, Lotung Poh-Ai Hospital, Ilan, Taiwan
  2. 2Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
  3. 3Department of Physical Medicine and Rehabilitation, Lotung Poh-Ai Hospital, Ilan, Taiwan
  4. 4College of Acupuncture and Tuina, Guangzhou University of Chinese Medicine, Guangdong, China
  1. Correspondence to Dr Ching-Hsiung Liu, Department of Neurology, Lotung Poh-Ai Hospital, 83 Nan-Cheng Street, Lotung Town, Ilan County 26514, Taiwan; chl{at}


Objective To determine the required sample size for, and feasibility of, a RCT examining the effectiveness of early acupuncture for acute ischaemic stroke.

Methods Thirty-eight patients aged 40–85 years with a first episode of acute ischaemic stroke presenting within 72 h of stroke onset were randomly assigned to receive manual acupuncture (MA group; n=20) plus standard care or standard care only (control group, n=18). The acupuncture treatment was provided daily for 2 weeks. The primary outcome was the change in the National Institutes of Health Stroke Scale (NIHSS) score between baseline and 4 weeks. Secondary outcomes included changes in the Fugl–Meyer assessment (FMA) and the functional independence measure scores between baseline and 4 weeks, and changes in NIHSS, Barthel Index and modified Rankin Scale scores at 12 weeks.

Results Thirty-one patients completed the study (dropout rate=18%) and adverse effects were minimal. No significant differences were seen between groups in the improvements in NIHSS scores, although there tended to be a greater reduction in NIHSS score after 1 week in the MA group relative to the control group (p=0.066). The post-stroke motor activity at 4 weeks was associated with a significantly increased FMA score in the acupuncture group compared with the control group (p<0.05), but not supported by intergroup analysis.

Conclusions This pilot study indicates that acupuncture appears to be safe for patients in the acute stage of ischaemic stroke. A subsequent trial with a larger sample size (estimated at n=122) is required to confirm whether early acupuncture intervention contributes to earlier functional improvement and to assess the longer-term clinical efficacy of acupuncture.

Trial registration number NCT02210988; Results.


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