Comprehensive rehabilitation with integrative medicine for subacute stroke: A multicenter randomized controlled trial

Jianqiao Fang, Lifang Chen, Ruijie Ma, Crystal Lynn Keeler, Laihua Shen, Yehua Bao, Shouyu Xu, Jianqiao Fang, Lifang Chen, Ruijie Ma, Crystal Lynn Keeler, Laihua Shen, Yehua Bao, Shouyu Xu

Abstract

To determine whether integrative medicine rehabilitation (IMR) that combines conventional rehabilitation (CR) with acupuncture and Chinese herbal medicine has better effects for subacute stroke than CR alone, we conducted a multicenter randomized controlled trial that involved three hospitals in China. Three hundred sixty patients with subacute stroke were randomized into IMR and CR groups. The primary outcome was the Modified Barthel Index (MBI). The secondary outcomes were the National Institutes of Health Stroke Scale (NIHSS), the Fugl-Meyer Assessment (FMA), the mini-mental state examination (MMSE), the Montreal Cognitive Assessment (MoCA), Hamilton's Depression Scale (HAMD), and the Self-Rating Depression Scale (SDS). All variables were evaluated at week 0 (baseline), week 4 (half-way of intervention), week 8 (after treatment) and week 20 (follow-up). In comparison with the CR group, the IMR group had significantly better improvements (P < 0.01 or P < 0.05) in all the primary and secondary outcomes. There were also significantly better changes from baseline in theses outcomes in the IMR group than in the CR group (P < 0.01). A low incidence of adverse events with mild symptoms was observed in the IMR group. We conclude that conventional rehabilitation combined with integrative medicine is safe and more effective for subacute stroke rehabilitation.

Figures

Figure 1. Flow of participants through the…
Figure 1. Flow of participants through the trial.
Figure 2. Means of MBI, NIHSS, FMA,…
Figure 2. Means of MBI, NIHSS, FMA, MMSE, HAMD at Four Testing Time points.
(a) MBI score for the IMR and CR at four testing time points (mean ± SEM; IMR n = 176, CR n = 172). **P < 0.01, compared to CR group. (b) NIHSS score for the IMR and CR at four time points (mean ± SEM; IMR n = 176, CR n = 172). **P < 0.01, compared to CR group. (c) FMA score for the IMR and CR at four testing time points (mean ± SEM; IMR n = 176, CR n = 172). **P < 0.01, compared to CR group. (d) MMSE score for the IMR and CR at four testing time points (mean ± SEM; IMR n = 62, CR n = 69). *P < 0.05, compared to CR group. (e) HAMD score means for the IMR and CR at four testing time points (mean ± SEM; IMR n = 76, CR n = 77). *P < 0.05, compared to CR group.

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