Post Stroke Acupuncture Care
I have found that I am treating quite a few post stroke patients lately with partial paralysis or hemiplegia with success using acupuncture. I utilize electro acupuncture, also called estim to treat these patients primarily. I have found that acupuncture in combination with rehabilitation or physical therapy has greatly improved these patients’ quality of life measures, visual analog scale pain ratings, functional comprehensive assessment scores, etc. that are often studied to see if stroke recovery is successful. There are many research studies that also produce these results and even have statistically significant results that point to acupuncture in combination with rehab is more effective then rehab and drug options alone. While I know this is effective, I often am asked how this medicine in particular works for stroke. Firstly, I think of acupuncture as working in two ways generally: acupuncture points are located near neuromuscular bundles and large blood vessels. For this reason, acupuncture can be said to influence circulation of blood, blood that carries anti-inflammatory markers, nutrients, and hormones within the body. The acupuncture needles act as a sort of lighting rod for this movement, directing attention and circulation to pinpointed areas of concern. Secondly, acupuncture interacts with the nervous system. It moves patients from a sympathetic stress response to a parasympathetic, rest and digest response. It is easier for a body to heal if it isn’t in a sympathetic dominant emergency stress state. We know acupuncture works in this way due to functional MRI findings as well as thermography that tracks blood flow during acupuncture sessions.
Now that we know how acupuncture generally works, we can talk about how electro acupuncture works. There are five researched mechanisms discovered in studies surrounding acupuncture and ischemic stroke that are at play and contribute to treatment success; Promotion of neurogenesis and cell proliferation in the CNS, regulation of cerebral blood flow in the ischemic area, anti-apoptosis in the ischemic area, regulation of neurochemicals, and finally, improvement of long term potentiation and memory after stroke.
Since the primary event in 85-90% of acute strokes is compromised vascular supply to the brain, the extent of the damage and therefor, potential for recovery, lies in the duration, severity, and location of the ischemia. Cell death can occur as well as metabolic acidosis. The speed with which someone can be seen by western and eastern doctors alike is key. Electro acupuncture can decrease cell death, help rebuild after damage thru the aforementioned neurogenesis, achieve blood flow return to the area of damage, regulate neurochemicals quickly after the trauma, and ensure better long term health options. Since stroke is the second leading cause of death as outlined by the WHO, this treatment of stroke can decrease the tax on the healthcare system if long term disability can be avoided.
Acupuncture is a tool for this scenario that is well researched, successful, and minimally invasive. It is a great adjunct to western care for post stroke patients and I hope that we can work together utilizing these modalities in the future to better address our patient’s recovery process.