A study found that six weeks of acupuncture treatment significantly improved language function, quality of life and neurological damage in patients with post-stroke speech disorders. Because improvements are still seen after six months, acupuncture may be a safe and effective adjunctive therapy to help stroke patients regain their speech.
In the acute phase after a stroke, about one-third of survivors develop post-stroke motor aphasia, the inability to speak or organize the muscle movements of speech, and 61% of survivors are still affected a year later. Disruptions in language and communication abilities can negatively impact quality of life.
The first-line rehabilitation treatment for post-stroke motor aphasia is behavioral speech therapy. In China, acupuncture is often recommended as a complementary and alternative treatment for post-stroke aphasia. Researchers at the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine in China conducted a new study investigating the effects of acupuncture on language function, quality of life, and neurological impairment in patients with post-stroke motor aphasia.
The researchers recruited 252 patients (78.6% male), aged 45 to 75, who were diagnosed with aphasia after a first ischemic stroke. Eligible participants were those with aphasia duration between 15 and 90 days and aphasia severity between 0 and 3 according to the Boston Diagnostic Aphasia Examination (BDAE). Participants were randomly assigned to receive manual acupuncture or "sham" acupuncture (using non-meridian acupuncture points and shallow needle insertion).
Both groups of patients received 30 sessions of therapy for six consecutive weeks, five times a week for 30 minutes each session, along with language training and conventional therapy. Manual acupuncture follows the standard "Qi-moving and resuscitating" protocol and "Virtue-Qi feeling" induction. Traditional Chinese medicine theory believes that "moral sense" is the key to successful acupuncture treatment. "Desense" refers to the patient's subjective feeling and the body's objective reaction when the needle pricks certain acupuncture points, as well as the acupuncturist's feeling.
The primary outcomes were the Aphasia Quotient (AQ) on the Western Aphasia Test and the Chinese Functional Communication Profile (CFCP) score at week six. AQ is a sensitive, valid and reliable indicator of the performance of aphasia. The lower the score (range: 0-100), the more severe the impairment of language function. CFCP measures functional communication ability in Mandarin, with higher scores (range: 0 to 250 points) indicating stronger abilities. Secondary outcomes included assessment of participants' stroke quality of life and degree of neurological deficit.
The average AQ score of the artificial acupuncture group in the sixth week was 69.66, an average increase of 29.60 points from the baseline, and the sham acupuncture group was 61.68, an average increase of 17.88 points. Compared with the sham acupuncture group, the AQ score of the manual acupuncture group increased by 7.99 points, which has significant clinical significance. At the sixth week, the average CFCP scores of the manual acupuncture group and the sham acupuncture group were 167.60 points and 144.08 points respectively, which were 72.68 points and 50.52 points higher than the baseline, respectively. At the end of the six-month follow-up, the manual acupuncture group also showed significant improvements in AQ and CFCP scores.
Compared with sham acupuncture, manual acupuncture also resulted in significant and sustained improvements in language function, quality of life, and neurological impairment at six-month follow-up after the onset of aphasia. Three treatment-related adverse reactions occurred in the manual acupuncture group and the sham acupuncture group respectively, but they were all transient and not serious.
To the researchers' knowledge, their study is the first randomized controlled trial with long-term follow-up to evaluate the efficacy of acupuncture in patients with post-stroke motor aphasia. Considering the reasons for acupuncture's effectiveness in improving speech disorders, they concluded that 30 treatments provided an "adequate dose of acupuncture" and attributed its effectiveness to strict adherence to the standard treatment protocol.
"The findings confirm that post-stroke motor aphasia is the main condition affected by acupuncture treatment, suggesting that acupuncture can be used as an adjunctive treatment for patients with post-stroke motor aphasia," the researchers said. "Additionally, the clinical efficacy and safety results provide policymakers, clinicians and patients with evidence for the use of acupuncture in the treatment of post-stroke aphasia."
The study was published in JAMA Network Open.