Recovering From Stroke With Acupuncture
By Brian B. Carter, MS, LAc, Thu Dec 8th

Q: I had a stroke 7 years ago. It was due to a blood clot in thebrain. I am making a good recovery, but I am curious to know ifacupuncture would benefit me. Tim

A: Tim, the best time to get acupuncture for stroke isimmediately afterwards - ideally while still in the hospital, ifthe docs will allow it. Seven years is a long time to wait foracupuncture. But it still may help you… You won't know unlessyou try it.

Scalp Acupuncture Usually scalp style acupuncture is used forstroke. Needles are "threaded" along the scalp underneath theskin. There are at least three different scalp systems (Dr. JiaoShun Fa's original style from the 1970s, Dr. Zhu's, and Dr.Yamamoto's styles). Call local acupuncturists and find out ifthey have experience with scalp acupuncture.

How Many Treatments? It may take 10-20 treatments to getresults. In China, they treat patients every day. That's notfinancially realistic here, but 2 or 3 times per week is good.In your case - after 7 years - it may take sustained and intensestimulus to make a change.

Complementary Therapies You can also take herbal formulas tobalance out the constitutional issues that led to the stroke,and help repair the damage. Acupuncture can be combined withphysical rehab. It can improve both motor function (ability tomove muscles) and sensory (ability to feel). You may recoverfunction to some degree, but in more serious strokes there maybe no response.

Will it Work for Me? It's hard to say whether an individual willrespond and how much- partner with the acupuncturist - they willget to know you case thoroughly, integrate what they're doingwith your other medical providers. See the acupuncturist untilyou hit a plateau. Then your acupuncturist may try anothersystem or strategy.

Stroke and Acupuncture Research What's clear from severalstudies is that very severe stroke patients may be less likelyto respond to acupuncture. This issue has not been thoroughlyresearched. Typically, American researchers have used inadequateacupuncture (style, points, and frequency of treatments). Theyconduct and review studies using points that Chineseacupuncturists would not use, and then conclude that acupuncturedoesn't work. I say, "No, it's your brain that doesn't work,because you don't do a thorough literature review beforedesigning your studies!"

As James Rotchford, MD, (a medical doctor and acupuncturist whohas reviewed hundreds of acupuncture research studies andreviews on his website, www.acubriefs.com) mentions below, thereare many approaches within acupuncture. Scalp styles (there are3 - who knows which is most effective when - a good researchtopic) appear to be best for neurological conditions likestroke, MS, and post-concussion syndrome. To study bodyacupuncture points for stroke demonstrates unfamiliarity withthe work that has been done thus far.

Is the acupuncture (style, points, and frequency of treatments)studied in most research considered the most effective kind byacupuncture experts?

It is not.

Why study acupuncture points and styles that cliniciansthemselves don't think work?

Three possibilities come to mind:

Arrogance: "Even though Chinese have been doing acupuncture forthousands of years, they don't know anything about it." Thisisn't so implausible - mainstream American docs and researchersalready ignore European research - why not Chinese, too? Iftheir methodology differs from the drug-model, it's because theyaren't as advanced as us. And if we disagree with the results,the methodology is criticized. Otherwise, it's fine.Psychological studies of the research review process have proventhis bias. Idiocy: It's hard to imagine that someone smartenough to do research isn't smart enough to read the literature,but I suppose it's possible, or Conspiracy: "Let's do the wrongacupuncture on purpose so we have proof that acupuncture doesn'twork." This would be fool's work, since there is alreadyincontrovertible evidence that it does. If the studies suck,then why review them?

Because a review of multiple studies carries more weight thanjust one study. It's easier to convince people with a review.

The major issue with research reviews is that if the studieswere inadequate in the first place, then the review'sconclusions will be wrong. Until the methodology and studydesigns are improved, what's the point?

Again, we suggest researchers review the Chinese medicineliterature. Rotchford advocates outcome studies rather thandrug-style RCT's. In outcome studies, no placebo is used, butthere is no satisfactory placebo for acupuncture research.

When acupuncture studies are done well, why aren't the resultsalways positive?

Rotchford says, "Dr. Naeser has shown that the extent of CTdemonstrated destruction does make a distinct difference inresponse to acupuncture. Why are Western studies equivocal whenthose from China and Japan so heavily support a role foracupuncture treatment in thousands of cases?

"First, the acupuncture approach is different. In the Orient,acupuncture is done daily to twice daily for maximum stimulationof the nervous system. Various experts recommend treating 3times weekly as a minimum; more would be better. "Second,Western studies use standard major Yang Ming and Shao Yangpoints. Chinese studies indicate that using scalp points aloneor in addition to provide a stronger input. A newer approach,Xingnao Kaiqiao (A consciousness awakening), generated by Dr.Shi Xuemen and co workers, appears extremely attractive. Theytreat PC 6, GV 26, SP 6, BL 40, HT 1 (a bit distal to theusually designated point), LU 5, and LI 4 in sequence each tothe point of tears (GV 26) and muscle jerking. In a series of3200 patients, an essential cure is claimed in 58% and 90%effective improvement to the point of reasonable selfsufficiency. Other points are added for pseudobulbar palsy,where good results are reported in over 300 patients. Comparingthis technique to traditional Yang points and to scalpacupuncture, they denote excellent results in 76% versus 36%. "Isuggest a study such as done by Johansson's group, using XingnaoKaiqiao, and with treatment given at least 5 days a week. Third,we must consider Qi transmission from healer to patient in anytherapy, especially in acupuncture. I believe intent isessential; and the intensity of interest and empathy mightcreate a much improved healing. Considering this, the backgroundand training of the involved acupuncturists in a study should benoted." - from his review of "Acupuncture For DysphagiaFollowing Stroke." (see link below)

So, the people doing acupuncture research don't study Chinesemedical acupuncture, but rather their own strange version of it- who knows where it comes from. I have no idea who's teachingthem (are they teaching themselves?), or what books they arereading, if any. I'm not usually so bluntly critical of people'swork, but as a body of work, I'd say that American acupunctureresearch has earned the distinction of being mostly useless.

About the author:Acupuncturist, herbalist, and medical professor Brian B. Carterfounded the alternative health megasite The Pulse of OrientalMedicine (http://www.PulseMed.org/). He is the author of thebook "Powerful Body, Peaceful Mind: How to Heal Yourself withFoods, Herbs, and Acupressure" (November, 2004). Brian speaks onradio across the country, and has been quoted and interviewed byReal Simple, Glamour, and ESPN magazines.