Abstract
Background: How to promote true recovery from poststroke upper limb motor impairment has remained an urgent public health problem. Acupuncture has the potential to facilitate poststroke recovery. Abdominal acupuncture, based on the recently discovered acupoint system on the anterior abdominal wall, appears attractive because it induces less pain, and allows concurrent limb rehabilitative training during treatment. However, its clinical efficacy has not been systematically demonstrated, and its neurophysiological mechanism has remained obscure.
Methods: First-onset stroke survivors (0.5-3 months post-stroke) will be randomly divided into 3 groups (N=22 in each), respectively receiving (1) abdominal acupuncture, (2) abdominal acupuncture with sham needles, and (3) no acupuncture. All subjects will concurrently receive basic treatment, including upper limb rehabilitative training and measures for secondary stroke prevention. Clinical scores reflective of motor functions and impairment (Wolf motor function test, Fugl-Meyer assessment, Brunnstrom staging), evaluation of daily life ability, surface electromyography, and motor-imagery functional magnetic resonance imaging will be collected as outcome measures before and after intervention. Upper-limb muscle synergies will be identified from the collected surface electromyography.
Discussion: The study will use abdominal acupuncture to improve recovery from motor dysfunction of the upper limb after stroke, to observe the effects of abdominal acupuncture on post-stroke upper limb motor functions, and to analyze the relationship between changes in upper-limb functions and measurements from both multi-muscle surface electromyographic data and brain activations during motor imagery from functional magnetic resonance imaging, so as to explore possible mechanisms of neuroplasticity associated with abdominal acupuncture.
Trial registration: This trial was registered with the ClinicalTrials.gov (ID: NCT03712085) on 7th July 2018, and last updated on 16th Oct 2018.
Functional Magnetic Resonance Imaging of Language Following Constraint-Induced Aphasia Therapy Primed with Intermittent Theta Burst Stimulation in 13 Patients with Post-Stroke Aphasia