Stroke is a leading cause of disability and the third most common cause of death in Australia. The biggest impact of stroke is not just the financial burden but also the loss of healthy life. Stroke is no longer only a male disease. Although age-specific stroke incidence and mortality rates for men are higher than for women, a recent research found that women are likely to have more stroke episodes than men. Some other risk factors for stroke include high blood pressure, smoking, poor diet, obesity, lack of exercise and excessive alcohol consumption. There are also certain diseases and medical conditions contributing as risk factors including diabetes, cardiovascular disease, transient ischaemic attack and so forth. However, most of these risk factors are controllable with regular check-ups and treatment.
Stroke can affect patients physically and mentally. Common post-stroke disabilities include fatigue, urinary or bowel incontinence, speech problem, difficult swallowing, weakness, paralysis, visual problem, memory problem, depression, anxiety, and mood swings. Despite the Australian government’s funding of millions of dollars for stroke recovery, rehabilitation and employment services, stroke survivors still suffered significant financial burden. After a stroke, recovery can be slow, depending on the type of stroke, post-stroke patients may need to work with speech therapists, physical therapists, or occupational therapists to regain physical strength and the ability to communicate effectively.
Acupuncture has been a cost-effective and safe alternative treatment for post-stroke rehabilitation and care. A recent article in the Royal Australian College of General Practitioners (RACGP) shows that stroke survivors are able to walk again with a walking aid after months of occupational, physiotherapy and acupuncture treatment. In 2013, the World Health Organisation (WHO) and the National Institute of Health (NIH) released a report with a list of medical conditions showing effectiveness by acupuncture treatment in controlled clinical trials. Among the list of disease conditions, stroke rehabilitation acupuncture shows significant beneficial effects in improving stroke conditions and recovery.
Mechanisms of Acupuncture Therapy for Stroke Prevention and Rehabilitation
1. Effect of Acupuncture in the regulation of Neurochemicals
The motor functions of the limbs for hemiplegic patients that were caused by acute stroke were seen to have significant improvement after treatment with electroacupuncture. This improvement is related with reduced levels of brain biomarkers that caused stroke, eg. serum neuron-specific enolase (NSE), soluble protein-100B (S-100B) and vasoconstrictor endothelin (ET).
In a research study, neurochemicals such as gelsolin, complement component I, C3, C4B, and beta-2-glycoprotein I proteins were increased in the post-stroke patients who received electroacupuncture. These neurochemicals help with the modulation of inflammatory responses, offered protection against neuro-degeneration following stroke. The release of these neurochemicals also act as membrane binding components that enhance phagocytosis that clear away cell debris.
2. Effect of Acupuncture on Hemorheology and Cerebral Microcirculation
Acupuncture has also shown to cause changes in the cerebral microvascular blood flow perfusion, which leads to changes of blood pressure and cardiovascular regulatory activities. Acupuncture improves cerebral circulation and increases the amount of oxygen delivered to the affected tissue, thus important for stroke victims in recovery and minimizing brain tissue damage.
3. Effect of Acupuncture on Metabolism and Activity of Neurons
Acupuncture regulates the glucose metabolism and activates cerebral structures and plasticity in cerebral function regions in chronic stage ischemic stroke patients. Acupuncture is also found to be effective for protecting neurons and facilitating stroke recovery by promoting neurogenesis and thus helping to create new neurons to replace the damaged ones.
4. Effect of Acupuncture on Local Functions of Brain and Muscles
Studies have shown significant structural changes of grey matter volume in frontal areas of motor-related brain regions in stroke patients following acupuncture treatment. The structural changes in these motor regions can stimulate motor recovery for stroke patients. The study also shows that acupuncture increased the motor cortex excitability and plasticity.
5. Effect of Acupuncture on Glutamatergic System
Excessive Glutamate release and dysfunction of the enzyme to destroy or reuptake the glutamate leading to certain diseases, such as stroke, autism, Alzheimer’s disease, intellectual disability and neurodegenerative diseases. Electroacupuncture shows a promising result in decreasing the concentration of glutamate in the Central Nervous System.
Acupuncture treatment shows positive effects on the prevention and rehabilitation for stroke. Acupuncture treatment, similar to physiotherapy treatment, can combine with conventional care to provide additional possibility of improving the efficacy for post-stroke rehabilitation.
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