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JKM > Volume 35(1); 2014 > Article
Kim, Lu, Cho, Jung, Moon, Park, Ko, Cho, and Park: Efficacy of Electroacupuncture with Dysphagia Caused by Stroke

Abstract

Objectives

This study investigated the effect of electroacupuncture on swallow function in stroke patients with dysphagia. The purpose was to determine whether electroacupuncture could improve swallow function and quality of life for patients with dysphagia caused by stroke. A pilot double-blind, randomized controlled trial design was used

Methods:

A total of 17 stroke patients with dysphagia were recruited to this study, 8 assigned to the swallowing electroacupuncture (SE) group and 9 to the control group. Swallowing electroacupuncture was assessed for 5 Hz electrical or sham stimulation for 20 min duration 3 times a week. Outcome measurements were DOSS, 14-item questionnaire from the SWAL-QOL, NIHSS and MBI. Assessment was carried out for baseline, 2 weeks and 4 weeks

Results:

In the 2 weeks follow up data, the study group showed significant difference in DOSS and SWAL-QOL compared with the baseline. The study group also showed significant difference in DOSS and SWAL-QOL compared with the control group. Similarly in the 4 weeks follow up data, the study group showed improvement tendency in DOSS and SWAL-QOL compared with baseline and also with the control. The NIHSS and MBI scores returned no significant differences. The swallowing electroacupuncture was well tolerated in all cases with no serious adverse effects.

Conclusions:

The findings from the pilot study indicated that electroacupuncture has significant effects on improvement in swallowing function and quality of life. With both inpatients and outpatients, further larger and longer-term follow-up study is needed to confirm this suggestion.

Fig. 1
Randomization and Patients Flow Chart
jkm-35-1-26-3f1.tif
Table 1
Baseline Characteristics of Patients
Characteristics SE (n=8) Control (n=9) p-value
Sex 0.48
  Male 7 6
  Female 1 3

Age (years) 65.8±11.4 70.7±9.2 0.32

Height (cm) 58.9±11.8 68.0±9.8 0.22

Weight (kg) 170.3±5.3 164.7±7.6 0.40

Blood Pressure (mmHg) 0.88
  Systolic 127.8±20.6 127.1±18.6
  Diastolic 71.0±7.2 73.8±6.2

On set (weeks) 10.3±8.8 7.7±3.2 0.74

Side of Lesion 0.74
  Right 4 3
  Left 2 4
  Both 2 2

Stroke type 0.88
  Infarction 5 6
  Hemorrhage 3 3

Stroke Classification 0.48
  TACS 3 2
  PACS 2 2
  POCS 3 5
  LACS 0 0

Feeding Type 0.27
  NG 7 5
  PO 1 4

DOSS 2.8±1.4 3.0±1.3 0.70

Values are mean±SD, n

SE:Swallowing Electroacupuncture therapy group, TACS:total anterior circulation stroke, PACS:partial anterior circulation stroke, POCS:posterior circulation stroke, NG:Nasogastric tube feeding, PO: modified oral feeding, DOSS:dysphagia outcome and severity scale

Table 2
Changes in Dysphagia Outcome and Severity Scale
Baseline 2 weeks follow up 4 weeks follow up
Study group 2.8±1.4 3.9±0.9 (n=7) * 5.0±0.8 (n=4)
Control group 3.0±1.3 3.4±1.3 (n=7) 3.6±1.3 (n=5)

Values are mean±standard deviation

* Indicates significant changes compared with baseline by Wilcoxon signed ranks test (p=0.03)

† Indicates significant differences compared with control group by Mann-Whitney U test (p=0.04)

Table 3
Changes in Swallowing Quality of Life
Baseline 2 weeks follow up 4 weeks follow up
Study group 42.6±13.7 48.4±10.0 (n=7)* 53.8±9.5 (n=4)
Control group 47.5±12.7 48.0±9.4 (n=7) 55.4±5.8 (n=5)

Values are mean±standard deviation

* Indicates significant changes compared with baseline by Wilcoxon signed ranks test (p=0.04)

Table 4
Changes in National Institutes of Health Stroke Scale
Baseline 2 weeks follow up 4 weeks follow up
Study group 11.3±4.1 10.9±3.4 (n=7) 11.0±2.0 (n=4)
Control group 11.2±4.4 9.0±3.0 (n=7) 8.6±2.9 (n=5)

Values are mean±standard deviation

Table 5
Changes in Modified Barthel Index
Baseline 2 weeks follow up 4 weeks follow up
Study group 5.3±6.6 7.1±6.4 (n=7) 5.5±3.0 (n=4)
Control group 4.1±4.5 4.4±4.9 (n=7) 5.0±5.7 (n=5)

Values are mean±standard deviation

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