Efficacy of Electroacupuncture with Dysphagia Caused by Stroke:

Double-blind, Randomized Controlled Trial

Article information

J Korean Med. 2014;35(1):26-40

Publication date (electronic) : 2014 March 30

doi : https://doi.org/10.13048/jkm.14003

Min-Kyung Kim, Hsu-Yuan Lu, Seung-Yeon Cho, Woo-Sang Jung, Sang-Kwan Moon, Jung-Mi Park, Chang-Nam Ko, Ki-Ho Cho, Seong-Uk Park

Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University

Correspondence to:박성욱(Seong-Uk Park), 서울시 강동구 동남로 892 강동경희대학교 병원 중풍뇌질환센터 한방내과, Tel: +82-2-440-6217, Fax: +82-2-440-6217, E-mail: seonguk.kr@gmail.com

Received 2013 September 11; Revised 2013 December 30; Accepted 2013 December 30.

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.

Keywords: Stroke; dysphagia; electroacupuncture; Dysphagia Outcome and Severity Scale (DOSS); Swallowing Quality of Life questionnaire (SWAL-QOL)

Fig. 1

Randomization and Patients Flow Chart

Table 1

Baseline Characteristics of Patients

Table 2

Changes in Dysphagia Outcome and Severity Scale

Table 3

Changes in Swallowing Quality of Life

Table 4

Changes in National Institutes of Health Stroke Scale

Table 5

Changes in Modified Barthel Index

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Article information Continued

Fig. 1

Randomization and Patients Flow Chart

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