Editorials

Stroke is a major health problem affecting millions of people worldwide, leaving many survivors with long-term disabilities such as weakness, spasticity, sensory loss, aphasia, dysphagia, depression, insomnia and cognitive changes, and reduced quality of life. 

Recent advances in acute stroke treatment, including thrombolysis and thrombectomy have improved survival rates. However, rehabilitation remains a critical component of recovery, especially in the early subacute phase.

Many studies from sources, i.e. PubMed, Embase, the Cochrane Library, etc., highlight the potential of integrating acupuncture and Asian herbal medicine with conventional rehabilitation to improve recovery outcomes for stroke patients. Those. especially with severe functional impairment and rehabilitation programs combined with acupuncture, can better improve post-stroke cognitive impairment, dysphagia, aphasia, insomnia, depression, spasticity, and shoulder-hand syndrome. 

It has also been reported that compared to rehabilitation therapy alone, rehabilitation therapy combined with acupuncture significantly improves limb movement on the Fugl-Meyer Assessment (FMA) scale, ADL performance on the Barthel Index (BI) scale, and the Modified Barthel Index (MBI) scale. Also, rehabilitation combined with acupuncture and Asian Herbal Medicine is more effective and safer for functional recovery in subacute stroke patients, under assessment by the MBI, FMA, National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination, Montreal Cognitive Assessment, Hamilton’s Depression Scale, and Self Rating Depression Scale. 

Acupuncture has been proven to improve overall neurological deficits, specific neurological impairments, and dependency in patients with stroke during recovery without serious side effects. The underlying mechanisms of acupuncture stroke treatment have been reported to promote neurogenesis and cell proliferation in the central nervous system, regulate cerebral blood flow in the ischemic area, inhibit cell death in the ischemic area, regulate neurochemicals, and enhance damaged organs and memory after stroke.

Acupuncture and Asian herbal medicine lead to better improvement in BI scores in patients with hemorrhagic and ischemic stroke with a baseline BI score of ≤ 40.  The pharmacological effects of Asian herbal medicine may contribute to improving neuroplasticity and recovery in patients with worse outcomes.

However, caution is advised when using herbal medicine in stroke patients who are on anticoagulant therapy, as certain herbs may increase the risk of bleeding. Patients with hemorrhagic stroke require special consideration regarding herbal interventions.