Evaluating the Long-Term Efficacy of Acupuncture Therapy for Subacute Poststroke Aphasia: Study Protocol for a Randomized, Blinded, Controlled, Multicentre Trial

Abstract

Background. Poststroke aphasia (PSA) is a disabling condition that decreases the quality of life, and the duration of the disease harms the quality of life of PSA patients. Acupuncture has been widely employed for PSA. There is some evidence for the immediate treatment efficacy of acupuncture for PSA; however, long-term results after acupuncture may be poorer. Methods. This is a multicentre, randomized, blinded, nonacupoint (NA) acupuncture controlled, multimodal neuroimaging clinical trial. A total of 48 subjects with subacute PSA will be randomly assigned to an acupoint group or an NA control group. The acupoint group will receive acupuncture with normal needling at DU20, EX-HN1, HT5, GB39, EX-HN12, EX-HN13, and CV23. The NA control group will receive acupuncture in locations not corresponding to acupuncture points as sham acupoints. Both groups will receive identical speech and language therapy thrice a week for four weeks. The primary outcome will be the change in the aphasia quotient (AQ) score measured by the Western Aphasia Battery (WAB) test during the 12th week after randomization. Participants will be blindly assessed at prerandomization (baseline) and 4 weeks, 12 weeks, and 24 weeks after randomization. The secondary outcomes include the Boston Diagnostic Aphasia Examination (BDAE) score, the Disease Prognosis Scale score for ischaemic stroke, etc. Magnetic resonance imaging (MRI) and electroencephalogram (EEG) will also be performed at 4-time intervals as secondary outcomes. All scores and image evaluations will be taken at the same point as the linguistic evaluation. The multilevel evaluation technique will be used to assess the long-term efficacy of acupuncture therapy. MRI scans and EEG will be used to assess acupuncture-related neuroplasticity changes. Discussion. The results from our trial will help to supply evidence for the long-term acupuncture effects for PSA over a long follow-up period. It will provide valuable information for future studies in the field of PSA treatment. The trial was registered at the Chinese Clinical Trial Registry on 16 March 2020 (ChiCTR2000030879).

Possible Effects of Acupuncture in Poststroke Aphasia

“…Body acupuncture emphasizes holistic treatment. Body acupuncture can combine syndrome differentiation with meridian differentiation and regulate the mind and Qi [ 123 , 124 ].…”

Cateter central de inserção periférica: contribuições para a enfermagem oncológica

“…18,24,27 It is recommended to verify the location of the catheter tip after insertion, for which there is evidence that ultrasound provides precise information about the position of the device tip. 5,8,11 It is observed that it is incumbent on the nurse to perform the procedures related to Nursing care for the patient using the PICC, being exclusive to this the maintenance of the same -care with the site of insertion, dressing and collection of blood in special situations. It should be emphasized that, when supervised by a trained nurse, the duties of the Nursing technician can perform the irrigation of the PICC / CCIP (flushing) and the administration of intravenous parenteral solutions, safeguarding the particularities of the drug therapy.…”

“…18 It is stated that the use of ultrasound with the Seldinger technique contributed to reduce complications and maintenance costs, which was reflected in the improvement of patients' comfort level; therefore, this procedure should be widely used. 11 In conclusion, considering the indications of use and the comfort provided to patients, considering the benefits to the professionals involved in the care, the cost-effectiveness, besides the low complication rates, that the selection of PICC / CCIP in the treatment of patients is an opportune and viable option.…”