Acupuncture Treatment of Post-Stroke Syndrome in Rehabilitation Settings

by Richard Kitaeff, MA, ND, DiplAc, LAc

Because acupuncture has the unique ability to regulate the nervous system directly, physically, at a deep level and with immediate effect, it fulfills a strong need of post-stroke patients. The majority of these patients are confined to rehabilitation hospitals, which provide minimal physical, speech, and occupational therapies that are extremely slow in effecting changes in mobility or mental function. It may be a revelation to some that in institutions across the country a vast population of the profoundly disabled are warehoused often in a semi-vegetative state. Patients and their families are fervently seeking the slightest improvement in conditions of quadriplegia, or more often hemiplegia, and speech defects. As in the case of chronic pain, our profession has the opportunity to address a condition for which conventional Western medicine has had limited effectiveness.

For acupuncturists willing to extend their work to a location outside their clinics, their services would create a valuable niche. They may be able to introduce themselves and present selections of the growing body of clinical research in this area to patient and family support groups usually associated with hospitals. For liability reasons, hospital approval through a credentialing procedure would be required for acupuncturists to work within the institutional setting. However, practitioners may contract directly with the families of patients. For disabled or Medicare-eligible patients, insurance is usually not billable; payment would be made in cash and should take into account additional travel time required for mobile treatment.

The stroke patient is severely deficient in Kidney Qi, particularly Kidney Yang Qi. Extremities are cold, and the pulse is thin and weak. Therefore, one purpose of treatment should be to strengthen this core Qi of the yin organs with stimulation of points such as KID 3, KID 7, LIV 3, SP 6 and CV 3. Concurrently, to address the paralysis of the limbs, meridian points such as GB 39, ST 36, GB 34, LI 4, LI 11, SI 3 and TH 5 should be stimulated with both acupuncture and electrical amplification of the acupuncture needles. I have been applying electrical pads of the Acutron Mentor device directly over needles on the limbs and delivering a program of variable frequency milliamperage followed by microcurrent over two consecutive 10-minute courses of treatment.

Relevant auricular and Korean hand acupuncture reflex points are also stimulated with needles, and remain stimulated after the treatment session by use of ear seeds and hand acupuncture magnetized pellets. Major body treatment points are also left stimulated with 100-gauss magnets under bandages. Of course, scalp reflex zones should always be treated contralaterally for post-stroke syndrome, as well as for any neuromuscular or musculoskeletal condition, to influence the affected side. Since my training in the scalp acupuncture system of Dr. Zhu Mingqing 20 years ago, I now utilize this system with all patients for general nervous system regulation as well as for its mobilizing and pain-relieving effect on any specific body area. Its effects are very profound and immediate.

For the duration of the treatment, I also apply an electromagnetic coil over the affected brain area (Example: left brain for right-sided paralysis). This procedure is based on published research showing improvement in speech for post-stroke patients by the application of electromagnetism over brain areas. At the same time, I have found it valuable to utilize the Acutonics system of tuning forks – “Ohm” frequency around the ears and at KID 1 bilaterally and the “opening” interval at gate points (LIV 3 and SP 6, LI 4 and LI 11).

At times I have applied essential oils at meridian points and have used specific combinations of oils purported to resonate with specific chakra or nervous plexi locations. I have emphasized these techniques particularly when consciousness has been blocked or clouded following the trauma of the Wind-Stroke. For several months I have been utilizing this combination of techniques in twice-weekly treatment of a 19-year-old girl who is in a vegetative, minimally conscious state as a result of a traumatic head injury.

External treatment with physical techniques such as acupuncture should always be accompanied by internal metabolic treatment. Unfortunately, oral supplementation for patients in rehabilitation hospital settings is restricted, and herbal treatment is usually contraindicated due to the possibility of interaction with blood-thinning and other medications that are routinely administered. But I have nevertheless usually been able to introduce a few fundamental liquid supplements. One is Intramax, produced by Drucker Labs. It is a mango-peach flavored combination of 415 distinct nutrients including highly absorbable forms of all vitamins, macro-minerals, trace minerals, amino acids, enzymes, probiotics, essential fatty acids and anti-oxidants. This comprehensive combination is made possible through a special carbon-bonding technology. A small dose (2 tablespoons morning and afternoon) is sufficient to provide a high quality of nutritional support that is certainly not provided by hospital food or drug-store multivitamins. If possible, I also introduce Mineral Qi Tonic from Nature Sunshine company as a strong tonic formula, which supplies in liquid form major traditional adaptogenic (or Kidney Yang activating) Chinese herbs along with trace minerals needed for enzyme activity. Finally, I always recommend Xango, the original brand of mangosteen juice, utilizing the puree from the whole mangosteen fruit found in Southeast Asia. This is a source of Cox-2 inhibitor anti-inflammatory ingredients along with powerful anti-oxidant and anti-microbial factors. Whenever permissible, I would add an intramuscular injection of vitamin B12, B complex, vitamin C and magnesium for powerful adrenal and nervous system support.

Overall progress is not always easily apparent in treatment of post-stroke patients, but the prognosis is always best when treatment can be initiated close to the time of the stroke. Within the course of a single treatment session, it is usually possible to demonstrate as much as 20%-50% improvement in mobility of a limb. With repetition of treatment, such improvement can become stable and long-term. In all cases, patients are aware of the general feelings of energy and relaxation immediately after treatment i.e., the general autonomic nervous system regulating effect of acupuncture. For this reason alone, acupuncture should be a required component of therapy for every stroke patient.

Rick Kitaeff, MA, ND, DiplAc, LAc was the first Western graduate from Meiji University of Oriental Medicine in Osaka, Japan, and was licensed as an acupuncturist by the government of Japan in 1975. He has interned at the Osaka Medical College Hospital Pain Clinic and the Kyoto Pain Control Institute. He was founding president of the Acupuncture Association of Washington and founding academic director of the Northwest Institute of Acupuncture and Oriental Medicine. His research on acupuncture and endorphins, carried out at the University of Washington and published in Pain journal, was the first to verify the analgesic effect of acupuncture through objective (EEG) measurement. He was a member of the first graduating class of naturopathic physicians from Bastyr University. He has lectured internationally and written for publication in journals and textbooks of acupuncture and naturopathic medicine. Currently, he directs New Health Medical Center, a comprehensive natural medicine center incorporating Asian and European treatment approaches. For the past 10 years, he has been a staff member of Northwest Hospital and has been granted medical privileges at several rehabilitation hospitals. For advanced students and practitioners, he offers individual preceptorship training in the integration of Chinese and Western natural medicine practice. (www.newhealthmed.com and newhealthmed@bigplanet.com)