Acupuncture had shown clinical benefits in stroke patients but there is no clear recommendation on the number of acupuncture sessions that should be done. This study aims to determine the optimal number of acupuncture therapy sessions, from which significant clinical improvement could be anticipated.

Methods

We performed a retrospective observational study in stroke patients who had acupuncture therapy as an adjunct treatment at Trang Hospital—a non-academic provincial hospital in Southern Thailand—during July 1, 2016-June 30, 2017. Significant clinical improvement of dependence in activities of daily living was defined as at least 10 points increase in the Barthel Index from the baseline. Survival analysis techniques were applied to determine the optimal number of acupuncture therapy sessions.

Results

Of 89 patients, 78% had significant clinical improvement. The Kaplan-Meier estimated that 50% of the patients had significant improvement by the 8^thacupuncture therapy session. By the 16^thsession, the proportion of patients increased to 81%. Subgroup analysis revealed that the clinical improvement did not depend on baseline Barthel Index whereas early treatment within 3 months after the stroke onset had a faster response than the late treatment. The median proportions of significant improvement for early and late treatment group were at the 8^thand 11^thsession respectively.

Conclusions

Stroke patients who were going to improve should see significant Barthel Index improvement by the 16^thacupuncture session and the marginal improvement declined substantially afterward. Our approach required minimal data available in medical records of a non-academic facility yet practical implication could be achieved.

Trial Registration

The study was retrospectively registered on Aug 18, 2017 with the Thai Clinical Trials Registry, Identification Number TCTR20170822002.