Chinese medicine rehabilitation scheme improved independence in daily life activities, cognitive and neurological functioning in stroke survivors: a prospective pragmatic multi-centre study [Extended Abstract]

Background: Stroke survivors often experience persistent physical, psychological, and cognitive deficits. This pragmatic real-world study assessed the effectiveness of a Chinese Medicine (CM) rehabilitation scheme, combining acupuncture and herbal medicine, in improving daily living activities, cognition, and neurological function post-stroke.

Methods: This was a prospective, pragmatic, multi-centre, single-arm study in real-care conditions. Participants who had stroke and discharged from Hong Kong public hospitals were recruited. Participants received 24 weeks of individualized CM therapy (72 sessions: thrice-weekly acupuncture and herbal granules tailored to CM syndrome differentiation). Outcomes included activities of daily living (ADL; primary), mini-mental state examination (MMSE), and traditional Chinese medicine syndrome score scale (TCMSSS).

Results: We included 398 patients over the 2021-2024 study period, for whom the primary endpoint was assessed in 304 patients. After 24 weeks of treatment, there were significant improvements in ADL score of 5.91 (95% Confidence Interval (CI) 4.83 to 7.00), MMSE of 3.73 (3.28 to 4.18) and TCMSSS score of -2.93 (-3.25 to -2.61). Multivariate logistic regression analysis revealed that participants with baseline ADL score <90 were more likely to become responder (odds ratio 14.00, 95% CI 7.51 to 26.12; P<0.001) to the scheme. The responders were also associated with duration after stroke no more than 12 months (1.71, 1.02 to 2.86; P=0.041) and lower baseline TCMSSS score (0.93, 0.90 to 0.97; P<0.001). 36% of patients exhibited significant improvement in ADL by 60 sessions of treatment. Subgroup analyses revealed that significant improvement depended on baseline ADL, and early treatment (within 12 months of stroke onset) was associated with a faster response than late treatment. The CM rehabilitation scheme was well-tolerated, with no treatment-related adverse events observed.

Conclusion: The CM rehabilitation scheme safely enhanced independence, cognition, and neurological function in stroke patients, particularly when initiated early. These findings support CM's therapeutic potential in post-stroke recovery.