Efficacy of acupuncture in reducing accidental injury risk in stroke patients: A national-scale cohort study

Background: Falls among stroke patients pose a significant health concern, leading to injuries, reduced mobility, and functional limitations. Recent research has suggested the potential benefits of acupuncture in enhancing balance and motor function in stroke patients. However, large-scale, long-term studies on acupuncture's role in reducing the risk of accidental injuries are scarce. This study aimed to evaluate acupuncture's effectiveness in decreasing the risk of accidental injuries in stroke patients.

Materials and methods: This study employed a large-scale cohort design, utilizing data from the 2000 Longitudinal Generation Tracking Database (LGTD 2000) in Taiwan, covering two million individuals. The cohort comprised stroke patients hospitalized between 2001 and 2012, with follow-up periods of at least six years to estimate accidental injury incidence and risk. Acupuncture treatments during both inpatient and outpatient phases after stroke diagnosis were included. Accidental injury data, including vehicular accidents and falls, were extracted from specialized hospitalization records. Hazard ratios were calculated, adjusting for variables like comorbidities, hypnotic medication usage, and demographic factors.

Result: A total of 108,196 newly diagnosed stroke patients were included in the final cohort, with 42,083 receiving acupuncture treatment and 66,113 not receiving acupuncture. The acupuncture group exhibited a significantly lower incidence rate of accidental injuries (10.2 per 1,000 person-years) compared to the non-acupuncture group (15.8 per 1,000 person-years). After adjusting for various covariates, the acupuncture group had a reduced risk of accidental injuries with an adjusted hazard ratio (aHR) of 0.74 (95 % CI: 0.51-0.92). Subgroup analyses revealed consistent protective effects of acupuncture across different patient profiles and treatment characteristics, including age, sex, comorbidities, and hypnotic medication usage.

Conclusion: This study provides evidence supporting the potential of acupuncture as an adjunctive therapy to reduce the risk of accidental injuries among stroke patients. Regardless of stroke subtype, age, or comorbidity burden, acupuncture was associated with a lower risk of accidental injuries.