Acupuncture-induced changes on brain excitability for stroke patients with motor dysfunction

INTERVENTION: Participants who meet the eligibility criteria will be randomly assigned to one of the two groups in a 1:1 ratio. Randomization will be conducted using computer‐generated random numbers placed in sequentially numbered, sealed opaque envelopes and kept by a clinician with no contact to study participants. Both acupuncture and rehabilitation groups will receive a total of 40 treatment sessions in 12 weeks. Participants in both groups will receive standard medical care for stroke throughout the trial, which will be conducted in accordance with the China Guideline for the Diagnosis and Treatment of Acute Ischemic Stroke (2010). The acupuncture group will additionally receive manual acupuncture for 12 weeks. Twelve acupoints will be used for all the patients. Each session will last for 40 minutes. For the control group, patients will undergo conventional physical therapy. The structure of the intervention will be customized to each individual’s functional level. Each session will have a duration of 40 minutes. Participants in both groups are followed up at the end of the intervention period (12 weeks), at which time they will undergo transcranial magnetic stimulation and motor function testing. CONDITION: Motor dysfunction after stroke ; Nervous System Diseases ; Motor dysfunction after stroke PRIMARY OUTCOME: Excitability of primary motor cortex measured by recruitment curve of Motor Evoked Potential by transcranial magnetic stimulation at baseline and 3 months SECONDARY OUTCOME: 1. Motor function of hand and arm are measured using the Action Research Arm Test and the upper‐extremity portion of the Fugl‐Meyer motor assessment at baseline and 3 months; 2. General motor disability is measured using the modified Rankin scale at baseline and 3 months; 3. Neurological deficit is measured using National Institutes of Health Stroke Scale assessment at baseline and 3 months; 4. The muscle strength level is measured using the UK Medical Research Council standard at baseline and 3 months INCLUSION CRITERIA: 1. First‐ever mono‐hemispheric ischemic stroke 2. Within 14 days after stroke onset 3. Hand weakness with MRC level of 1 to 4 4. Aged between 18 and 80