Abstract DP399: Clinical Effectiveness of Integrated Chinese-Western Medicine Program in Stroke Rehabiliation

Background: Post-stroke permanent disability posed a huge socio-economic burden. It was unclear whether adjunctive traditional Chinese medicine (TCM) consisting of acupuncture and herbal therapy in an Integrated Chinese-Western Medicine (ICWM) rehabilitation programme might improve stroke outcomes. Objective: We aimed to evaluate the safety and efficacy of an ICWM Programme implemented in public hospitals in Hong Kong since 2014. Methods: In this retrospective cohort study, we compared the outcome of all patients who received ICWM treatment during acute-to-subacute phase of strokes between September 2014 and December 2022 with that of control patients who underwent conventional stroke rehabilitation in the same period selected by propensity score matching in a 1:1 ratio. We measured and compared 3 functional outcomes between ICWM and control groups by multivariable generalized linear models: 1) Ambulation as measured by the Modified Functional Ambulatory Category (MFAC); 2) Activities of daily living by the Modified Barthel Index (MBI); and 3) Swallowing function by the Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS). We conducted a secondary analysis to determine the association between functional recovery and TCM syndromes. Results: Of the 917 patients who received ICWM and the 21,342 patients with conventional stroke rehabilitation, 666 pairs were matched. Baseline characteristics, including MFAC, MBI and RBHOMS scores at stroke onset were balanced. The magnitude of improvement in MFAC (ICWM vs control: 1.3±1.2 vs 0.9±1.3, P <0.001), MBI (16.9±15.3 vs 9.2±14.9, P <0.001) and RHOMBS (1.1±1.4 vs 0.4±1.4, P <0.001) was significantly higher in the ICWM group compared to the control group. On discharge, MFAC (5[4, 6] vs 4[3, 6], P =0.03) and RBHOMS (8 [7, 9] vs 8 [6, 9], P <0.001) were significantly higher in the ICWM group. Among patients participating in the ICWM program, Phlegm-Heat Syndrome and Wind-Phlegm Syndrome were associated with better functional recovery. Conclusion: Compared to conventional stroke rehabilitation, the ICWM program was associated with a greater magnitude of stroke recovery in terms of mobility, activities of daily living, and swallowing function. Furthermore, TCM syndrome categorization may inform stroke prognosis.