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My brother had a serious stroke in Aug 2011.

This is a very good question. It is the received wisdom inside the profession that treatment should be started as soon as possible after a stroke, and that the potential for change and improvement diminishes over time. This is driven in part by the fact that in China it is not at all unusual for someone to start having treatment on the day of a stroke, the logic being that the energy of the body has been disturbed and the sooner that it is corrected, the less likely the disturbance is to be 'set' in the system. 

We have some sympathy with this view. There have been several books published in the last couple of decades which have explored the possibility that once an energetic pattern has become established it is no longer seen as a pathological factor but becomes the essence of the person. This means that someone can in a rather peculiar way become invested in the post-illness state as their reality, with the attendant difficulty in getting things to change. If you talk to people who teach the Alexander Technique you find the same model; once the body has  a set pattern it takes a long time to re-train it.

However, our clinical experience with post-stroke patients is rather more mixed than this. Whilst we have always warned patients who come in many months or years after the initial stroke that progress may be slow or in some cases non-existent, we have found that some people do have a marked and immediate response to treatment, often in direct proportion to their underlying constitutional health. A person who was strong and energetically in good shape before the CVA often has a greater power to recover.

There has been a mountain of research into this area, as you can see from the rather long review paper which we have on our website

 https://www.acupuncture.org.uk/arrc/public-review-papers/stroke-and-acupuncture-the-evidence-for-effectiveness.html


but which may be a little technical for many readers. It has long been our hope that the evidence will reach a critical mass where we can argue a case for early intervention within the NHS with acupuncture treatment, if for no other reason than the fact that increasing the speed of recovery would save the NHS millions of pounds in rehabilitation costs. We have some hope that familiarity with the Chinese system will encourage some trials in the UK.

As far as your brother is concerned, however, it is rather difficult to say what might be possible without a face to face assessment. What you and he will find, however, is that most of our members are very happy to give up a little time without charge to prospective patients to see whether acupuncture treatment would be a good option. Most of us are very frank about someone's chances because the disappointment of achieving nothing or very little is just as palpable by the practitioner as the patient. We get it wrong - some people we think we can't help recover amazingly and we think we can help don't. In the main, however, we tend to recognise those people for whom acupuncture is well worth a try.

The crucial thing is to try to set measurable outcomes so that improvements are not just a matter of feeling better in oneself, good as this is, but visible through verifiable markers - better range of movement, greater endurance in in walking, and so on. This avoids the problem of running up a large bill without really getting anything back. If it isn't working after five to ten sessions it is better to draw a line unless there are secondary improvements which render the treatment worthwhile.

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