{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T07:32:08Z","timestamp":1793345528081,"version":"4.5.0"},"reference-count":46,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chinese medicine (acupuncture and herbal medicine) is widely used in post\u2010stroke rehabilitation in Southeast Asia. However, evidence on its effectiveness and optimal timing remains inconclusive. This study aimed to determine whether early integration (\u2264\u20096\u2009months post\u2010stroke) of individualized Chinese medicine rehabilitation (CMR) improves functional outcomes compared with delayed integration (&gt;\u20096\u2009months) in stroke survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective pragmatic study enrolled stroke survivors aged 35\u201390\u2009years from five Hong Kong community centers following hospital discharge. All subjects received a 24\u2010week individualized CMR scheme comprising acupuncture and Chinese herbal medicine (CHM) granules (administered thrice weekly for 24\u2009weeks, totaling 72 sessions). Outcomes included the changes in activities of daily living (ADL; primary), mini\u2010mental state examination (MMSE), and traditional Chinese medicine syndrome score scale (TCMSSS). Effectiveness was assessed using linear mixed\u2010effect models for repeated measures. Multivariate logistic regression identified factors associated with treatment response. In a post hoc nested case\u2013control analysis, early CMR integration (\u2264\u20096\u2009months post\u2010stroke) was compared with delayed integration (&gt;\u20096\u2009months) using 1:1 propensity score matching (age, sex, stroke number\/type, baseline ADL, hypertension, diabetes, dyslipidaemia, acupuncture sessions, CHM duration).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 398 patients were recruited, of whom 344 (86.6%) completed \u2265\u200975% of the treatments (\u2265\u200954 sessions). After 24\u2009weeks of treatment, significant improvements were observed in ADL (mean change 5.99, 95% confidence interval [CI] 4.50 to 7.48), MMSE (1.21, 95% CI 0.87 to 1.55), and TCMSSS (\u22122.89, 95% CI \u22123.30 to \u22122.47). Multivariate logistic regression identified baseline ADL dependence (odds ratio [OR] 13.45, 95% CI 7.01 to 25.81), early CMR initiation (OR 2.03, 95% CI 1.23 to 3.35), and lower baseline TCMSSS (OR 0.94, 95% CI 0.91 to 0.98) as independent predictors of response. Kaplan\u2013Meier analysis showed that patients with baseline ADL &lt;\u200990 had markedly higher responder proportions (46.8% at 60 sessions, 53.6% at 72 sessions) than those with ADL \u2265\u200990 (9.4% and 12.3%, respectively; log\u2010rank\n                      <jats:italic>P<\/jats:italic>\n                      s &lt;\u20090.001). Patients who initiated CMR within 6\u2009months had significantly higher responder proportions at 72 sessions (42.9%) compared with those starting later (25.0%; log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005). Propensity score matching confirmed that early integration yielded superior ADL (mean difference 3.89, 95% CI 1.30 to 6.48;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003) and TCMSSS (\u22120.86, 95% CI \u22121.69 to \u22120.04;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.041) outcomes at Week 24. CMR scheme was well\u2010tolerated, with no treatment\u2010related adverse events observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Initiating CMR within 6\u2009months post\u2010stroke significantly enhances functional and neurological recovery compared with delayed initiation. These findings support integrating early, individualized CMR into standard stroke rehabilitation protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.71077","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:24:32Z","timestamp":1786112672000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Early Integration of Chinese Medicine Rehabilitation Improves Functional Outcomes in Stroke Patients: A Prospective Pragmatic Study and Nested Case\u2013Control Analysis"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0900-4617","authenticated-orcid":false,"given":"Jialing","family":"Zhang","sequence":"first","affiliation":[{"name":"Vincent V.C Woo Chinese Medicine Clinical Research Institute, School of Chinese Medicine Hong Kong Baptist University  Hong Kong China"},{"name":"School of Chinese Medicine Hong Kong Baptist University  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Yan","family":"Chow","sequence":"additional","affiliation":[{"name":"School of Chinese Medicine Hong Kong Baptist University  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5933-4672","authenticated-orcid":false,"given":"Chin Pong","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Chinese Medicine Hong Kong Baptist University  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1064-0445","authenticated-orcid":false,"given":"Zhilin","family":"Lin","sequence":"additional","affiliation":[{"name":"Vincent V.C Woo Chinese Medicine Clinical Research Institute, School of Chinese Medicine Hong Kong Baptist University  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun Hoi","family":"Cheung","sequence":"additional","affiliation":[{"name":"Vincent V.C Woo Chinese Medicine Clinical Research Institute, School of 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