{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T22:38:32Z","timestamp":1794436712555,"version":"4.9.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Post-Stroke Dysphagia (PSD) is a common complication of stroke, significantly impairing recovery and quality of life. Acupuncture has shown potential in improving swallowing function, yet the optimal timing of intervention remains unclear. This study evaluated the effect of acupuncture timing on swallowing recovery in stroke patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a multicenter real-world study across 27 hospitals in China, enrolling 382 stroke patients with PSD. Inclusion required symptom onset within 90\u202fdays and a Water Swallowing Test (WST) score &amp;gt; 2. The primary outcome was swallowing function recovery at discharge, 90\u202f\u00b1\u202f7\u202fdays, and 180\u202f\u00b1\u202f7\u202fdays post-onset. Multivariate logistic regression was used to adjust for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 359 participants with complete data, early acupuncture (0\u201314\u202fdays post-stroke) was strongly associated with improved swallowing recovery. Delayed treatment beyond 28\u202fdays significantly reduced recovery odds at discharge (adjusted OR\u202f=\u202f2.17; 95% CI: 1.12\u20134.21) and 90\u202fdays (adjusted OR\u202f=\u202f2.57; 95% CI: 1.31\u20135.04). This effect diminished at 180\u202fdays (adjusted OR\u202f=\u202f1.55; 95% CI: 0.52\u20134.61). Medullary lesions and diabetes were also associated with poorer outcomes, while hyperlipidemia showed a potential protective effect. The study relied on WST as the sole functional assessment, which, while practical, lacks the sensitivity of instrumental measures like VFSS or FEES for detecting silent aspiration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Early acupuncture intervention within 2 weeks post-stroke is strongly associated with improved swallowing recovery in real-world clinical practice. Delayed treatment may limit clinical benefit. Future research should incorporate instrumental swallowing assessments and randomized trials to refine acupuncture timing and validate these findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p>ChiCTR2100042721.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1553947","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T12:56:01Z","timestamp":1757940961000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Early acupuncture intervention strongly associates with improved swallowing recovery in post-stroke dysphagia: a multicenter real-world cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Junlong","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guiping","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sha","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhijie","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengnan","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiliang","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjun","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangfang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoshan","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2756","DOI":"10.1161\/01.STR.0000190056.76543.eb","article-title":"Dysphagia after stroke: incidence, diagnosis, and pulmonary complications","volume":"36","author":"Martino","year":"2005","journal-title":"Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1016\/S1474-4422(23)00153-9","article-title":"The assessment of dysphagia after stroke: state of the art and future directions","volume":"22","author":"Labeit","year":"2023","journal-title":"Lancet Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e876","DOI":"10.1212\/WNL.0000000000011350","article-title":"Neurogenic dysphagia: systematic review and proposal of a classification system","volume":"96","author":"Warnecke","year":"2021","journal-title":"Neurology"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1007\/s00455-013-9490-9","article-title":"Bedside screening to detect oropharyngeal dysphagia in patients with neurological disorders: an updated systematic review","volume":"29","author":"Kertscher","year":"2014","journal-title":"Dysphagia"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1161\/STROKEAHA.111.640946","article-title":"Valid items for screening dysphagia risk in patients with stroke: a systematic review","volume":"43","author":"Daniels","year":"2012","journal-title":"Stroke"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"3472","DOI":"10.1161\/STR.0000000000000045","article-title":"Clinical performance measures for adults hospitalized with acute ischemic stroke: performance measures for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"45","author":"Smith","year":"2014","journal-title":"Stroke"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1111\/j.1747-4949.2010.00488.x","article-title":"Measuring the quality of dysphagia management practices following stroke: a systematic review","volume":"5","author":"Luker","year":"2010","journal-title":"Int J Stroke"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1136\/jnnp-2016-313356","article-title":"The association between delays in screening for and assessing dysphagia after acute stroke, and the risk of stroke-associated pneumonia","volume":"88","author":"Bray","year":"2017","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"CD012679","DOI":"10.1002\/14651858.CD012679.pub2","article-title":"Screening for aspiration risk associated with dysphagia in acute stroke","volume":"10","author":"Boaden","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"817732","DOI":"10.3389\/fncel.2022.817732","article-title":"The impact of acupuncture on neuroplasticity after ischemic stroke: a literature review and perspectives","volume":"16","author":"Qin","year":"2022","journal-title":"Front Cell Neurosci"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"19521","DOI":"10.1038\/srep19521","article-title":"Acupuncture for neurogenesis in experimental ischemic stroke: a systematic review and meta-analysis","volume":"6","author":"Lu","year":"2016","journal-title":"Sci Rep"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1186\/s12906-015-0676-6","article-title":"Real world research: a complementary method to establish the effectiveness of acupuncture","volume":"15","author":"Luo","year":"2015","journal-title":"BMC Complement Altern Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"7770380","DOI":"10.1155\/2022\/7770380","article-title":"Real-world evidence of traditional Chinese medicine treatment on cancer: a literature-based review","volume":"2022","author":"Peng","year":"2022","journal-title":"Evid Based Complement Alternat Med"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"e21345","DOI":"10.1097\/MD.0000000000021345","article-title":"Acupuncture reduced the medical expenditure in migraine patients: real-world data of a 10-year national cohort study","volume":"99","author":"Tsai","year":"2020","journal-title":"Medicine"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"7801","DOI":"10.3390\/ijerph17217801","article-title":"Association of acupuncture treatment with mortality of type 2 diabetes in China: evidence of a real-world study","volume":"17","author":"Sui","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"o487","DOI":"10.1136\/bmj.o487","article-title":"Improving acupuncture research: progress, guidance, and future directions","volume":"376","author":"Zhang","year":"2022","journal-title":"BMJ"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"7801","DOI":"10.3390\/ijerph17217801","article-title":"Association of acupuncture treatment with mortality of type 2 diabetes in China: evidence of a real-world study","volume":"17","author":"Zhao","year":"2020","journal-title":"J Integr Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1153","DOI":"10.3969\/j.issn.1673-5765.2019.11.014","article-title":"Experts Group for the Chinese Dysphagia and Nutrition Management Manual for Acute Stroke Patients, Chinese Stroke Association, China National Clinical Research Center for Neurological Diseases","volume":"14","author":"Wang","year":"2019"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"405","DOI":"10.3760\/cma.j.issn.1006-7876.2017.06.002","article-title":"Guidelines for early rehabilitation treatment of stroke in China","volume":"50","year":"2017","journal-title":"Chin J Neurol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"LXXXIX","DOI":"10.1177\/23969873211039721","article-title":"European stroke organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia","volume":"6","author":"Dziewas","year":"2021","journal-title":"Eur Stroke J"},{"key":"ref21","volume-title":"Clinical guidelines for diagnosis and treatment of internal diseases in TCM post-stroke dysphagia","year":"2019"},{"key":"ref22","volume-title":"International standardized manipulations of Chinese medicine Xingnao Kaiqiao acupuncture for stroke (T\/WFCMS SCM69-2021)","year":"2021"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"68","DOI":"10.3390\/geriatrics4040068","article-title":"An overview of systematic reviews and meta-analyses on acupuncture for post-acute stroke dysphagia","volume":"4","author":"Tian","year":"2019","journal-title":"Geriatrics"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.21037\/apm-21-3551","article-title":"Effect of acupuncture treatment on dysphagia caused by pseudobulbar paralysis after stroke: a systematic review and meta-analysis","volume":"11","author":"Wang","year":"2022","journal-title":"Ann Palliat Med"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1837","DOI":"10.2147\/JPR.S449619","article-title":"Bibliometric analysis: research trends and performances of stroke on acupuncture","volume":"17","author":"Yang","year":"2024","journal-title":"J Pain Res"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"585","DOI":"10.13703\/j.0255-2930.20210330-k0002","article-title":"Analysis on influencing factors of acupuncture curative effect based on experts' experience","volume":"42","author":"Meng","year":"2022","journal-title":"Zhongguo Zhen Jiu"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"201","DOI":"10.4103\/bc.bc_33_23","article-title":"Optimal rehabilitation strategies for early postacute stroke recovery: an ongoing inquiry","volume":"9","author":"Tong","year":"2023","journal-title":"Brain Circ"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"e1174","DOI":"10.1212\/WNL.0000000000010149","article-title":"Patterns of motor recovery and structural neuroplasticity after basal ganglia infarcts","volume":"95","author":"Liu","year":"2020","journal-title":"Neurology"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"e58087","DOI":"10.7759\/cureus.58087","article-title":"Functional training for lower extremities in stroke survivors: a scoping review","volume":"16","author":"Jharbade","year":"2024","journal-title":"Cureus"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1429","DOI":"10.1161\/01.STR.31.6.1429","article-title":"Outcome measures in acute stroke trials: a systematic review and some recommendations to improve practice","volume":"31","author":"Duncan","year":"2000","journal-title":"Stroke"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1142\/S0192415X20500895","article-title":"Earlier acupuncture enhancing long-term effects on motor dysfunction in acute ischemic stroke: retrospective cohort study","volume":"48","author":"Xu","year":"2020","journal-title":"Am J Chin Med"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"463","DOI":"10.2147\/JMDH.S398202","article-title":"Influence of acupuncture and other clinical factors on the recovery of limb motor function in patients after stroke: a retrospective study","volume":"16","author":"Wu","year":"2023","journal-title":"J Multidiscip Healthc"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1005819","DOI":"10.3389\/fneur.2022.1005819","article-title":"An overview of the evidence to guide decision-making in acupuncture therapies for early recovery after acute ischemic stroke","volume":"13","author":"Wang","year":"2022","journal-title":"Front Neurol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00455-022-10443-3","article-title":"Clinical predictors of dysphagia recovery after stroke: a systematic review","volume":"38","author":"D\u2019Netto","year":"2023","journal-title":"Dysphagia"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1007\/s11910-020-01081-z","article-title":"Post-stroke dysphagia: recent insights and unanswered questions","volume":"20","author":"Jones","year":"2020","journal-title":"Curr Neurol Neurosci Rep"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1421","DOI":"10.1016\/j.jstrokecerebrovasdis.2019.03.031","article-title":"Factors influencing oral intake improvement and feeding tube dependency in patients with poststroke dysphagia","volume":"28","author":"Wilmskoetter","year":"2019","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s40141-016-0129-6","article-title":"Dysphagia management and stroke units","volume":"4","author":"Smithard","year":"2016","journal-title":"Curr Phys Med Rehabil Rep"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1080\/08990220.2023.2165058","article-title":"The relationship between dysphagia and the localisation of brain lesion in stroke: is the involvement of the pons and medulla important?","volume":"41","author":"Konak","year":"2024","journal-title":"Somatosens Mot Res"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1161\/STROKEAHA.119.027900","article-title":"Adiposity and outcome after ischemic stroke: obesity paradox for mortality and obesity parabola for favorable functional outcomes","volume":"52","author":"Liu","year":"2021","journal-title":"Stroke"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1016\/j.jstrokecerebrovasdis.2015.08.029","article-title":"Obese Japanese patients with stroke have higher functional recovery in convalescent rehabilitation wards: a retrospective cohort study","volume":"25","author":"Nishioka","year":"2016","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"2552","DOI":"10.1111\/ene.14881","article-title":"Association between abnormal body weight and stroke outcome: a meta-analysis and systematic review","volume":"28","author":"Zhang","year":"2021","journal-title":"Eur J Neurol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1177\/17474930231212972","article-title":"Effect of abnormal body weight on mortality and functional recovery in adults after stroke: an umbrella review","volume":"19","author":"Holland","year":"2024","journal-title":"Int J Stroke"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"608","DOI":"10.1097\/PHM.0000000000001159","article-title":"Relationship between body mass index and rehabilitation outcomes in subacute stroke with dysphagia","volume":"98","author":"Morone","year":"2019","journal-title":"Am J Phys Med Rehabil"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1553947\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T12:56:18Z","timestamp":1757940978000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1553947\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":43,"alternative-id":["10.3389\/fneur.2025.1553947"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1553947","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,15]]},"article-number":"1553947"}}