{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:06:40Z","timestamp":1784696800058,"version":"3.55.0"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In inpatient stroke rehabilitation settings where acupuncture is part of routine care, several practical questions arise: when treatment should begin, how intensively it should be delivered, and whether data on treatment patterns can help guide individualized discharge planning. We examined treatment-pattern associations in a retrospective acupuncture-treated cohort; lesion-side analyses were treated as secondary exploratory heterogeneity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 1,048 stroke rehabilitation inpatients who received acupuncture during hospitalization. Median onset-to-first acupuncture was 26\u202fdays (IQR 20\u201335), median total exposure was 20 sessions (IQR 15\u201326), and median weekly frequency was 5.0 sessions\/week (IQR 4.5\u20135.5). Primary outcomes were admission-to-discharge changes in Barthel Index (BI), Fugl-Meyer Assessment upper extremity (FMA-UE), lower extremity (FMA-LE), and balance; composite recovery was the mean standardized z-score across these four primary change domains. Secondary\/exploratory outcomes were Montreal Cognitive Assessment (MoCA) and FMA-ROM\/Pain. Home discharge was analyzed as a pragmatic discharge-planning endpoint. Analyses included regression models, subgroup interaction tests, total-session, extended-adjustment, and missingness-oriented sensitivity analyses, inverse-probability weighting, and 3-fold internally validated machine-learning benchmarks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients improved in BI (13.74 +\/\u2212 6.57), FMA-UE (10.18 +\/\u2212 5.86), FMA-LE (4.90 +\/\u2212 3.08), and FMA-balance (2.85 +\/\u2212 2.22). Because these instruments have different score ranges, standardized effect sizes and recovery ratios were used to support cross-domain interpretation. Earlier acupuncture initiation was the most consistent favorable exposure signal; for BI gain, the timing coefficient was beta\u202f=\u202f\u22121.55 (95% CI \u22121.96 to \u22121.14;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Mean total sessions were higher among patients discharged home than among non-home patients (21.86 +\/\u2212 8.19 vs. 19.60 +\/\u2212 7.62;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001), and total-session models were associated with BI gain (beta\u202f=\u202f2.83, 95% CI 2.46\u20133.20;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and home discharge (OR 1.39, 95% CI 1.19\u20131.62;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Left-versus-right interactions were not significant; stroke-type interaction was evident only for timing with FMA-LE gain (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.012). In prediction benchmarks, LARE had AUROC 0.804 (95% bootstrap CI 0.778\u20130.829) for home discharge but was not statistically distinguishable from CatBoost or RandomForest; BI-gain regression was moderate.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Within this acupuncture-treated inpatient cohort, earlier initiation, weekly frequency, and total exposure were associated with short-term ADL and motor recovery. These findings are consistent with timing- and dose\u2013response hypotheses from the broader rehabilitation and acupuncture literature, but prospective studies with non-acupuncture comparators and acute neurologic severity measures are needed before causal efficacy claims can be made.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1848746","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:38:49Z","timestamp":1784695129000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of acupuncture timing and treatment intensity with short-term functional recovery in stroke rehabilitation inpatients: a retrospective cohort and prediction study"],"prefix":"10.3389","volume":"17","author":[{"given":"Yanling","family":"Gao","sequence":"first","affiliation":[{"name":"Fujian Key Laboratory of Rehabilitation Technology","place":["Fuzhou, Fujian, China"]},{"name":"Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajun","family":"Kang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Rao","sequence":"additional","affiliation":[{"name":"Fujian Key Laboratory of Rehabilitation Technology","place":["Fuzhou, Fujian, China"]},{"name":"Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhua","family":"Lu","sequence":"additional","affiliation":[{"name":"Fujian Key Laboratory of Rehabilitation Technology","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyan","family":"Su","sequence":"additional","affiliation":[{"name":"Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Sun","sequence":"additional","affiliation":[{"name":"Fujian Key Laboratory of Rehabilitation Technology","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyue","family":"Dai","sequence":"additional","affiliation":[{"name":"Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990\u20132019: a systematic analysis for the global burden of disease study 2019","volume":"20","author":"Feigin","year":"2021","journal-title":"Lancet Neurol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1161\/STR.0000000000000098","article-title":"Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"47","author":"Winstein","year":"2016","journal-title":"Stroke"},{"key":"ref3","first-page":"523","volume-title":"National Institute for Health and Care Excellence stroke rehabilitation guidance\u2013is it useful, usable, and based on best evidence?","author":"Drummond","year":"2014"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1097\/WCO.0000000000000404","article-title":"Early rehabilitation after stroke","volume":"30","author":"Bernhardt","year":"2017","journal-title":"Curr Opin Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1016\/S0140-6736(15)60690-0","article-title":"Efficacy and safety of very early mobilisation within 24 h of stroke onset (AVERT): a randomised controlled trial","volume":"386","author":"Bernhardt","year":"2015","journal-title":"Lancet"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2053","DOI":"10.1161\/STROKEAHA.114.004695","article-title":"Is more better? 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