Effects of Functional Acupuncture on Upper Limb Spasticity After Ischemic Stroke: A Protocol for a Randomized Controlled Parallel Clinical Trial.

Background: Upper limb spasticity (ULS) is a common complication after stroke, which seriously affects the quality of life and rehabilitation of patients. There are different treatment methods for post-stroke spasticity (PSS). Our group found that functional acupuncture (FA) can effectively improve forearm spasticity and hand dysfunction after stroke, but the efficacy of ULS needs to be further verified. Therefore, this subject has mainly used clinical randomized controlled trials to evaluate the clinical efficacy of FA in the treatment of ULS after ischemic stroke. Method: This is a parallel design and randomized controlled trial. We selected 108 patients who met the predefined criteria and randomized them into two groups, the experimental group and the control group. The experimental group receives FA and routine rehabilitation treatment. The control group received traditional acupuncture (TA) and routine rehabilitation treatment. All patients received 20 courses of treatment for 4 weeks, and the modified Ashworth score (MAS), clinical neurological deficit score (CSS), Fugl-Meyer upper extremity function assessment (FMA-UE), and the Modified Barthel Index (MBI) scores were evaluated before and after treatment. Discussion: This trial is mainly to study the clinical efficacy of FA in the treatment of ULS after ischemic stroke. It will not only provide a new idea for the clinical treatment of upper limb post-stroke spasticity (ULPSS) but also will provide effective experimental support and a theoretical basis for the clinic. Trial registration: China Clinical Trials Registry No. ChiCTR2100050440. Registered on 27 August 27 2021.

[Yin-yang balance penetrating acupuncture combined with rehabilitation training on upper limb spasticity in stroke hemiplegia].

OBJECTIVE: To compare the therapeutic effect of yin-yang balance penetrating acupuncture combined with rehabilitation training and single rehabilitation training on upper limb spasticity in patients with stroke hemiplegia. METHODS: A total of 60 patients with upper limb spasticity of stroke hemiplegia were randomized into an observation group and a control group, 30 cases in each one. On the basis of conventional western medication, rehabilitation training was adopted in the control group. On the basis of treatment in the control group, yin-yang balance penetrating acupuncture was applied from Jianyu (LI 15) to Binao (LI 14), Quchi (LI 11) to Shaohai (HT 3), Yanglingquan (GB 34) to Yinlingquan (SP 9), Xuanzhong (GB 39) to Sanyinjiao (SP 6), etc. of the affected side in the observation group. The treatment was given once a day, 5 days were as one course, with a 2-day interval between two courses, 4 courses were required in both groups. The classification of modified Ashworth spasticity scale (MAS), surface integrated electromyogram (iEMG) of affected upper limb and the scores of National Institute of Health stroke scale (NIHSS), Fugl-Meyer assessment (FMA) of upper limb and modified Barthel index (MBI) before and after treatment were observed, the therapeutic effect was evaluated in both groups. RESULTS: ①After treatment, the MAS classification reduced in both groups (P<0.05), the cases of grade 0 to Ⅰ+ in the observation group were more than those in the control group (P<0.05); iEMG values of the maximum isometric voluntary contraction of affected usculus biceps brachii, musculus triceps brachii, musculus flexor carpi, musculus extensor carpi, extensor digitorum, aductor pollicis brevis were increased in both groups (P<0.05), and the variations of iEMG of above muscles on the affected side in the observation group were larger than those in the control group (P<0.05). ②After treatment, the scores of NIHSS were decreased (P<0.05), the scores of FMA, MBI were increased in both groups (P<0.05), and the variations of NIHSS, FMA and MBI scores were larger than those in the control group (P<0.05). ③The total effective rate was 93.3% (28/30) in the observation group, which was superior to 70.0% (21/30) in the control group (P<0.05). CONCLUSION: Yin-yang balance penetrating acupuncture combined with rehabilitation training can improve upper limb spasticity, heighten the motor function of upper limb and daily self care in patients with stroke hemiplegia, its therapeutic effect is superior to single rehabilitation training.

- balance penetrating acupuncture combined with rehabilitation training on upper limb spasticity in stroke hemiplegia / 中国针灸

OBJECTIVE@#To compare the therapeutic effect of - balance penetrating acupuncture combined with rehabilitation training and single rehabilitation training on upper limb spasticity in patients with stroke hemiplegia.@*METHODS@#A total of 60 patients with upper limb spasticity of stroke hemiplegia were randomized into an observation group and a control group, 30 cases in each one. On the basis of conventional western medication, rehabilitation training was adopted in the control group. On the basis of treatment in the control group, - balance penetrating acupuncture was applied from Jianyu (LI 15) to Binao (LI 14), Quchi (LI 11) to Shaohai (HT 3), Yanglingquan (GB 34) to Yinlingquan (SP 9), Xuanzhong (GB 39) to Sanyinjiao (SP 6), etc. of the affected side in the observation group. The treatment was given once a day, 5 days were as one course, with a 2-day interval between two courses, 4 courses were required in both groups. The classification of modified Ashworth spasticity scale (MAS), surface integrated electromyogram (iEMG) of affected upper limb and the scores of National Institute of Health stroke scale (NIHSS), Fugl-Meyer assessment (FMA) of upper limb and modified Barthel index (MBI) before and after treatment were observed, the therapeutic effect was evaluated in both groups.@*RESULTS@#①After treatment, the MAS classification reduced in both groups (<0.05), the cases of grade 0 to Ⅰ in the observation group were more than those in the control group (<0.05); iEMG values of the maximum isometric voluntary contraction of affected usculus biceps brachii, musculus triceps brachii, musculus flexor carpi, musculus extensor carpi, extensor digitorum, aductor pollicis brevis were increased in both groups (<0.05), and the variations of iEMG of above muscles on the affected side in the observation group were larger than those in the control group (<0.05). ②After treatment, the scores of NIHSS were decreased (<0.05), the scores of FMA, MBI were increased in both groups (<0.05), and the variations of NIHSS, FMA and MBI scores were larger than those in the control group (<0.05). ③The total effective rate was 93.3% (28/30) in the observation group, which was superior to 70.0% (21/30) in the control group (<0.05).@*CONCLUSION@#- balance penetrating acupuncture combined with rehabilitation training can improve upper limb spasticity, heighten the motor function of upper limb and daily self care in patients with stroke hemiplegia, its therapeutic effect is superior to single rehabilitation training.

[Blood-letting and cupping therapy for upper limb spasticity in recovery phase of stroke].

OBJECTIVE: To observe the effect difference between blood-letting and cupping therapy combined with basic treatment and simple basic treatment for upper limb spasticity in the recovery phase of stroke. METHODS: Sixty patients of upper limb spasticity in the recovery phase of stroke were randomly assigned into an observation group and a control group, 30 cases in each group. In the control group, the basic treatment, including the internal treatment, acupuncture and rehabilitation, was used for 2 weeks, 6 times a week, once a day. Based on the basic treatment, blood-letting, at 3 jing-well points each time, and cupping therapy were used at the most obvious spasm point in the belly of biceps muscle in the observation group for 2 weeks, 3 time a week, once every other day. The spasm score, passive traction value, and moter function score of upper limb were assessed in the two groups before and after treatment. The effects were compared between the two groups. RESULTS: After treatment, the spasm scores and passive traction values were lower than those before treatment in the two groups (all P<0.01), with better score and value as well as different values before and after treatment in the observation group (P<0.05, P<0.01). After treatment, the motor function scores were higher than those before treatment in the two groups (both P<0.01), with better score and different value before and after treatment in the observation group (both P<0.05). The total effective rate was 90.0% (27/30) in the observation group, which was better than 76.7% (23/30) in the control group (P<0.05). CONCLUSION: Based on the basic treatment, blood-letting combined with cupping therapy are effective for upper limb spasticity in the recovery phase of stroke.

Blood-letting and cupping therapy for upper limb spasticity in recovery phase of stroke / 中国针灸

OBJECTIVE@#To observe the effect difference between blood-letting and cupping therapy combined with basic treatment and simple basic treatment for upper limb spasticity in the recovery phase of stroke.@*METHODS@#Sixty patients of upper limb spasticity in the recovery phase of stroke were randomly assigned into an observation group and a control group, 30 cases in each group. In the control group, the basic treatment, including the internal treatment, acupuncture and rehabilitation, was used for 2 weeks, 6 times a week, once a day. Based on the basic treatment, blood-letting, at 3 -well points each time, and cupping therapy were used at the most obvious spasm point in the belly of biceps muscle in the observation group for 2 weeks, 3 time a week, once every other day. The spasm score, passive traction value, and moter function score of upper limb were assessed in the two groups before and after treatment. The effects were compared between the two groups.@*RESULTS@#After treatment, the spasm scores and passive traction values were lower than those before treatment in the two groups (all <0.01), with better score and value as well as different values before and after treatment in the observation group (<0.05, <0.01). After treatment, the motor function scores were higher than those before treatment in the two groups (both <0.01), with better score and different value before and after treatment in the observation group (both <0.05). The total effective rate was 90.0% (27/30) in the observation group, which was better than 76.7% (23/30) in the control group (<0.05).@*CONCLUSION@#Based on the basic treatment, blood-letting combined with cupping therapy are effective for upper limb spasticity in the recovery phase of stroke.

Effect of Acupuncture Combined with Vibroacoustic Therapy on Upper Limb Spasticity Post Stroke / 中国康复理论与实践

Objective To observe the clinical effect of acupuncture combined with vibroacoustic therapy on upper limb spasticity post stroke. Methods From November, 2014 to November, 2015, 90 patients with upper limb spasticity post stroke were randomized into treat-ment group (acupuncture combined with vibroacoustic therapy), control 1 group (simple vibroacoustic therapy) and control 2 group (simple acupuncture) with 30 cases in each group. All the patients accepted routine fundamental treatment and rehabilitation training. The modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) were used to assess the upper limb muscle ten-sion, motor function and activities of daily living before and four weeks after treatment. Results After treatment, MAS score decreased in all groups (Z>3.067, P3.326, P2.919, P0.05). The total effective rate was 80%in the treatment group, 50%in the control group 1 and 53%in the control group 2 (χ2=8.573, P=0.014), respectively. Conclusion Acupuncture combined with vibroacoustic therapy can alleviate the upper limb spasticity, and promote the recovery of motor function and activities of daily living.