ABSTRACT
Objective To observe the efficacy difference between different needling manipulations in treating acute stroke with point-toward-point needling at scalp acupoints, for seeking the optimal treatment protocol. Method Ninety patients with acute stroke were randomized into a manual needling group, an electroacupuncture group, and a needle-retaining group, 30 cases each. In addition to the neurological treatment, the three groups were all given point-toward-point needling from Baihui (GV20) to Taiyang (EX-HN5) on the affected side, respectively with manual twisting, electroacupuncture and needle retaining methods. Before and after 14-day treatment, the Neurological Deficit Score (NDS), level of neuron specific enolase (NSE) and total efficacy were compared among the three groups. Result The NDS dropped significantly in the three groups after the intervention (P<0.05); the manual needling group showed the most significant improvement, better than the electroacupuncture group and needle retaining group. The level of NSE declined significantly in the three groups after the intervention (P<0.05); the decrease in the manual needling group was the most significant compared to that in the electroacupuncture group and needle retaining group. The total effective rate in the manual needling group (90.0%) was significantly higher than that in the electroacupuncture group and needle retaining group (P<0.05). Conclusion Point-toward-point needling at scalp acupoints with manual operation can effectively improve the neurological deficit in stroke patients, and the application of needling manipulations can further enhance the therapeutic efficacy, which is specific.
ABSTRACT
Objective To investigate the immediate effect of twirling reinforcing manipulation, twirling reducing manipulation and mild reinforcing-reducing manipulation on motor functions for patients with acute ischemic stroke. Methods Totally 116 patients with ischemic stroke were randomly divided into twirling reinforcing manipulation group (TRFM, n=39), mild reinforcing-reducing manipulation group (TRRM, n=37), and twirling reducing manipulation group (TRDM, n=40) by stratified blocked randomization. Each group was treated in Baihui-Taiyang acupoint area accordingly with twirling reinforcing manipulation, mild reinforcing-reducing manipulation and twirling reducing manipulation once. The operation time for each needle was 1 minute. Interval time between every 2 needles was 10 minutes, and each needle was retained for 30 minutes. Neurological deficit score (NDS) and simplified Fugl-Meyer assessment (FMA) were evaluated before and immediate time, 1 h, 2 h and 3 h after treatment. Results FMA in TRFM was higher than that of TRDM and TRRM at immediate time, 1 h and 2 h after treatment (P0.05). DNS in TRFM decreased sharply at immediate time, 1 h, 2 h and 3 h compared with TRDM and TRRM (P0.05). Conclusion TRFM has an advantage over TRDM and TRRM in immediate effect of motor functions for patients with acute ischemic stroke.
ABSTRACT
Peripheral neuropathy is highly associated with foot complications among diabetics. This study aimed to identify risk factors associated with the development of peripheral neuropathy in diabetic patients and their association with degree of severity of peripheral neuropathy. A cross-sectional study was conducted in follow-up clinics at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Malaysia involving 72 diabetic patients and 19 controls. Exclusion criteria were those with amputated limbs, gross foot deformity and existing peripheral neuropathy. Controls were non diabetics who walked normally, had no history of foot problem and attended the clinic as subjects’ companion. Quantitative assessment of neuropathy was done using Semmes-Weinstein monofilament. Neuropathy Disability Score (NDS) were used to quantify severity of diabetic neuropathy. Spearman’s Rank test and Mann-Whitney test were used to determine correlation between variables and their differences. Logistic regression analysis was used to determine risk factors associated with peripheral neuropathy. The mean HbA1c among diabetics was 8.6% + 4.1, and mean NDS was 7.0 + 6.0. A total of 79.1% demonstrated various level of neuropathy with presence of callus was associated with higher NDS scores. Older age (P=0.02), body weight (P=0.03), HbA1c (P=0.005) and duration of diabetes (P <0.005) showed positive correlation with NDS. Proper foot care program for diabetics should include recognition of the callus, with special emphasis given to those with heavier weight and increasing age.