- 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 / 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.

Botulinum toxin A for the treatment of upper limb spasticity after stroke:a Meta-analysis / 中国脑血管病杂志

Objective To systematically review the clinical efficacy of botulinum toxin A for the treatment of upper limb spasticity after stroke. Methods PubMed,EMbase,Cochrane Library,CBM, China National Knowledge Internet (CNKI),and Wanfang Data were retrieved by a computer. The randomized controlled trials and Case-control study of comparing botulinum toxin A combined with rehabilitation training and routine rehabilitation treatment for upper limb spasticity after stroke were collected. The retrieval time was from the foundation of the database to September 1,2016. At least two reviewers conducted literature screening,data extraction,and quality evaluation according to the inclusion and exclusion criteria. The Rev-Man 5. 3 software provided by the Cochrane Collaboration was used to conduct the Meta-analysis. Results A total of 356 articles were retrieved. Finally,11 articles met the inclusion criteria. The modified Jadad score showed that the scores of 9 articles were more than 4,which belonged to high-quality literature. Eleven articles included 614 patients,in which 316 were treated with botulinum toxin A. There were 298 patients in the control group. The results of Meta-analysis indicated that the Fugl-Meyer score (SMD =0. 94,95% CI 0. 75 to 1. 12),modified Ashworth score (SMD = - 1. 59,95% CI - 1. 78 to - 1. 40),and modified Barthel index (SMD = 0. 86,95% CI 0. 65 to 1. 08)in the botulinum toxin treatment group were superior to the control group. There were significant differences (all P 0. 05). Conclusion The efficacy of treatment of upper limb spasticity after stroke with botulinum toxin A is exact,and the security is high. The appropriate rehabilitation training can effectively improve the limb motor function,muscle tension,and quality of life of patients.

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.

Apropos of one case of upper limb spasticity treated by botulinum toxin type A (Dysport)

Report one case of patient with upper limb spasticity after traumatic brain injury treated at Rehabilitation Center, Bach Mai Hospital at September 2003. Results: muscle tone and pain decreased significantly by Dysport injections. This drug facilitated patient’s care, hygiene and exercises, and had no side-effect. However, this was the first case of Dysport therapy, and the time of follow-up still short (1 month), so this result was initial outcome. It is necessary to carry out a study with larger sample so that to have clear and definitive results.