Electroacupuncture may help motor recovery in chronic stroke survivors: a pilot study.

Past studies have suggested that acupuncture may reduce spasticity in stroke survivors. We do not know, however, whether acupuncture may enhance the effect of strength training on motor function. This study compared upper-limb motor functional improvement in chronic stroke survivors who received a combination of acupuncture and strength training with that of subjects who received strength training alone. A total of 10 chronic stroke patients with moderate or severe wrist muscle spasticity were recruited for this study. The study used a crossover design with a random order of either combined electroacupuncture and strength training or strength training alone. Each subject received one of the two types of treatment twice a week for the first 6 weeks and switched to the other for another 6 weeks. Quantitative measurements of wrist spasticity, active wrist extension range of motion, isometric wrist strength, and clinical evaluation with Fugl-Meyer (FM) upper-limb motor scores were conducted before and after either treatment. After the combined treatment, the quantitative spasticity level, active wrist extension range of motion (increased by a mean of 16.3 degrees), and FM upper-limb motor score (increased by a mean of 4.9 points) changed significantly (p < 0.01) but no significant changes were noted in isometric wrist strength. The strength training alone resulted in no significant changes to any measured variable. The results of the current study indicate that the combined acupuncture and strength training treatment reduced muscle spasticity and may have improved motor function for chronic stroke survivors with moderate or severe muscle spasticity.

[1]  L. Widén Holmqvist,et al.  Spasticity and Its Association with Functioning and Health-Related Quality of Life 18 Months after Stroke , 2006, Cerebrovascular Diseases.

[2]  C. Winstein,et al.  A randomized controlled comparison of upper-extremity rehabilitation strategies in acute stroke: A pilot study of immediate and long-term outcomes. , 2004, Archives of physical medicine and rehabilitation.

[3]  S. Black,et al.  The Fugl-Meyer Assessment of Motor Recovery after Stroke: A Critical Review of Its Measurement Properties , 2002, Neurorehabilitation and neural repair.

[4]  Ki-Ho Cho,et al.  Antispastic effect of electroacupuncture and moxibustion in stroke patients. , 2003, The American journal of Chinese medicine.

[5]  D. Bourbonnais,et al.  Weakness in patients with hemiparesis. , 1989, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[6]  C. H. Chen,et al.  A randomized controlled trial on the treatment for acute partial ischemic stroke with acupuncture. , 1993, Neuroepidemiology.

[7]  Z. Guo,et al.  Acupuncture methods for hemiplegic spasm. , 1997, Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan.

[8]  Effects of Acupuncture Treatment on Poststroke Motor Recovery and Physical Function: A Pilot Study , 2004, Neurorehabilitation and neural repair.

[9]  M. Leathley,et al.  Prevalence of spasticity post stroke , 2002, Clinical rehabilitation.

[10]  G. Recanzone,et al.  Progressive improvement in discriminative abilities in adult owl monkeys performing a tactile frequency discrimination task. , 1992, Journal of neurophysiology.

[11]  L. Sun,et al.  The effect of electro-acupuncture on motor function recovery in patients with acute cerebral infarction: a randomly controlled trial. , 2001, Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan.

[12]  L. Baker,et al.  Functional test for the hemiparetic upper extremity. , 1984, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[13]  M. V. von Arbin,et al.  Spasticity After Stroke: Its Occurrence and Association With Motor Impairments and Activity Limitations , 2003, Stroke.

[14]  A. Jahangir,et al.  Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after stroke. , 2007, The Medical journal of Malaysia.

[15]  J. Froger,et al.  Efficacy of botulinum toxin A in upper limb function of hemiplegic patients , 2002, Journal of Neurology.

[16]  Y Yu,et al.  [Transcutaneous electric stimulation at acupoints in the treatment of spinal spasticity: effects and mechanism]. , 1993, Zhonghua yi xue za zhi.

[17]  B. Fagerberg,et al.  Effects of acupuncture treatment on daily life activities and quality of life: a controlled, prospective, and randomized study of acute stroke patients. , 1998, Stroke.

[18]  M. Inaba,et al.  Effectiveness of functional training, active exercise, and resistive exercise for patients with hemiplegia. , 1973, Physical therapy.

[19]  I. Wiklund,et al.  Can sensory stimulation improve the functional outcome in stroke patients? , 1993, Neurology.

[20]  Richard W. Bohannon Muscle strength and muscle training after stroke. , 2007, Journal of rehabilitation medicine.

[21]  唐强,et al.  COMPARISON OF EFFECTS OF ACUPUNCTURE ON CEREBRAL INFARCTION IN DIFFERENT PARTS , 1998 .

[22]  Richard W. Bohannon,et al.  Relationship between static muscle strength deficits and spasticity in stroke patients with hemiparesis. , 1987, Physical therapy.

[23]  I. Hwang,et al.  Quantitative analysis of the velocity related pathophysiology of spasticity and rigidity in the elbow flexors , 2002, Journal of neurology, neurosurgery, and psychiatry.

[24]  R. Schmidt,et al.  Motor control and learning: A behavioral emphasis, 4th ed. , 2005 .

[25]  M. Alexander,et al.  Real Versus Sham Acupuncture in the Treatment of Paralysis in Acute Stroke Patients: A CT Scan Lesion Site Study , 1992 .

[26]  R. Nudo,et al.  Neural Substrates for the Effects of Rehabilitative Training on Motor Recovery After Ischemic Infarct , 1996, Science.

[27]  S O'Donovan Why bother? , 1988, Nursing times.

[28]  J. Woo,et al.  Does Acupuncture Have Additional Value to Standard Poststroke Motor Rehabilitation? , 2002, Stroke.

[29]  J. Bean,et al.  High intensity strength training improves strength and functional performance after stroke. , 2000, American journal of physical medicine & rehabilitation.

[30]  R W Bohannon,et al.  Correlation of knee extensor muscle torque and spasticity with gait speed in patients with stroke. , 1990, Archives of physical medicine and rehabilitation.

[31]  J. Stanghelle,et al.  A one year follow-up study on the effects of acupuncture in the treatment of stroke patients in the subacute stage: a randomized, controlled study , 1997, Clinical rehabilitation.

[32]  F. Tang,et al.  Clinical trial of electrical acupuncture on hemiplegic stroke patients. , 1999, American journal of physical medicine & rehabilitation.

[33]  M. Merzenich,et al.  Functional reorganization of primary somatosensory cortex in adult owl monkeys after behaviorally controlled tactile stimulation. , 1990, Journal of neurophysiology.

[34]  J. B. Redford,et al.  The effect of electro-acupuncture on spasticity of the wrist joint in chronic stroke survivors. , 2007, Archives of physical medicine and rehabilitation.

[35]  J. Han,et al.  Transcutaneous electrical nerve stimulation for treatment of spinal spasticity. , 1994, Chinese medical journal.

[36]  A. Fugl-Meyer,et al.  The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. , 1975, Scandinavian journal of rehabilitation medicine.

[37]  E. Elovic,et al.  Intramuscular injection of botulinum toxin for the treatment of wrist and finger spasticity after a stroke. , 2002, The New England journal of medicine.

[38]  J. Woo,et al.  Does Acupuncture Improve Motor Recovery After Stroke?: A Meta-Analysis of Randomized Controlled Trials , 2002, Stroke.

[39]  Xiangyi,et al.  Does Acupuncture Have Additional Value to Standard Poststroke Motor Rehabilitation , 2002 .

[40]  Werner Poewe,et al.  A Randomized, Double-Blind, Placebo-Controlled, Dose-Ranging Study to Compare the Efficacy and Safety of Three Doses of Botulinum Toxin Type A (Dysport) With Placebo in Upper Limb Spasticity After Stroke , 2000, Stroke.

[41]  G. Wu,et al.  Effects of electroacupuncture on acute cerebral infarction. , 1998, Acupuncture & electro-therapeutics research.

[42]  N. V. van Meeteren,et al.  Functional‐Task Exercise Versus Resistance Strength Exercise to Improve Daily Function in Older Women: A Randomized, Controlled Trial , 2005, Journal of the American Geriatrics Society.

[43]  Timothy D. Lee,et al.  Motor Control and Learning: A Behavioral Emphasis , 1982 .

[44]  M. Mishkin,et al.  Massive cortical reorganization after sensory deafferentation in adult macaques. , 1991, Science.

[45]  B. Johansson,et al.  Acupuncture and Transcutaneous Nerve Stimulation in Stroke Rehabilitation: A Randomized, Controlled Trial , 2001, Stroke.

[46]  Mary Ann O'Brien,et al.  Progressive resistance strengthening exercises after stroke: a single-blind randomized controlled trial. , 2003, Archives of physical medicine and rehabilitation.

[47]  W. Landau Spasticity after stroke: why bother? , 2004, Stroke.

[48]  L. Debreceni,et al.  Unique changes found on the Qi Gong (Chi Gong) Master's and patient's body during Qi Gong treatment; their relationships to certain meridians & acupuncture points and the re-creation of therapeutic Qi Gong states by children & adults. , 1989, Acupuncture & electro-therapeutics research.

[49]  J. Domenech,et al.  [Motor rehabilitation]. , 2002, Revista de neurologia.

[50]  R L Hewer,et al.  Arm function after stroke. An evaluation of grip strength as a measure of recovery and a prognostic indicator. , 1989, Journal of neurology, neurosurgery, and psychiatry.

[51]  J. Stanghelle,et al.  [Acupuncture therapy in stroke during the subacute phase. A randomized controlled trial]. , 1995, Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke.