Development of a disease-specific health-related quality of life questionnaire for patients with post-stroke spasticity

OBJECTIVE： This study was designed to develop a disease-specific health-related quality of life （HR-QOL） measure for patients with post-stroke spasticity. METHODS; Based on responses from 20 patients with post-stroke spasticity and an extensive literature search, items potentially used to measure these patients＇ recovery status were identified and the Apoplexy Spastic-Paralysis Questionnaire （ASPQ） was formed. A sample of 106 patients was then tested twice using the ASPQ, the Self-rating Depression Scale （SDS） and the Stroke-specific Quality of Life （SS-QOL）. Clinicians also examined all the patients using the Ashworth Scale （AS）. Inter- nal reliability was assessed using Cronbach＇s coeffi- cient a, while construct validity was determined us- ing principal component analysis （PCA）. Empirical validity was evaluated between patients with de- pression and those without depression by single factor analysis. Sensitivity was examined by calcu- lating the Spearman correlation coefficient be- tween the changes in scores of the ASPQ, the AS and the SS-QOL. RESULTS： The ASPQ had adequate internal consis- tency reliability （a=0.874） and sensitivity, with sig- nificant correlations between the changes in scores of the AS, the SS-QOL and the ASPQ, with three do- mains. In a construct validity test, six factors were extracted; the overall variance explained by all fac- tors was 72.6%. For empirical validity, mean values of 19 items and 3 domains were all higher in the de- pressive patients than in the non-depressive pa- tients. CONCLUSION： The ASPQ is a reliable and valid self-rating scale for measuring the HR-QOL in pa- tients with post-stroke spasticity.

A comparative study of electroacupuncture at Zhongliao （BL33） and other acupoints for overactive bladder symptoms

Electroacupuncture （EA） at Zhongliao （BL33） can improve the symptoms of overactive bladder （OAB）, such as urinary frequency, urgency, and incontinence. However, its performance compared with other acupoints remains unclear. This study investigated the effects of EA at BL33 with deep needling on rats with OAB by detecting urodynamics in eight groups： no intervention group, D-BL33 group （deep needling at BL33）, S-BL33 group （shallow needling at BL33）, non-acupoint group （needling at the non-acupoint next to BL33）, Weizhong （BL40） group, Sanyinjiao （SP6） group, Tongtian （BL7） group, and Hegu （LI4） group. Results revealed that EA at BL33 with deep needling, BL40, and SP6 prolonged the intercontraction interval （ICI） of rats with OAB （P= 0.001, P = 0.005, P = 0.046, respectively, post-treatment vs. post-modeling）. Furthermore, the change in ICI from post-modeling in the D-BL33 group was significantly greater than those of the no intervention and other EA groups （all P 〈 0.01）. Significantly shortened vesical micturition time （VMT） and elevated maximum detrusor pressure （MDP） were also observed in the D-BL33 group （P = 0.017 and P = 0.024, respectively, post-treatment vs. post-modeling）. However, no statistically significant differences in the changes of VMT and MDP from post- modeling were observed between D-BL33 and the other EA groups. In conclusion, EA at BL33 with deep needling may inhibit acetic-acid-induced OAB more effectively.