Research of efficacy assessment of post-stroke hemiplegic spasticity treated with acupuncture and rehabilitation:a multi-centre randomized controlled trial

Objective To observe the therapeutic effect of acupuncture and rehabilitation on poststroke hemiplegic spasticity, and probe into the indices of efficacy assessment of the disease. Methods According to the randomized, controlled and blind clinical trial design, 229 cases enrolled in accordance with the inclusive criteria were divided into 3 groups based on visiting sequence： treatment group 1 （74 cases）, treated with acupuncture [Jianyu （肩髃 LI 15）, Quchi （曲池 LI 11）, Waiguan （外关 TE 5） etc. on the affected side]; treatment group 2 （75 cases）, treated with acupuncture as treatment group 1 and combined with rehabilitation as control group; control group （80 cases）, treated with rehabilitation （Bobath facilitation technique）. 5 treatments were given each week, continuously for 4 weeks. The clinical efficacy on post-stroke hemiplegic spasticity was observed systematically after the treatment of acupuncture combined with rehabilitation. Results The research showed that the baseline situations of 3 groups were good, the group division was proportionate, indicating strong comparability （P〉0.05）. Based on the modified Ashworth Spasticity Scale （modified ASS）, the total effective rate was 63.01% （46/73） in treatment group 1, 66.67%（50/75） in treatment group 2 and 44.00% （33/75） in control group, indicating a statistical significant difference among 3 groups （P〈0.05）. Based on MAS motor function scale, the function improvement in treatment group 2 was superior to that in treatment group 1 and control group, indicating statistical significant differences among 3 groups （both P〈0.05）. Based on modified Barthel index, the daily life activity in treatment group 2 was superior in the improvement as compared with treatment group 1 and control group, but without statistical significant difference indicated （P〉0.05）. Conclusion The efficacy of post-stroke hemiplegic spasticity is definite with acupuncture combined with rehabilitation, and the acupuncture program is safe and effective.

Effect of Acupuncture and Rehabilitation Training on Barthel Index in Early-stage of Stroke Cases

Objective： To study the effect of combined acupuncture and rehabilitation training on early-stage Barthel index of ischemic stroke cases. Method： Fifty ischemic stroke cases were randomized into a treatment group of 24 cases and control group of 26 cases. In addition to routine internal treatment methods, rehabilitation training was applied to cases in the control group, and combined acupuncture and rehabilitation training were applied to cases in the treatment group. Warming and reinforcing manipulations were applied to Jianyu （LI 15）, Quchi （LI 11）, Hegu （LI 4）, Yanglingquan （GB 34）, Yinlingquan （SP 9）, Zusanli （ST 36）, and Sanyinjiao （SP 6）, 20 rain of needle retaining for each point in one treatment. Then the scores of clinical neurological impairment and Barthel index of stroke cases were evaluated before the treatment and 3 weeks after respectively. Results： The significant progress and progress cases in the treatment group were 14 and 12 respectively, whereas that in the control group were 6 and 11 respectively, coupled with 7 cases of no progress. The therapeutic effect in the treatment is substantially better than the control group （P〈0.05）. There was no significant difference （P〉0.05） in neurological impairment and scores of Barthel index of the two groups before the treatment, whereas significant difference （P〈0.05） after the treatment. The scores of neurological impairment in the treatment group were significantly reduced after the treatment （P〈0.05）, and the scores of Barthel index were significantly increased （P〈0.05）. Conclusion： Combined acupuncture and rehabilitation training can produce significantly better effect on early neurological impairment and Barthel index of stroke cases than rehabilitation training alone.