An overview of acupuncture for the treatment of limb spasticity in cerebral palsy-A mini review

Cerebral palsy is a common chronic disabling disease in children with special needs,and rehabilitation for cerebral palsy is characterized by a long period,multiple methods and limited efficacy.Due to the limited motor function of cerebral palsy patients,the quality of life of patients is reduced,and their ability to participate in society is reduced,so the improvement of patients’motor function has become an important goal of cerebral palsy rehabilitation.The motor function of cerebral palsy has become an important goal of cerebral palsy rehabilitation.Limb spasticity is one of the main clinical signs of cerebral palsy patients,and the more severe the limb spasticity is,the greater the impact on the patient's motor function,so improving limb spasticity in patients with cerebral palsy is particularly important.Acupuncture,as a Chinese medicine treatment method,has been widely used in the clinical treatment of cerebral palsy in China,and has shown certain efficacy.To promote the clinical application of acupuncture technique in cerebral palsy limb spasticity,this paper analyses and summarizes the relevant literature on acupuncture treatment of cerebral palsy limb spasticity summarizes the current status of the clinical application of acupuncture in cerebral palsy limb spasticity,and provides clinical references for the reasonable application of acupuncture in cerebral palsy limb spasticity.

Clinical Study on Improving Articulation Clarity in Spastic Cerebral Palsy with 120 Cases of Oral-Facial Acupressure Combined with Oral Placement Therapy

Objective:To observe the efficacy of oral-facial acupressure combined with oral placement therapy(OPT)in improving articulation clarity in 120 children with spastic cerebral palsy,and to explore effective therapeutic solutions for speech disorders associated with spastic cerebral palsy.Methods:A total of 120 children with spastic cerebral palsy and speech disorders,meeting the inclusion criteria,were randomly assigned into two groups:60 cases in the treatment group and 60 cases in the control group.The treatment group received orofacial acupressure combined with OPT,while the control group received only OPT.The Oral Motor Function Assessment Scale(OMFAS),developed by the China Rehabilitation Research Centre(CRRC),was used to evaluate the treatment outcomes before and after the intervention.Results:After the treatment,both the treatment and control groups showed improved mobility of the mandible,lips,and tongue.However,the treatment group exhibited significantly better improvement than the control group,with the difference between the two groups being statistically significant(P<0.05).Conclusion:Oral-facial acupressure combined with OPT can effectively improve articulation clarity in children with spastic cerebral palsy.This combined therapy is recommended for clinical promotion and application.

Effect of acupuncture on inflammatory cytokines expression of spastic cerebral palsy rats

Objective:To To investigate the effect of acupuncture on the tumor necrosis factor- α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),nitric oxide synthase(NOS) content and muscular tension of spasticity cerebral palsy rat model.Methods:The rats with spastic cerebral palsy were randomly divided into the control group,model group and acupuncture group.After successful modeling,the muscular tension and the content of TNF- α,IL-6,CRP.NOS were measured.Results:The serum TNF- α,IL—6,CRP,NOS content were significantly decreased in the acupuncture group(P<0.05).The low and high shear viscosity of whole blood of the acupuncture group were significantly lower than the control group and the model group(P<0.05).The erythrocyte electrophoresis indexes in the acupuncture group were significantly lower than that in the model group and the control group(P<0.05).Acupuncture significantly reduced the muscular tension of spastic cerebral palsy rat and increased the active extent in the paralytie extremity(P<0.05),but it could not be restored to normal level.Compared with the control group,the difference had significant(P<0.05).Conclusions:Acupuncture treatment can inhibit the release of inflammatory cells after brain injury,then reduce immune injury,relieve muscle spasms and reduce muscular tension.

Combined treatment using acupuncture and music therapy on children with cerebral palsy Gross motor function measure comparison in 60 cases

BACKGROUND： The use of acupuncture has received recognition to effectively treat cerebral palsy. Moreover, music therapy can be used to modify treatment of cerebral palsy. OBJECTIVE： To study the effects of combined treatment using acupuncture and music therapy on gross motor function measure （GMFM） of children with cerebral palsy, compared with acupuncture treatment alone. DESIGN, TIME AND SETTING： Randomized, controlled, clinical study. The experiment was conducted in Shenzhen Hospital of Traditional Chinese Medicine between January 2007 and September 2007. PARTICIPANTS： All children with cerebral palsy in the trial were from the outpatient department of Shenzhen Hospital of Traditional Chinese Medicine. The children were randomly divided into two groups： 30 children in Group B received acupuncture and music therapy, while 30 children in Group A received only acupuncture therapy. METHODS： Subjects in Groups A and B received acupuncture based on syndrome differentiation. The main acupoints were necessary for all participants. At first, flash needling was applied to the acupoints. For the remaining acupoints, the technique of transverse needling was applied to the head acupoints, and perpendicular needling was used for the other points. The inserted needles were twirled and then maintained for 30 minutes. The needle was twirled for one second every other 10 minutes, without reinforcing-reducing techniques. The therapy was performed every other day. The trial consisted of three periods each, and lasted for 84 days. Subjects in Group B received music therapy. They listened to music that they preferred while acupuncture was being performed. Following acupuncture, they were allowed to perform musical activities, such as percussion, singing, and dancing. The music therapy was scheduled for one hour, including listening to music for 30 minutes and music activities for 30 minutes. MAIN OUTCOME MEASURES： The comprehensive functional evaluation scale of cerebral palsy and the GMFM were applied to test symptoms before and after respective treatment. RESULTS： All 60 children were included in final analysis. The general function of all children with cerebral palsy improved, but the general efficiency in Group B was obviously higher than in Group A （93% and 73%, Х^2 = 4.32, P 〈 0.05）. GMFM evaluation showed that the function of crawling and kneeling, standing, and walking improved more significantly in Group B than in Group A （P 〈 0.05）, while the function of lying down, rolling, and sitting remained similar between the two groups （P 〉 0.05）. CONCLUSION： The combination of acupuncture and music therapy on the treatment of cerebral palsy is more effective than acupuncture alone. The various activities in music therapy may affect treatment of cerebral palsy.

ACUPUNCTURE THERAPY AND POINT-INJECTION OF MEDICINE FOR TREATMENT OF 32 CASES OF INFANTILE CEREBRAL PALSY

In the present study, 32 cases of infantile cerebral palsy were treated with acupunc-ture and point-injection therapies. Among them, 15 cases were cured basicaly, 7 markedly efec-tive, 9 improved and 2 failed, with a total effective rate being 93. 8%. The results showed thatthe therapies both could improve the microcirculation of the brain tissues in favour of recovery ofcerebral functions.

TREATMENT OF CEREBRAL PALSY WITH APHASIA BY LINGUISTIC TRAINING COMBINED WITH ACUPUNCTURE

Objective： To explore the best remedies for cerebral palsy with aphasia. Methods： A total of 76 cases of cerebral palsy children with aphasia were evenly randomized into control group and treatment group. Patients of treatment group were treated with “consciousness-restoring needling” plus linguistic training and these of control group treated with simple linguistic training method. Acupuncture was given once every other day, and linguistic training conducted once 6 times a week, with 10 times being a therapeutic course and the interval between two weeks being 10 - 15 days. Following 3 courses of treatment, the therapeutic effect was analyzed. Results. After 3 courses of treatment, of the two 38 cases in treatment and control groups, 27 （71.1% ） and 13 （34.2%） had remarkable improvement in their symptoms. The therapeutic effect of treatment group was significantly superior to that of control group （P 〈 0.01 ）. The developmental quotient values of speech of treatment and control groups were 56.36 ± 19.77 and 46.96± 15.63 respectively, displaying that acupuncture could significantly improve cerebral palsy patients＇ speaking ability （P〈0 05）. Conclusion. The therapeutic effect of acupuncture therapy plus linguistic training is significantly superior to that of simple linguistic training .

Therapies for children with cerebral palsy A Web of Science-based literature analysis

OBJECTIVE： To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL： We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2002 to 2011 retrieved from Web of Science. SELECTION CRITERIA： Inclusion criteria： （a） peer-reviewed published articles on botulinum toxin, constraint-induced movement therapy, or acupuncture for children with cerebral palsy indexed in Web of Science; （b） original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and （c） publication between 2002 and 2011. Exclusion criteria： （a） articles that required manual searching or telephone access; （b） documents that were not published in the public domain; and （c） a number of corrected papers from the total number of articles. MAIN OUTCOME MEASURES： （1） Number of publications on the three therapies; （2） annual publication output, distribution by journals, distribution by institution, and top-cited articles on botulinum toxin; （3） annual publication output, distribution by journal, distribution by institution, and top-cited articles on constraint-induced movement therapy; （4） annual publication, distribution by journal, distribution by institution, and top-cited articles on acupuncture. RESULTS： This analysis, based on Web of Science articles, identified several research trends in studies published over the past 10 years of three therapies for children with cerebral palsy. More articles on botulinum toxin for treating children with cerebral palsy were published than the articles regarding constraint-induced movement therapy or acupuncture. The numbers of publications increased over the 10-year study period. Most papers appeared in journals with a focus on neurology, such as Developmental Medicine and Child Neurology and Journal of Child Neurology.Research institutes publishing on botulinum toxin treatments for this population are mostly in the Netherlands, the United States of America, and Australia; those publishing on constraint-induced movement therapy are mostly in Australia and the United States of America; and those publishing on acupuncture are mostly in China, Sweden and the United States of America.CONCLUSION： Analysis of literature and research trends indicated that there was no one specific therapy to cure cerebral palsy. Further studies are still necessary.

A Randomised Controlled Study to Investigate Effects of Bobath Based Trunk Control Training on Motor Function of Children with Spastic Bilateral Cerebral Palsy

Purpose: The aim of this study was to investigate the effects of trunk control on motor function, which plays an important role in the daily activities of children with Cerebral Palsy (CP) and is often observed as a deficiency in children with CP. Material and Methods: Forty children with spastic bilateral CP, ages between 3 to 10 years and with Gross Motor Function Classification System (GMFCS) level I, II, and III were included in this study. Children were divided into two groups using randomization and in training group;Bobath Therapy for trunk control in addition to classical physiotherapy programs was performed for 45 minutes, for two days a week, for 6 weeks. In control group, existing physiotherapy program, 45 minutes for two days a week, continued. Any addition was not made into the existing program of the control group. Modified Ashworth Scale (MAS), Pediatric Berg Balance Scale (PBBS), Trunk Control Measurement Scale (TCMS), 1 Minute Walking Test (1MWT), Timed Up and Go Test (TUG) were applied to both groups before and after 6 weeks. Moreover, trunk muscle strength of children was evaluated. Results: After therapy, differences were found in results of MAS and PBBS, and trunk extensor strength between the training group and the control group in favor of the training group (p Conclusion: This study shows that adding exercises which aim trunk to conventional physiotherapy and exercise programs of children with CP, affects motor function positively.

CURRENT SITUATION OF CHINESE REHABILITATION TREATMENT OF CEREBRAL PALSY

Analyze present situation of treatment of cerebral palsy at home and abroad, review in detail concrete methods and studies of mechanisms of acupuncture and moxibustion as main therapeutic way adopted at home, probe characteristics and models of Chinese rehabilitation treatment for cerebral palsy. Results indicate that acupuncture and moxibustion treatment of cerebral palsy has very great potential social and economic results. Therefore, it is appropriate to approach establishment of a comprehensive rehabilitation system of cerebral palsy with Chinese characteristics, and with acupuncture and moxibustion used as main way.

Scalp acupuncture Yikang therapy on Baihui(GV20),Sishencong(EX-HN1),Zhisanzhen,Niesanzhen improves neurobehavior in young rats with cerebral palsy through Notch signaling pathway

OBJECTIVE:To investigate the efficacy of scalp acupuncture Yikang therapy on Baihui(GV20),Sishencong(EX-HN1),Zhisanzhen,Niesanzhen,on neurobehavior in young rats with cerebral palsy based on Notch signaling pathway.METHODS:Thirty 7-day-old rats were randomly divided into sham,model and acupuncture,10 rats in each group.The cerebral palsy model was established by the accepted modeling method,the acupuncture group selected"Baihui(GV20)","Sishencong(EX-HN1)","Zhisanzhen"and"Niesanzhen"for intervention 24 h after the model was made.The body masses were recorded before and after the treatment,respectively.After the intervention,the rats were subjected to suspension experiment,slope experiment,tactile stimulation experiment and Morris water maze experiment.After the end of the experiment,the morphological changes of hippocampal histology were observed by hematoxylineosin(HE)staining under light microscope,and the expression of Notch1,Notch3 and Hes5 were detected by Western blot and quantitative real-time polymerase chain reaction(PCR).RESULTS:The changes in body mass of the rats in each group were different;in behavioral experiments,compared with the sham,the suspension time of the model was shortened,the slope experiment,tactile stimulation experiment,and escape latency time were prolonged,and the number of platform crossing was reduced in the model,compared with the model,the suspension time of the acupuncture was prolonged,the slope experiment,tactile stimulation experiment,and escape latency time were shortened,and the number of platform crossing times was increased;HE staining showed severe hippocampal damage in the model and reduced hippocampal damage in the acupuncture.Western Blot and real-time fluorescence quantitative PCR showed that the expression of Notch1,Notch3 and Hes5 were increased in the model and the expression of Notch1,Notch3,Hes5 in acupuncture were decreased.CONCLUSIONS:Scalp acupuncture Yikang therapy may improve neurobehavior and reduce brain injury in rats with cerebral palsy by downregulating the expression of Notch1,Notch3,and Hes5.

CLINICAL OBSERVATION ON TREATMENT OF CHILD CEREBRAL PALSY WITH PENETRATION NEEDLING FROM SISHENCONG TO BAIHUI POINT

This study is designed to observe the therapeutic effect of penetrating needling Sishencong (EX-HN1 ) through to Baihui (GV 20), etc.. A total of 100 cases of infantile cerebral palsy were divided into acupuncture group (n = 50) and control group (n = 50, oral administration of cerebrolysin). After 3-4 courses of treatment, results showed that the total effective rates of acupuncture group and control group were 84. 0% and 48. 0 % respectively. Comparison between two groups in the effective rate showed a significant difference (P < 0.05 ), suggesting that the therapeutic effect of acupuncture stimulation is superior to that of Western medicine in treatment of child cerebral palsy.

Effect of acupuncture and tuina plus rehabilitative therapy on lower limb motor dysfunction in infants with spastic cerebral palsy

Objective： To observe the effect of acupuncture, tuina plus rehabilitative therapy on lower limb motor dysfunction in infants with spastic cerebral palsy. Methods： A total of 60 infants with spastic cerebral palsy were randomly divided into a treatment group and a control group by random digital table, 30 cases in each group. The treatment group was treated with acupuncture, tuina therapy plus rehabilitative therapy of Western medicine. The control group was simply treated with rehabilitative therapy of Western medicine, as same as that for the treatment group. The assessment was respectively given to the sick infants before the treatment and after the treatment of six months, to evaluate lying and rolling scores in dimension A, to evaluate sitting score in dimension B, to evaluate crawling and kneeling scores in dimension C, and evaluate standing score in dimension D in the gross motor functions and determine the muscle tone of the gastrocnemius muscle by modified Ashworth scale （MAS）. Results： The differences were not statistically significant in comparison of the gross motor functions and the muscle tone of the gastrocnemius muscle between the two groups of sick infants before the treatment （P〉O.OS）; after the treatment of six months, the above items were obviously improved in the two groups （P〈O.01）, better in the treatment group than in the control group, with the statistical significance in the differences between the groups （P〈O.01）. Conclusion： Acupuncture, tuina plus rehabilitative therapy of Western medicine are remarkable in the therapeutic effects in the treatment of motor disorders of the lower limbs in the sick infants with spastic cerebral palsy. This therapeutic method is safe, simple and convenient and needs to be clinically popularized and applied.

Clinical observation on acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy

Objective： To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy. Methods： A total of 80 cerebral palsy kids with fine motor dysfunction were allocated into two groups by envelop, 40 cases in each group. Cases in the control group were treated with occupation therapy. Based on the therapy given to the control group, cases in the treatment group were supplemented with acupuncture at the points of the three yang meridians of hand. The treatment was done every other day and 10 times for a course. There was a 15-day interval between two courses, and 3 courses in total. The therapeutic efficacies were evaluated using Peabody developmental motor scale 2 （PDMS-2） and modified Ashworth scale （MAS） before and after treatment. Results： After treatment, the standard score for grasping （Grs）, standard score for visual-motor integration （Vis）, fine motor quotient （FMQ） and modified Ashworth scale （MAS） were significantly improved in both groups （P〈0.05）. The improvement in the treatment group was more obvious than that in the control group （P〈0.01）. Conclusion： Acupuncture plus occupation therapy can achieve better effect than occupation therapy alone in improving fine motor functions of upper limbs in cerebral palsy kids.

Occupational therapy with or without combined acupuncture on upper limb pain and hand functions in children with spastic hemiplegic cerebral palsy:A three-arm randomized,placebo-controlled trial

Objective:This study is conducted to investigate the effects of occupational therapy(OT) with or without combined acupuncture for upper limb pain and hand functions among children with spastic hemiplegic cerebral palsy.Methods:A total of 90 patients who met the inclusion criteria were enrolled in a three-arm randomized,placebo-controlled trial,and were allocated to mono-occupational therapy(OT) group(patients=30),OT combined with real-acupuncture(ORA) group(patients=30),and OT combined with placeboacupuncture(OPA) group(patients=30),respectively.In addition to receiving the conventional OT program as the basic treatment for total 8 weeks,patients in ORA and OPA group also received corresponding acupuncture treatment 5 days per week for the first two weeks,3 days per week for the next two weeks,2 days per week for another two weeks,and 1 day per week for the last two weeks.Non-communicating children’s pain checklist-revised scale(NCCPC-R) was used for assessing the upper limb pain among patients.Squeeze dynamometry,modified Ashworth scale(MAS),manual muscle testing(MMT),JebsenTaylor hand function test(JTHFT) and box and block test(BBT) were used for assessing various aspects of upper limb and hand functions among patients.Meanwhile,adverse effects were monitored and recorded.Results:After 8-week treatment,NCCPC-R global scores witnessed a dramatic decline in ORA group(P<0.05),but not in either OPA(P> 0.05) or OT group(P> 0.05).Dramatic increases were identified in both squeeze dynamometry scores and MMT scores in all three groups(all P <0.05).Furthermore,the increases of ORA group were more significant than those of another two groups(both P <0.05).There were no significant changes in MAS global scores in each group(all P> 0.05).The BBT global scores of all three groups significantly increased(all P <0.05) after treatment.Among them,the increase of the ORA group was more than that of the other two groups(P <0.05).The 8-week treatment also had a significant impact on several sub-tests of JTFHT in each group.No significant adverse event was reported.Conclusion:ORA is a potential and promising alternative therapy for mitigating upper limb pain as well as improving both upper limb and hand functions among children with spastic hemiplegic cerebral palsy.

Effects of scalp acupuncture plus acupuncture exercise therapy on walking ability in children with spastic cerebral palsy

Objective:To compare the effect of scalp acupuncture and scalp acupuncture plus acupuncture exercise therapy(AET)on walking ability in children with spastic cerebral palsy(CP).Methods:A total of 60 spastic CP children with gross motor function classification system(GMFCS)gradesⅠ-Ⅲwere divided into a control group and an observation group by the random number table method,with 30 cases in each group.Both groups were treated with the same conventional rehabilitation and scalp acupuncture therapy for CP.The control group received conventional rehabilitation first and then scalp acupuncture.The observation group received AET,which was to receive the conventional rehabilitation and scalp acupuncture simultaneously.Before and after treatment,the clinical efficacy was evaluated by the modified Ashworth scale(MAS)score,scores of dimensions D and E of the gross motor function measure(GMFM)scale,walking speed,and walking distance.Results:During treatment,there were 2 dropouts in the observation group.After 3 courses of treatment,the MAS scores in both the control group and observation group decreased compared with the same group before treatment(P<0.05),and the scores of dimensions D and E of the GMFM,walking speed,and walking distance were increased(P<0.05);the between-group comparison showed that the MAS score in the observation group was lower than that in the control group(P<0.05),and the scores of dimensions D and E of the GMFM,walking speed,and walking distance in the observation group were higher or longer than those in the control group(P<0.05).Conclusion:W ith the same treatments,scalp acupuncture combined with AET is superior to the conventional scalp acupuncture method in reducing lower-limb muscle tone,improving standing balance ability,and walking stability in children with spastic CP.

Effects of acupuncture plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy

Objective To observe the clinical efficacy of acupuncture plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy,and analyze the effects on lower limb motor function,intelligence development level,immune function and cerebral hemodynamics.Methods A total of 42 children with spastic cerebral palsy were selected as the observation objects,and enrolled into the observation group.Another 42 cases treated in the same period were selected as the control group.Both groups received MOTOmed intelligent motor training,and the observation group was given additional acupuncture therapy,and the control group was given additional conventional rehabilitation treatment.After 2 consecutive treatment courses,the psychomotor development index(PDI)and mental development index(MDI)of Children’s Developmental Center of China(CDCC)scale,the scores of gross motor function measure(GMFM)scale and modified Ashworth scale(MAS),and the changes in CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)were observed.The peak systolic velocity(PSV)and mean flow velocity(MFV)of the anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA)were observed and measured.The clinical efficacy was evaluated.Results Compared with the same group before treatment,the scores of GMFM,PDI and MDI,levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+),PSV and MFV levels of ACA,MCA and PCA in both groups were significantly increased after treatment(all P<0.05),while the CD8^(+)level had no significant change(both P>0.05).After treatment,the total effective rate of lower limb spasm in the observation group was 90.5%,significantly higher than 71.4%in the control group(P<0.05).The scores of GMFM,PDI and MDI,the levels of CD3^(+)and CD4^(+),PSV and MFV,and the levels of ACA,MCA and PCA in the observation group were all significantly higher than those in the control group(all P<0.05).There were no significant differences in the CD8^(+)level and CD4^(+)/CD8^(+)between the groups(all P>0.05).Conclusion Acupuncture plus MOTOmed intelligent motor training has a better clinical efficacy than conventional rehabilitation plus MOTOmed intelligent motor training in treating children with spastic cerebral palsy,and is also superior in improving lower limb motor function and the level of intellectual development.And the mechanism may be related to the improvement of cerebral hemodynamics.

Acupuncture Combined with Music Therapy for Treatment of 30 Cases of Cerebral Palsy

To observe clinical therapeutic effects of acupuncture combined with music therapy for treatment of cerebral palsy. Methods： Sixty children with cerebral palsy were randomly divided into an acupuncture group （Group Acup.） and an acupuncture plus music group （Group Acup.＋ M）. Simple acupuncture was applied in Group Acup., and acupuncture at 5 groups of points plus music were applied in Group Acup. ＋M., The treatment was given once every two days with 3 treatments weekly, and 36 treatments constituted a therapeutic course. Therapeutic effects including movement improvement were observed for comparison after 3 courses of treatments. Results： The comprehensive functions were elevated in both groups, and the total effective rate in Group Acup. ＋ M was obviously better than that in Group Acup （P〈0.05）. Movement functions were also improved in both groups, but the differences in improvement of creeping and kneeling, standing, and walking were significant between the two groups （P〈0.01）, showing the effect in Group Acup. ＋ M was better than that in Group Acup.. Conclusion： The therapy of acupuncture plus music gained better therapeutic effect on cerebral palsy than simple acupuncture, which provided new thoughts for treating the disease by comprehensive therapies.

Clinical study on acupuncture combined with low-frequency electric stimulation for scissor gait in children with spastic cerebral palsy

Objective：To observe the clinical effect of acupuncture combined with low-frequency electric stimulation on scissor gait in children with spastic cerebral palsy. Methods：A total of 60 spastic cerebral palsy kids were allocated into two groups by random number table, 30 in each group. Cases in the control group were treated with physical exercise therapy, massage and hydrotherapy. Based on the therapies given to the control group, cases in the observation group were supplemented with acupuncture combined with low-frequency electric stimulation. Selected points included Zusanli （ST 36）, Sanyinjiao （SP 6）, Yanglingquan （GB 34）, Jiexi （ST 41）, Chengshan （BL 57）, Naoqing [Extra, locates at 2 cun directly above Jiexi （ST 41）] and Genping （Extra, locates at the midpoint of the line connecting medial and lateral malleolus）. The treatment was done once every other day and 10 d made up a treatment course. The low-frequency electric stimulation was applied to anterior tibia, 6 times a week and 20 times made up a treatment course. Cases were treated for a total of 3 courses and there was a 15-20 d interval between two courses. The low limb functions were assessed before and after treatment using the modified Ashworth scale （MAS） and composite spasticity scale （CSS）. In addition, the ankle dorsiflexion angles were measured before and after treatment. Results：After treatment, the ankle dorsiflexion angles and CSS scores in the observation group were better than those in the control group, showing statistical significances （P〈0.05）; the effective rate in the observation group calculated by MAS and ankle dorsiflexion angle were both higher than that in the control group, showing a statistical significance （P〈0.05）. Conclusion：Rehabilitation training combined with acupuncture and low-frequency electric stimulation can achieve better effect than rehabilitation training alone in improving scissor gait in kids with spastic cerebral palsy.

Pseudobulbar Paralysis Treated by Acupuncture——Clinical Observation in 36 Cases

Pseudobulbar paralysis is a kind of common clinical syndromes of cerebral vascular diseases, which is manifested as dyslalia, dysphagia and choking. By several-year clinical observations, 36 cases were treated with satisfactory therapeutic effects as reported in the following.Clinical DataOf 36 in-patients, there were 24 males and 12 females, aged from 44 to 81 years, averaging 64.92 years. Of 36 cases, 24 were at the acute stage and 12 at the recovery stage. All the cases were diagnosed as cerebral vascular diseases by cranial CT scan and MRI, of which, 4 were cerebral infarction, 26 lacunar cerebral infarction, 5 cerebral hemorrhage and 1 mixed type. Of 36 cases, 15 were the first attack of wind-stroke, 15 the second attack, 5 the third attack and 1 the forth attack. There were 26 patients with hypertension among 36 cases, of which, 8 patients suffered from hypertension within 10 years, 6 for more than 10 years, 9 for more than 20 years and 3 for more than 30 years. All the 36 cases were associated with dysphagia and agreeable to Standard on Diagnosis and Evaluation of Therapeutic Effects of Wind-stroke issued by the State Scientific Committee 85-919-01-01, 1995.

Therapeutic efficacy of acupuncture plus Tuina for spastic cerebral palsy and discussion of its mechanism

Objective To discuss the effects of acupuncture plus Tuina(Chinese therapeutic massage)in intervening the mental development,motor function,cerebral hemodynamics,and muscle tone in kids with spastic cerebral palsy(CP).Methods A retrospective analysis was conducted on 87 kids with spastic CP.They were divided into a control group and an observation group based on their original treatment plan.Kids in the control group received symptomatic treatment,motor development therapy,and Tuina treatment.The observation group was additionally given acupuncture treatment.One month was taken as a treatment course.After six courses,the efficacy,change in muscle tone,mental development,gross motor function,fine motor function,and the systolic velocity(Vs),mean velocity(Vm),and pulsatility index(PI)of the anterior cerebral artery(ACA),middle cerebral artery(MCA),and posterior cerebral artery(PCA)were compared between the two groups.Results After treatment,the muscle tone score dropped in both groups(P<0.05)and was significantly lower in the observation group than in the control group(P<0.05).The observation group achieved more significant efficacy than the control group(P<0.05).After the intervention,the mental development index(MDI),psychomotor development index(PDI),gross motor function measure(GMFM)score,and fine motor function measure(FMFM)score all increased in both groups(P<0.05)and were notably higher in the observation group than in the control group(P<0.05).After treatment,the Vs and Vm of the ACA,MCA,and PCA were markedly higher in the observation group than in the control group(P<0.05),and the observation group was significantly lower than the control group comparing the PI of the ACA,MCA,and PCA(P<0.05).Conclusion Based on the symptomatic treatment and motor development therapy,Tuina and acupuncture treatment can effectively treat spastic CP children,manifesting as reducing muscle tone,boosting mental development,and improving motor function and cerebral hemodynamics.