Stroke Spasticity and Acupuncture: A Study

Spasticity: a major problem

There are two kinds of paralysis – flaccidity and spasticity.  Flaccid means the muscles have no tone and are soft.  Spastic means they’re tight and hard to move.

A major problem with spasticity is that it is difficult to help the patient move around, leading to caregiver fatigue.  Also, spasticity leads to pain.  This makes rehabilitation more difficult.

Can acupuncture help?

Physical Therapy and Rehabilitation remain standard for Stroke treatment, but acupuncture can help. photo by Praisang / http://www.freedigitalphotos.net

The Study

Here we take a look at a study entitled “Electro-acupuncture for post-stroke spasticity: a systematic review and meta-analysis.’ (link) by Cai, et al.

What they did was to look at various studies and try to put the information together.

DATA SOURCES:

Five English (PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and AMED) and four Chinese databases (CBM, CNKI, CQVIP and Wanfang) were searched from their inception to September 2016.

DATA SELECTION:

Randomized controlled trials were included if they measured spasticity with Modified Ashworth Scale in stroke patients and investigated the add-on effects of electro-acupuncture to routine pharmacotherapy and rehabilitation therapies.

DATA EXTRACTION:

Information on patients, study design, treatment details and outcomes assessing spasticity severity, motor function and activity of daily living were extracted.

The Results

In total, 22 trials met the search criteria and were included involving 1,425 participants. The estimated add-on effects of EA to reduce spasticity in upper limb measured by MAS (SMD: -0.57[-0.84, -0.29]) and improve overall motor function measured by FMA (MD: 10.60[8.67, 12.53]) were significant. It was also found that for spasticity in lower limb, lower-limb motor function and activity of daily living, significant add-on effects of EA were also shown (SMD: -0.88[-1.42, -0.35], MD:4.42[0.06, 8.78] and MD: 6.85[3.64, 10.05] respectively), though with high heterogeneity. For upper-limb motor function, no significant add-on effects of EA was received.

What this means is that when they tried to estimate how much good effect electroacupuncture did, there was a significant increase from normal.  This was true for arm and leg spasticity.  When it comes to function, it seems that arm movement wasn’t that increased.

Reference:

Cai Y, Zhang CS, Liu S, Wen Z, Zhang AL, Guo X, Lu C, Xue CC. “Electro-acupuncture for post-stroke spasticity: a systematic review and meta-analysis.” Arch Phys Med Rehabil. 2017 Apr 25. pii: S0003-9993(17)30257-5. doi: 10.1016/j.apmr.2017.03.023.
Dr. Philip Nino Tan-Gatue

Dr. Philip Nino Tan-Gatue MD, CAc, CMA,is one of the leading experts in Traditional Medicine and Chinese Medicine in the Philippines. Currently, he is a Clinical Associate Professor in the University of the Philippines College of Medicine and is Director of Acupuncture Services at The Medical City.
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