Abstract
Background: Poststroke spasticity (PSS) is a common complication of stroke. Current PSS treatments have been linked to high costs, lack of long-term effectiveness, and undesirable side effects. Vibrational and heated stone-needle therapy (VHS) has not been utilized to treat PSS, and its safety and effectiveness have yet to be proven by high-quality clinical research. Objective: The aim of this study was to determine the effectiveness of VHS combined with meridian dredging exercise (MDE) in patients with PSS. Methods: One hundred participants with stroke were included and randomly assigned to a treatment group (VHS plus MDEs) and a control group (MDEs alone). Patients in both groups were treated for 4 weeks. The primary outcome measures were the Modified Ashworth Scale (MAS) and Fugl-Meyer Assessment (FMA), while the secondary outcome measures were the Activity of Daily Living (ADL) Scale and Stroke-Specific Quality of Life Scale (SS-QOL). The evaluations were at baseline (T0) at 4 weeks of treatment (T1) and at 12 weeks of follow-up without treatment (T2). Results: At T1 and T2, there were significant differences in MAS between the two groups (p = 0.001). From the perspective of distribution, the VHS plus MDE group had significant changes, and the group-time interactions of upper and lower extremities in FMA, ADL, and SS-QOL were statistically significant (p < 0.001), indicating that patients’ symptoms improved after treatment. But the overall effect size is small, especially the effect size of improvement in SS-QOL at T1. Conclusion: VHS in combination with MDE can consistently alleviate PSS, enhance limb function, and improve the quality of life of patients with PSS. But we need to optimize the device further and observe the improvement of patients for a more extended period.
Journal Section:
Research Article / Originalarbeit
References
1.
Li
S
, Francisco
GE
. New insights into the pathophysiology of post-stroke spasticity
. Front Hum Neurosci
. 2015
;9
:192
.2.
Urban
PP
, Wolf
T
, Uebele
M
, Marx
JJ
, Vogt
T
, Stoeter
P
. Occurence and clinical predictors of spasticity after ischemic stroke
. Stroke
. 2010
;41
(9
):2016
–20
.3.
Wissel
J
, Schelosky
LD
, Scott
J
, Christe
W
, Faiss
JH
, Mueller
J
. Early development of spasticity following stroke: a prospective, observational trial
. J Neurol
. 2010
;257
(7
):1067
–72
.4.
Bethoux
F
. Spasticity Management after stroke
. Phys Med Rehabil Clin N Am
. 2015
;26
(4
):625
–39
.5.
Brady
MC
, Kelly
H
, Godwin
J
, Enderby
P
, Campbell
P
. Speech and language therapy for aphasia following stroke
. Cochrane Database Syst Rev
. 2016
2016
CD000425
.6.
Brady
MC
, Godwin
J
, Kelly
H
, Enderby
P
, Elders
A
, Campbell
P
. Attention control comparisons with SLT for people with aphasia following stroke: methodological concerns raised following a systematic review
. Clin Rehabil
. 2018
;32
(10
):1383
–95
.7.
Chavez
LM
, Huang
SS
, MacDonald
I
, Lin
JG
, Lee
YC
, Chen
YH
. Mechanisms of acupuncture therapy in ischemic stroke rehabilitation: a literature review of basic studies
. Int J Mol Sci
. 2017
;18
(11
):2270
.8.
Zhang
AJ
, Wang
S
, Wang
P
, Wang
YR
. Progress in pathological mechanism of ischemic stroke and prevention and treatment of traditional Chinese Medicine
. Chin J Exp Trad Med Formulae
. 2020
;26
(5
):227
–40
.9.
Huang
XY
, Xia
QF
, Zhu
HW
, Jiang
SY
, Yu
Y
, Zhu
RJ
. Therapeutic effect on post-stroke spastic paralysis of upper extremity treated with combination of kinematic-acupuncture therapy and rehabilitation training
. Zhongguo Zhen Jiu
. 2020
;40
(5
):473
–8
.10.
Yang
L
, Tan
JY
, Ma
H
, Zhao
H
, Lai
J
, Chen
JX
. Warm-needle moxibustion for spasticity after stroke: a systematic review of randomized controlled trials
. Int J Nurs Stud
. 2018
;82
:129
–38
.11.
Cai
Y
, Zhang
CS
, Liu
S
, Wen
Z
, Zhang
AL
, Guo
X
. Electroacupuncture for poststroke spasticity: a systematic review and meta-analysis
. Arch Phys Med Rehabil
. 2017
;98
(12
):2578
89.e4
.12.
Xiao
F
, Li
LY
, Qian
X
. Research progress on rehabilitation of limb dysfunction after stroke
. Shanxi Med J
. 2017
;46
(22
):2740
–3
.13.
Wu
HM
, Tang
JL
, Lin
XP
, Lau
J
, Leung
PC
, Woo
J
. Acupuncture for stroke rehabilitation
. Stroke
. 2008
;39
(2
):517
–8
.14.
Huang
CS
, Fan
WC
, Yu
AS
, Cui
XK
, Wu
J
. Penetrating acupuncture at Baxie (EX-UE 9) combined with rehabilitation for swelling hand of post-stroke shoulder-hand syndrome
. Zhongguo Zhen Jiu
. 2017
;37
(2
):121
–4
.15.
Mei
J
, Xue
Y
, Li
J
, Zhang
L
, Zhang
J
, Wang
Y
. Effects of functional acupuncture on upper limb spasticity after ischemic stroke: a protocol for a randomized controlled parallel clinical trial
. Front Neurol
. 2022
;13
:835408
.16.
Huang
T
, Han
B
, Tian
YY
, Wang
GJ
, Jia
SY
, Zhang
WB
. Low back pain of cold-damp pattern treated with electric-thermal Bian-stone therapy and traditional moxibustion: a randomized controlled trial
. Zhongguo Zhen Jiu
. 2014
;34
(6
):585
–9
.17.
Hatano
S
. Experience from a multicentre stroke register: a preliminary report
. Bull World Health Organ
. 1976
;54
(5
):541
–53
.18.
Lu
J
, Zhang
J
, Zhou
H
. Study for the effect of “collateral dredging therapy” on rehabilitation nursing of patients with stroke
. J Nurs Train
. 2016
;31
(21
):1937
–40
.19.
Chinese Society of Neurology
. Chinese guideline for the secondary prevention of ischemic stroke and transient ischemic attack 2022
. Chin J Neurol
. 2022
;55
(10
):1071
–110
.20.
Lu
J
, Liu
Y
, Zhao
J
. Effect of original collateral dredging therapy on self-care ability of stroke patients during convalescence
. J Nurs Sci
. 2011
;26
(09
):75
–7
.21.
Griessenauer
CJ
, Medin
C
, Maingard
J
, Chandra
RV
, Ng
W
, Brooks
DM
. Endovascular mechanical thrombectomy in large-vessel occlusion ischemic stroke presenting with low national institutes of health stroke scale: systematic review and meta-analysis
. World Neurosurg
. 2018
;110
:263
–9
.22.
Hsueh
IP
, Hsu
MJ
, Sheu
CF
, Lee
S
, Hsieh
CL
, Lin
JH
. Psychometric comparisons of 2 versions of the fugl-meyer motor scale and 2 versions of the stroke rehabilitation assessment of movement
. Neurorehabil Neural Repair
. 2008
;22
(6
):737
–44
.23.
Ho
J
, Ngai
SPC
, Wu
WKK
, Hou
WK
. Association between daily life experience and psychological well-being in people living with nonpsychotic mental disorders: protocol for a systematic review and meta-analysis
. Medicine
. 2018
;97
(4
):e9733
.24.
Lima
RCM
, Nascimento
LR
, Michaelsen
SM
, Polese
JC
, Pereira
ND
, Teixeira-Salmela
LF
. Influences of hand dominance on the maintenance of benefits after homebased modified constraint-induced movement therapy in individuals with stroke
. Braz J Phys Ther
. 2014
;18
(5
):435
–44
.25.
Wang
HQ
, Hou
M
, Bao
CL
, Min
L
, Li
H
. Effects of acupuncture treatment on lower limb spasticity in patients following hemorrhagic stroke: a pilot study
. Eur Neurol
. 2019
81
1–2
5
12
.26.
Beran
RG
. The ethics of clinical research and the conduct of clinical drug trials: international comparisons and codes of conduct
. Med Law
. 2000
;19
(3
):501
–21
.27.
Johnson
GR
. Outcome measures of spasticity
. Eur J Neurol
. 2002
9
s1
10
6
.28.
Nair
KP
, Marsden
J
. The management of spasticity in adults
. BMJ
. 2014
349
g4737
.29.
Blackburn
M
, van Vliet
P
, Mockett
SP
. Reliability of measurements obtained with the modified ashworth scale in the lower extremities of people with stroke
. Phys Ther
. 2002
;82
(1
):25
–34
.30.
Aloraini
SM
, Gäverth
J
, Yeung
E
, MacKay-Lyons
M
. Assessment of spasticity after stroke using clinical measures: a systematic review
. Disabil Rehabil
. 2015
;37
(25
):2313
–23
.31.
Gladstone
DJ
, Danells
CJ
, Black
SE
. The fugl-meyer assessment of motor recovery after stroke: a critical review of its measurement properties
. Neurorehabil Neural Repair
. 2002
;16
(3
):232
–40
.© 2023 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2023
You do not currently have access to this content.
