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Randomized Controlled Trial
. 2014:9:147-56.
doi: 10.2147/CIA.S53814. Epub 2014 Jan 10.

Selection of acupoints for managing upper-extremity spasticity in chronic stroke patients

Bi-Huei Wang  1 , Chien-Lin Lin  2 , Te-Mao Li  3 , Shih-Din Lin  4 , Jaung-Geng Lin  5 , Li-Wei Chou  6
Affiliations
Randomized Controlled Trial

Selection of acupoints for managing upper-extremity spasticity in chronic stroke patients

Bi-Huei Wang et al. Clin Interv Aging. 2014.

Abstract

Background: This study investigated the clinical efficacy of electroacupuncture (EA) in inhibiting upper-extremity spasticity in chronic stroke patients, and also in mapping a unique preliminary acupoint-selection protocol.

Methods: Fifteen patients were divided into two groups: patients in the control group (n=6) received minimal acupuncture (MA), and those in the experimental group (n=9) received EA. Four acupoints, which include Neiguan (PC6), Shaohai (HT3), Zeqian (Ex-UE, A32), and Shounizhu (EX-UE), were treated near the motor points of the muscles for elbow flexion, forearm pronation, and finger flexion. Both groups were treated for twelve sessions, 20 minutes per session, for 6 weeks (two sessions per week). The outcome measures in this study included angle of muscle reaction (R1), passive range of motion (R2), and dynamic component (R2-R1).

Results: In the experimental group, the R2-R1 of the elbow joint was significantly decreased at 1 (P=0.0079), 3 (P=0.0013), and 6 weeks (P=0.0149) after treatment compared with pretreatment levels (P<0.05). The between-group difference in the R2-R1 of the elbow joint after the 6-week treatment was statistically significant.

Conclusion: Combining the 6-week EA and standard rehabilitation treatment reduced the spasticity of the elbow for chronic stroke survivors. However, no significant effect was observed in the spasticity of the wrist joints. The choice of acupoints and the frequency of EA have to be taken into account to achieve a positive treatment effect. The correlation between acupoints and motor points provides a model of acupoint selection to improve spasticity.

Keywords: acupoints; acupuncture; electroacupuncture; motor point; spasticity; stroke.

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Figures

Figure 1
Figure 1
Flow diagram showing the paths for recruited patients. Abbreviations: EA, electroacupuncture; SR, standard rehabilitation; MA, minimal acupuncture.
Figure 2
Figure 2
Intragroup and between-group change of R2–R1 of elbow joint and wrist joint. *P<0.05.
Figure 3
Figure 3
Comparison of acupoints used in this study and motor point of forearm muscle (drawn by Wang). Abbreviations: Ex-UE, extra acupuncture point instead of meridian acupuncture point.
See this image and copyright information in PMC

References

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    1. Sommerfeld DK, Eek EU, Svensson AK, Holmqvist LW, von Arbin MH. Spasticity after stroke: its occurrence and association with motor impairments and activity limitations. Stroke. 2004;35(1):134–139. - PubMed
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