Effectivenss of electroacupuncture for skeletal muscle pain in Parkinson's disease: a Clinical randomized controlled trial

Abstract

Objective: To explore the effect of electroacupuncture on skeletal muscle pain in Parkinson's disease (PD).

Methods: A single-center randomized controlled trial was conducted with sixty patients with Parkinson's disease with skeletal muscle pain were randomly divided into electroacupuncture group and sham acupuncture control group with 30 patients each. The electric acupuncture group was treated with electric acupuncture, while the control group was treated with Park needle pseudoacupuncture. Both groups were treated 5 times a week for a total of 4 weeks, and both groups completed 20 treatments. King's Parkinson's Pain Scale (KPPS) and visual analog scale (VAS) were used before and after treatment to evaluate the pain degree of patients. Real-time shear wave elastography (SWE) and modified Ashworth score (MAS) were used to evaluate the changes of muscle tone. Parkinson's comprehensive Score Scale (MDS-UPDRS, including UPDRSⅡ and UPDRS Ⅲ) was used to evaluate exercise ability. Hamilton Depression Scale (HAMD) score was used to evaluate the emotional changes of patients. Spearman correlation analysis was used to explore the correlation between pain degree and muscle tone, exercise ability and emotion.

Results: During the study, one case fell off in the control group, and 30 cases were eventually included in the analysis and treatment group and 29 cases in the control group. After treatment, Young's modulus of biceps and quadriceps and shear wave velocity of biceps were decreased in electroacupuncture group compared with before treatment, while KPPS score, VAS score, UPDRSⅡ, UPDRS Ⅲ and modified Ashworth score were decreased, with statistical significance (P < 0.05). There was no statistical significance in control group (P > 0.05). After treatment, KPPS score, VAS score, UPDRSⅡ and UPDRS Ⅲ, MAS, HAMD score, Young's modulus of biceps and shear wave velocity in electroacupuncture group were significantly lower than those in control group (P < 0.05). Spearman correlation analysis showed that KPPS score was positively correlated with UPDRS Ⅲ (r = 0.414, P < 0.05). KPPS score was positively correlated with HAMD score (r = 0.576, P < 0.01).

Conclusion: Electroacupuncture therapy can effectively improve skeletal muscle pain in patients with Parkinson's disease, reduce the muscle hardness of patients, improve patients' daily life ability, and improve patients' emotional disorders. The degree of skeletal muscle pain in PD patients is correlated with motor ability and emotional disorders, but there is no significant correlation between the degree of skeletal muscle pain and the muscle tone of PD patients.

Keywords: Parkinson disease; electroacupuncture; mood disorders; muscle tention; muscle, skeletal, pain; randomized controlled trial.

Figure 1. Flow chart of a randomized controlled clinical study of electroacupuncture for skeletal muscle pain in Parkinson's disease

Figure 2. Correlation between KPPS score and SWE velocity of the biceps, Young's modulus of the biceps, MAS

A: correlation between KPPS score and SWE velocity of the biceps; B: correlation between KPPS score and Young's modulus of the biceps; C: correlation between KPPS score and MAS. KPPS: King's Parkinson's Pain Scale; SWE: Shear wave ultrasonic elastography; MAS: modified Ashworth score.

Figure 3. Correlation between KPPS score and UPDRS Ⅲ, HAMD score

A: correlation between KPPS score and UPDRS Ⅲ score; B: correlation between KPPS score and HAMD score. KPPS: King's Parkinson's Pain Scale; UPDRS Ⅲ: Unified-Parkinson Disease Rating for motor function examination; HAMD: Hamilton depression scale.