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


CONCLUSIONS
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.
Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan.
Bi-Huei
BH
Wang
Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan ; School of Chinese Medicine, College of Chinese Medicine, Taichung, Taiwan.
Chien-Lin
CL
Lin
School of Chinese Medicine, College of Chinese Medicine, Taichung, Taiwan ; Graduate Institute of Acupuncture Science, Taichung, Taiwan.
Te-Mao
TM
Li
Graduate Institute of Acupuncture Science, Taichung, Taiwan.
Shih-Din
SD
Lin
School of Chinese Medicine, College of Chinese Medicine, Taichung, Taiwan.
Jaung-Geng
JG
Lin
Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan ; School of Chinese Medicine, College of Chinese Medicine, Taichung, Taiwan ; Acupuncture Research Center, China Medical University, Taichung, Taiwan.
Li-Wei
LW
Chou
D015669:Acupuncture Points; D015671:Electroacupuncture / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000628:therapy*; D016059:Range of Motion, Articular / Q000502:physiology; D016037:Single-Blind Method; D020521:Stroke / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology
acupoints; acupuncture; electroacupuncture; motor point; spasticity; stroke