title: Efficacy and safety of transcutaneous electrical acupoint stimulation to treat muscle spasticity following brain injury: a double-blinded, multicenter, randomized controlled trial.
abstract: OBJECTIVE
  This study was aimed at evaluating the clinical efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) to treat muscle spasticity after brain injury (Chinese Clinical Trial Registry: ChiCTR-TRC-11001310).
  
  
  METHODS
  A total of 60 patients with muscle spasticity after brain injury were randomized to the following 3 groups: 100, 2, and 0 Hz (sham) TEAS. The acupoints Hegu (LI4)--Yuji (LU10) and Zusanli (ST36)--Chengshan (BL57) on the injured side were stimulated at 0, 2, or 100 Hz, 5 times per week for 4 weeks. The patients were followed up for 1 and 2 months after the treatments. The effects of the treatments on muscle spasticity at the wrist, thumb, the other 4 fingers, elbow, shoulder, knee, and ankle were evaluated by the Modified Ashworth Scale, and the effects on disability were assessed by the Disability Assessment Scale. The walking capability was evaluated by the Holden functional ambulation classification score. The overall performance was assessed by the Global Assessment Scale score and the improved Barthel Index. The safety of the treatments administered was also monitored.
  
  
  RESULTS
  The wrist spasticity was significantly reduced from baseline at weeks 2, 3, and 4 of treatment and at the 1- and 2-month follow-up visits in the 100 Hz group (P < 0.01). Compared with 2 Hz or sham TEAS, 100 Hz TEAS decreased wrist spasticity at weeks 2, 3, and 4 of treatment and 1 month after treatment (P < 0.001). The other endpoints were not affected by the treatments. No treatment-emergent adverse events were reported during treatments and follow-up visits.
  
  
  CONCLUSIONS
  TEAS appears to be a safe and effective therapy to relieve muscle spasticity after brain injury, although large-scale studies are required to further verify the findings.
  
  
  BACKGROUND
  Chinese Clinical Trial Registry ChiCTR-TRC-11001310 http://www.chictr.org.
authors: Department of Neurology, Tianjin Nankai Hospital, Tianjin, 300100, China.
authors: Wenli
authors: W
authors: Zhao
authors: Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
authors: Chao
authors: C
authors: Wang
authors: Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
authors: Zhongzheng
authors: Z
authors: Li
authors: Department of Acupuncture and Moxibustion, Tianjin Ninghe Hospital, Tianjin, 301500, China.
authors: Lei
authors: L
authors: Chen
authors: Department of Acupuncture and Moxibustion, Tianjin Ninghe Hospital, Tianjin, 301500, China.
authors: Jianbo
authors: J
authors: Li
authors: Department of Acupuncture and Moxibustion, Tianjin Ninghe Hospital, Tianjin, 301500, China.
authors: Weidong
authors: W
authors: Cui
authors: Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
authors: Shasha
authors: S
authors: Ding
authors: Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
authors: Qiang
authors: Q
authors: Xi
authors: Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
authors: Fan
authors: F
authors: Wang
authors: Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
authors: Fei
authors: F
authors: Jia
authors: Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
authors: Shuhua
authors: S
authors: Xiao
authors: Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China.
authors: Yi
authors: Y
authors: Guo
authors: Department of Clinical Research, Tianjin Nankai Hospital and Tianjin Academy of Integrative Medicine, Tianjin, 300100, China.
authors: Ye
authors: Y
authors: Zhao
mesh_terms: D015669:Acupuncture Points; D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications*; D004311:Double-Blind Method; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000150:complications* / Q000628:therapy*; D012449:Safety; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome; D014953:Wrist / Q000503:physiopathology; D055815:Young Adult
references: Acupunct Electrother Res. 2010;35(3-4):147-85
references: 21319603
references: J Neurol Phys Ther. 2010 Dec;34(4):208-13
references: 21084922
references: Clin Physiol Funct Imaging. 2011 Sep;31(5):363-70
references: 21771255
references: Eur J Neurol. 2012 Jan;19(1):21-7
references: 21707868
references: Acupunct Electrother Res. 2011;36(3-4):231-58
references: 22443026
references: J Rehabil Med. 2012 Sep;44(9):747-55
references: 22854805
references: Stroke. 2012 Nov;43(11):3132-6
references: 22984012
references: Am J Chin Med. 2013;41(2):301-13
references: 23548121
references: Trials. 2013;14:153
references: 23710881
references: Int J Neurosci. 2013 Dec;123(12):850-8
references: 23819835
references: Anesthesiology. 2014 Feb;120(2):482-503
references: 24322588
references: J Neurosci Res. 2014 May;92(5):555-63
references: 24482187
references: Chin Med J (Engl). 1994 Jan;107(1):6-11
references: 8187575
references: Br Med Bull. 2000;56(2):476-85
references: 11092096
references: Arch Gen Psychiatry. 1976 Jun;33(6):766-71
references: 938196
references: Phys Ther. 1987 Feb;67(2):206-7
references: 3809245
references: Stroke. 1989 Jun;20(6):766-9
references: 2728043
references: J Clin Epidemiol. 1989;42(8):703-9
references: 2760661
references: Pain. 1991 Dec;47(3):295-8
references: 1686080
references: Zhonghua Yi Xue Za Zhi. 1993 Oct;73(10):593-5, 637
references: 8313180
references: J Neurol Neurosurg Psychiatry. 1994 Jul;57(7):773-7
references: 8021658
references: Ann Intern Med. 2004 Dec 21;141(12):911-9
references: 15611488
references: Clin Rehabil. 2005 Mar;19(2):117-25
references: 15759526
references: Arch Phys Med Rehabil. 2005 Jun;86(6):1234-8
references: 15954065
references: Am J Phys Med Rehabil. 2005 Aug;84(8):584-92
references: 16034227
references: Brain Res Bull. 2005 Oct 15;67(3):189-95
references: 16144654
references: Pain. 2007 Feb;127(3):214-20
references: 17030438
references: J Rehabil Med. 2007 Jan;39(1):33-7
references: 17225035
references: Clin Med Res. 2007 Jun;5(2):132-8
references: 17607049
references: Integr Cancer Ther. 2007 Sep;6(3):251-7
references: 17761638
references: Curr Med Res Opin. 2008 Feb;24(2):425-39
references: 18167175
references: J Rehabil Med. 2009 Apr;41(5):312-6
references: 19363561
references: Pain. 2011 Mar;152(3 Suppl):S41-8
references: 21078546