Efficacy of a poly-herbal Unani formulation and dry cupping in treatment of post-stroke hemiplegia: An exploratory, single arm clinical trial

Abstract

Background and objectivesHemiplegia exhibits persistent disability of motor functions in patients. Unani physicians mentioned the treatment of hemiplegia (Fālij-i-Nisfi) and postulated several treatment regimes. This study examines an Unani approach to treatment of post-stroke hemiplegia Methods30 eligible patients of post-stroke hemiplegia with residual motor functional disabilities were enrolled in an open, single arm, pre and post, exploratory clinical trial with 30 days treatment duration. A decoction of a Unani polyherbal formulation of phlegmatic concoctive drugs (Joshanda Munzij-i-Balgham) was given orally once in the morning for 15 days. The ingredients of phlegmatic purgative formulation were added on 12th and 15th day in phlegmatic concoctive formulation. From 16th day to 30th day of the study, dry cupping (Hijamah Bila Shart) was performed at muscles origins of paralyzed limbs for 10 min daily. Patients were assessed for motor recovery by Motor Assessment Scale and Barthel Index at baseline, 15th and 30th day of treatment. ResultsThe Mean ± SD of Barthel Index (BI) at 0 day was 44.00 ± 14.17; while it improved to 50.83 ± 13.52 at 15th day and 65.00 ± 12.32 at 30th day. The Mean±SD of Motor Assessment scale (MAS) at 0 day was 15.80 ± 4.05 while it was 19.70 ± 5.26 at 15th day and 22.33 ± 4.95 at 30th day. Significant statistical difference in BI and MAS was observed in motor recovery of paralyzed limbs at 15th and 30th day (p < 0.001). ConclusionA poly-herbal Unani formulation (Munzij wa Mus′hil Balgham) and dry cupping were found to be an effective treatment in the treatment of hemiplegic stroke disabilities in this single-arm study. Larger randomized and controlled studies are required to confirm results.