Abstract
Objective: The goal of this study is to explore the effect of wrist-ankle acupuncture combined with 5-Hz repetitive transcranial magnetic stimulation (rTMS) on improving spastic state and motor function of children with spastic cerebral palsy by measuring electrophysiological parameters and behaviors.Methods: Twenty-five children with spastic cerebral palsy were enrolled in a single-blind and randomized controlled trial. The control group received 20 sessions of 5-Hz rTMS over the affected hemisphere with 1,000 pulses. The experimental group was given wrist-ankle acupuncture on the basis of the control group. Gross motor function measure (GMFM-66), muscle tension, and electrophysiological parameters of the two groups were assessed at baseline and after intervention.Results: After treatment, the GMFM-66 scores in the same groups were significantly improved (p < 0.001). Besides, the R-value of soleus, gastrocnemius, and hamstring muscle decreased (p < 0.05), and the results showed a trend of shortening MEP latency, increasing amplitude and duration (p < 0.05). Compared to the controlled group, the experimental group displayed more excellent changes in the GMFM-66 scores and motor evoked potential (MEP) latency. The statistical results showed that the increase of GMFM-66 score and the shortening of MEP latency in the experimental group were greater than that in the control group (p < 0.05). However, no significant differences were found in the assessment of muscle tension, amplitude, and duration of MEPs between two groups (p > 0.05).Conclusion: Wrist-ankle acupuncture combined with 5-Hz rTMS is optimal to improve gross motor function and enhance the conductivity of corticospinal tract in children with cerebral palsy but cannot highlight its clinical superiority in improving spasticity.Clinical Trial Registration: [http://www.chictr.org.cn/index.aspx], identifier [chictr2000039495].
Highlights
Cerebral palsy (CP) is considered to be a group of persistent central and postural developmental disorders and activity limitation syndrome caused by non-progressive brain injury in fetus or infants, occurring in 1–3 per 1,000 live births (Sellier et al, 2016)
The goal of this study is to explore the effect of wrist-ankle acupuncture combined with 5-Hz repetitive transcranial magnetic stimulation on improving spastic state and motor function of children with spastic cerebral palsy by measuring electrophysiological parameters and behaviors
Wrist-ankle acupuncture combined with 5-Hz repetitive transcranial magnetic stimulation (rTMS) is optimal to improve gross motor function and enhance the conductivity of corticospinal tract in children with cerebral palsy but cannot highlight its clinical superiority in improving spasticity
Summary
Cerebral palsy (CP) is considered to be a group of persistent central and postural developmental disorders and activity limitation syndrome caused by non-progressive brain injury in fetus or infants, occurring in 1–3 per 1,000 live births (Sellier et al, 2016). It is generally believed that the higher central nervous system is damaged, which leads to the obstacle of the central nervous system in the regulation of spinal cord stretch reflex, making the stretch reflex stronger (Kesar et al, 2012). Compared with other acupuncture therapies, it has the characteristics of relative safety, convenient operation, and rapid pain relief and has the function of promoting Qi and blood circulation and mobilizing Wei Qi to regulate the metabolism of human body fluid. The study suggests (Qinghui, 2017) that one of the mechanisms of wrist-ankle acupuncture may be due to the existence of nerve conduction function activities. When the nerve endings are stimulated, it will trigger a series of nerve conduction activities of connecting nerves in the reflex arc and play a complex adjustment role
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