Tongdu Tiaoshen acupuncture combined with Bobath rehabilitation training for upper limb spasm after stroke: a randomized controlled trial.

Abstract

To observe clinical effect of Tongdu Tiaoshen (promoting the circulation of the governor vessel and regulating the spirit) acupuncture combined with Bobath rehabilitation training in the treatment of upper limb spasm after stroke. A total of 66 patients with upper limb spasm after stroke were randomly divided into an observation group (33 cases, 1 case dropped out) and a control group (33 cases, 2 cases dropped out). The control group received Bobath rehabilitation training. On the basis of the control group, the patients in the observation group received Tongdu Tiaoshen acupuncture at Baihui (GV 20), Fengfu (GV 16), Mingmen (GV 4), Yaoyangguan (GV 3) and bilateral C4-T1 Jiaji points (EX-B 2), etc. Both groups were treated once a day, with 6 days of continuous treatment followed by 1 day of rest, and totally 4 weeks were required. The modified Ashworth scale ( MAS ) grade, Fugl-Meyer assessment of upper extremity ( FMA-UE ) score, modified Barthel index ( MBI ) score, serum level of neurotransmitter (glutamic acid [Glu] and γ-aminobutyric acid [GABA]) were compared between the two groups before and after treatment, and the clinical effect was evaluated. After treatment, MAS grade and serum level of Glu in the two groups were lower than those before treatment (P<0.05), and FMA-UE, MBI scores and serum level of GABA were higher than those before treatment (P<0.05). The MAS grade and serum level of Glu in the observation group were lower than those in the control group (P<0.05), and the FMA-UE, MBI scores and serum level of GABA were higher than those in the control group (P<0.05). The total effective rate of the observation group was 87.5% (28/32), which was better than 45.2% (14/31) of the control group (P<0.05). The combination of Tongdu Tiaoshen acupuncture and Bobath rehabilitation training can effectively reduce the upper limb muscle tension level of patients with upper limb spasm after stroke, improve upper limb motor function, enhance self-care ability, and regulate serum level of neurotransmitter.