Clinical Study Of The Effect Of Acupuncture Treatment In Post Stroke Leg Spasticity

Back ground:Muscle spasticity is a common disability syndrome after a stroke. It can manifest itself in different ways, including the loss of free movement of a limb, joint contracture and can severely affects the normal walking ability and activities of daily life. Reducing the spasticity is often an important problem in the management of patients after stroke. Many studies reported different findings about the effectiveness of acupuncture to control spasticity but its efficacy had not been proven yet with a comprehensive study.Material and methods:In this clinical trial we randomly divided 60 patients with post stroke spasticity into two groups:acupuncture (treatment group) and physiotherapy (control group). All of the patients received their treatment five times per week during four weeks. The outcome measures used were:the Modified Ashworth Scale (MAS), the Clinical Spasm Index (CSI), the Barthel Index (BI), gait and foot print analysis, and Patient-reported Outcomes (PROs). This study was conducted at the Dongzhimen Hospital of Beijing University of Chinese Medicine.Result:Both therapeutic methods significantly decreased the CSI of the participants at the end of the treatment(P<0.005),however acupuncture was significantly more effective to decrease the CSI after 4 weeks of treatment(P<0.05).The average of Ashworth Scale for lower limb significantly decreased from 2.73±0.82 before treatment to 1.86±0.81 after acupuncture treatment (ankle joint), and from 2.33±0.66 to 1.6±0.49 (knee joint) for treatment group. There were significant differences noted between the treatment group and the control group after intervention and acupuncture was significantly more effective (P<0.05).Both groups showed an improvement in Barthel Index. However, the improvement in acupuncture group was better than the control group (P<0.05). Our findings in the foot print analysis showed that both treatments significantly decreased the difference of step length between affected and unaffected sides but acupuncture was significantly more effective (P< 0.05).Acupuncture showed better effects of improvement of the foot length and correction of the foot angle(P<0.05). Therapeutic effects on step length and foot angle just after one week of treatment were also significantly higher in the acupuncture group (P<0.05). Each of the two treatments decreased the stride width during walking but the difference between the two groups was not significant. Acupuncture and physiotherapy both increased the gait speed and there was no significant difference between them.50% of the patients were very satisfied about the outcome of acupuncture at the end of treatment course whereas 53% of the patients in physiotherapy group were moderately satisfied of the results in the end of their treatment.Conclusion:Acupuncture is significantly effective in reducing spasticity in post stroke patients, and could improve walking ability and gait parameters. It could thus be recommended as a safe and effective therapeutic method for post stroke patients. Besides, foot print analysis is a clinical and economical measurement method to evaluate of spasticity.