2.The Effects of Acupuncture on Shoulder-Hand Syndrome (SHS) as a Complication of Hemiplegia.
Mari TSUIKI ; Akira YOSHIDA ; Fumiko YASUNO ; Yoshihiro AIKAWA ; Fumihiko FUKUDA ; Tomomi SAKAI
The Journal of The Japanese Society of Balneology, Climatology and Physical Medicine 2002;65(3):128-136
Hemiplegia after a cerebrovascular event is a complication that causes problems in daily life such as difficulty of walking and may lead to social disadvantages. Furthermore, various subsequent health issues that accompany hemiplegia tend to hinder rehabilitation. In particular, Shoulder-Hand Syndrome (SHS) is an intractably painful disease with primary symptoms of pain and swelling in the upper limbs of patients. We investigated the effect of the acupuncture treatment on those patients with hemiplegia after a cerebrovascular event who are suspected to have SHS because of such symptoms as pain, swelling, and paresthesia in the upper limb of the affected side by measuring the changes in the numerical scale (NS), Gibbons' RSD score, and range of motion (ROM) in upper extremities.
The present study consisted of 13 hemiplegic subjects (eight males, five females) with pain, swelling, and paresthesia in the upper limbs. Acupuncture treatment was applied twice a week for over two months. Specifically electrical acupuncture and/or the retaining needle technique was applied to the upper extremities for 20 minutes in each session. Of 13 participants, 10 showed a significant decrease in NS (reduced by five or more points), eight showed improvement of the swelling in the upper limbs, and nine showed reduction in paresthesia.
From these results, we concluded that the acupuncture treatment was effective for SHS that accompanies hemiplegia after a cerebrovascular event and that the improvement of the peripheral blood flow might play an important role in generating treatment effects.
3.Depression after Subarachnoid Hemorrhage: A Systematic Review
Wai Kwong TANG ; Lisha WANG ; George KWOK CHU WONG ; Gabor S. UNGVARI ; Fumihiko YASUNO ; Kelvin K.F. TSOI ; Jong S. KIM
Journal of Stroke 2020;22(1):11-28
Background:
and Purpose Depression is common and debilitating illness accompanying many neurological disorders including non-traumatic subarachnoid hemorrhage (SAH). The aim of this systematic review was to identify and critically appraise all published studies that have reported the frequency, severity and time course of depression after SAH, the factors associated with its development and the impact of depression on patients’ quality of life after SAH.
Methods:
The PubMed database was searched for studies published in English that recruited at least 40 patients (>18 years old) after SAH who were also diagnosed with depression.
Results:
Altogether 55 studies covering 6,327 patients met study entry criteria. The frequency of depression ranged from 0% to 61.7%, with a weighted proportion of 28.1%. Depression remained common even several years after the index SAH. Depression after SAH was associated with female sex, premorbid depression, anxiety, substance use disorders or any psychiatric disorders, and coping styles. Comorbid cognitive impairment, fatigue, and physical disability also increased the risk of depression. Aneurysmal SAH and infarction may be related to depression as well. Depression reduces the quality of life and life satisfaction in patients after SAH.
Conclusions
Depression is common after SAH and seems to persist. Further research is needed to clarify its time course and identify the neuroendocrine and neurochemical factors and brain circuits associated with the development of post-SAH depression. Randomized controlled treatment trials targeting SAH-related depression are warranted.