Three-dimensional kinematic analysis can improve the efficacy of acupoint selection for post-stroke patients with upper limb spastic paresis: A randomized controlled trial.
10.1016/j.joim.2024.12.004
- Author:
Xin-Yun HUANG
1
;
Ou-Ping LIAO
2
;
Shu-Yun JIANG
3
;
Ji-Ming TAO
4
;
Yang LI
5
;
Xiao-Ying LU
5
;
Yi-Ying LI
5
;
Ci WANG
1
;
Jing LI
6
;
Xiao-Peng MA
7
Author Information
1. Acupuncture Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Yueyang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
2. Yueyang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
3. Yueyang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Gait and Motion Analysis Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
4. Department of Rehabilitation, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
5. Gait and Motion Analysis Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
6. Acupuncture Center, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; Yueyang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China. Electronic address: lijing@shyueyanghospital.com.
7. Yueyang Clinical Medical College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China. Electronic address: maxiaopeng@shutcm.edu.cn.
- Publication Type:Research Support, Non-U.S. Gov't
- Keywords:
Acupuncture;
Kinematic analysis;
Rehabilitation;
Spastic paresis;
Stroke;
Upper limb
- MeSH:
Humans;
Male;
Female;
Middle Aged;
Acupuncture Points;
Upper Extremity/physiopathology*;
Biomechanical Phenomena;
Single-Blind Method;
Aged;
Stroke/therapy*;
Acupuncture Therapy/methods*;
Stroke Rehabilitation/methods*;
Adult;
Muscle Spasticity/therapy*;
Paresis/physiopathology*;
Treatment Outcome
- From:
Journal of Integrative Medicine
2025;23(1):15-24
- CountryChina
- Language:English
-
Abstract:
BACKGROUND:China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis (PSSP-UL). Although acupuncture is known to be effective for PSSP-UL, there is room to enhance its efficacy.
OBJECTIVE:This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis (3DKA) results to select additional acupoints, and investigated the feasibility, efficacy and safety of this approach.
DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS:This single-blind, single-center, randomized, controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis. The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio. Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks. The main acupoints in both groups were the same, while participants in the intervention group received additional acupoints selected on the basis of 3DKA results. Follow-up assessments were conducted for 8 weeks after the treatment.
MAIN OUTCOME MEASURES:The primary outcome was the Fugl-Meyer Assessment for Upper Extremity (FMA-UE) response rate (≥ 6-point change) at week 4. Secondary outcomes included changes in motor function (FMA-UE), Brunnstrom recovery stage (BRS), manual muscle test (MMT), spasticity (Modified Ashworth Scale, MAS), and activities of daily life (Modified Barthel Index, MBI) at week 4 and week 12.
RESULTS:Sixty-four participants completed the trial and underwent analyses. Compared with control group, the intervention group exhibited a significantly higher FMA-UE response rate at week 4 (χ2 = 5.479, P = 0.019) and greater improvements in FMA-UE at both week 4 and week 12 (both P < 0.001). The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4 (P = 0.007, P = 0.049, P = 0.019, P = 0.008, P = 0.029, respectively). The intervention group showed a better change in the MBI at both week 4 and week 12 (P = 0.004 and P = 0.010, respectively). Although the intervention group had a higher BRS for the hand at week 12 (P = 0.041), no intergroup differences were observed at week 4 (all P > 0.05). The two groups showed no differences in MAS grades as well as in BRS for the arm at weeks 4 and 12 (all P > 0.05).
CONCLUSION:Semi-personalized acupuncture prescription based on 3DKA results significantly improved motor function, muscle strength, and activities of daily living in patients with PSSP-UL.
TRIAL REGISTRATION:Chinese Clinical Trial Registry ChiCTR2200056216. Please cite this article as: Huang XY, Liao OP, Jiang SY, Tao JM, Li Y, Lu XY, Li YY, Wang C, Li J, Ma XP. Three-dimensional kinematic analysis can improve the efficacy of acupoint selection for post-stroke patients with upper limb spastic paresis: A randomized controlled trial. J Integr Med. 2025; 23(1): 15-24.
