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.
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

Segmental zoster paresis(SZP)is a rare complication in herpes zoster infection,with its symptoms often neglected due to the co-existence of pain.Here we reported a case of SZP.Also,we analyzed 42 Chinese SZP cases in literature,which revealed that the male to female ratio of SZP patients was 13∶8,and the median age of disease onset was 65 years.The most commonly affected region is upper limb.The diagnosis depends mainly on typical medical history and clinical symptoms.Although there is no definite therapy for SZP,the antiviral therapy is the most commonly used treatment,which achieved complete recovery in 78.6% of the patients and partial recovery in 14.3% of the patients.
Aged ; Female ; Herpes Zoster/diagnosis* ; Humans ; Male ; Paresis/etiology* ; Upper Extremity/physiopathology*

OBJECTIVETo assess the effect of electroacupuncture in different frequencies by electromyography and walking function measure in post-stroke patients with lower-extremity (OLE) spasticity and hemiparesis.

METHODSFifty cases of post-stroke whose motor deficit was classified into Brunnstrom stage II - IV were randomly divided into a 100 Hz group, a 50 Hz group and a 2 Hz group. They were accepted 100 Hz, 50 Hz or 2 Hz of electroacupuncture (EA) therapy combined with standard rehabilitation program. Main outcome measures included integrated electromyography (IEMG) score during maximum isometric voluntary contraction (MIVC) of the knee flexors and extensors, ankle dorsiflexors and planterflexors in the affected LE recorded by surface EMG, Co-contraction ratio calculated by IEMG score of the antagonist over that of the agonist plus antagonist, Composite Spasticity Scale (CSS), Fugl-Meyer Motor Scale (FMS) and Functional Ambulation Categories (FAC) on LE. All outcomes were assessed at the baseline and after treatment by the professional practitioners who blinded to the treatment.

RESULTSAfter EA treatment, IEMG of rectus femoris were decreased in 100 Hz and 50 Hz groups (P < 0.01, P < 0.05), and better than that in 2 Hz group (both P < 0.05); gastrocnemius IEMG were decreased in 100 Hz and 50 Hz groups (P < 0.05, P < 0.01); but IEMG of tibialis anterior muscle was increased only in 50 Hz group (P < 0.05). During knee flexion, EMG co-contraction ratio in MIVC declined in 100 Hz and 50 Hz groups were decreased significantly (P < 0.05, P < 0.01), and the co-contraction ratio between the non-affected and affected side were increased significantly in all the 3 groups after treatment (P < 0.01, P < 0.05). During ankle dorsiflexion, co-contraction ratio were decreased significantly in all the 3 groups (P < 0.05, P < 0.01), and cocontraction ratio between the non-affected and affected side was increased significantly only in 100 Hz after treatment (P < 0.01). FMS score, CSS and FAC were improved in all the 3 groups after treatment (all P < 0.01), but only FAC in 100 Hz group showed better effect than that in 50 Hz group or 2 Hz group (both P < 0.05).

CONCLUSIONElectroacupuncture therapy combined with rehabilitation program is effective for the spasticity status of lower-extremity in post-stroke. The therapeutic effect of EA in the frequencies of 100 Hz or 50 Hz is superior to that of 2 Hz stimulation and parameter of 100 Hz may be optimal.

Aged ; Electroacupuncture ; Electromyography ; Female ; Humans ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Muscle Spasticity ; etiology ; physiopathology ; therapy ; Paresis ; etiology ; physiopathology ; therapy ; Stroke ; complications ; Treatment Outcome ; Walking

OBJECTIVE: To calculate and compare the change of canal paresis (CP) and directional preponderance (DP) before and after changing air flow rate of testing ear, and to discuss the influence of air flow rate change of single ear on the final result of caloric test. METHOD: The CPs and DPs were calculated when the caloric tests were carried out with the air flow rate 6 L/min in both ears as symmetry stimulation, and with the air flow rate 6 L/min in left ear and 3 L/min in right ear as asymmetric stimulation. Paired T test was used in analysis between symmetry and asymmetric group. RESULT: CPs and DPs declined significant in asymmetric group, and the difference was statistically significant. CONCLUSION When air flow rate declined, CP was to the same side, while DP was to opposite side. There might be false positive or negative result.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Air ; Caloric Tests ; Child ; Female ; Humans ; Male ; Middle Aged ; Paresis ; physiopathology ; Semicircular Canals ; physiology ; Young Adult

OBJECTIVE: Comparison of the bithermal test in benign paroxysmal positional vertigo (BPPV) before and after particle repositioning maneuver (PRM), identify the possible mechanisms of canal paralysis in BPPV. METHOD: Ninety-six BPPV cases during 2005-2008 were randomly divided into two groups: 52 cases were carried bithermal test before PRM, and the other 44 cases were carried after successful PRM. According to the canal paresis(CP) > or = 20%, subdivided each patients group the normal semicircular canal (SC) function group and the paresis SC function group. Compared the ratio of paresis SC function between the subgroups. RESULT: Except the ages of the first group were younger than the second group, the gender rate, semicircular canal involved, side involved, course of the disease, recurrent attacks were all equal between the two groups. Using chi square test to compare the ratio of paresis SC between the two groups (t = 0.654, P < 0.05), the differences between the two groups were not statistical. CONCLUSION PRM has no influence to the bithermal test in BPPV. The mechanisms of the paresis SC function may be the extensive pathological changes in the vestibular system. The floating otolith has little effect on the dynamic of the endolymph.
Adult ; Aged ; Aged, 80 and over ; Caloric Tests ; Female ; Humans ; Male ; Middle Aged ; Otolithic Membrane ; Paresis ; physiopathology ; Semicircular Canals ; physiopathology ; Vertigo ; physiopathology ; Young Adult

OBJECTIVETo investigate the manifestation of head shaking nystagmus (HSN) and the relationship between HSN and vestibular bithermal test while cross-checking the HSN and vestibular bithermal test.

METHODSOne hundred and twenty-four patients were examined by HSN and vestibular bithermal test. The latency and duration of HSN were observed and the dynamic changes of HSN were also investigated. The results of bithermal test were clarified by the values of canal paresis (CP).

RESULTSThere were 3 types of HSN, including 41 monophasic HSN, 11 biphasic HSN and 7 perverted HSN. The latency of monophasic HSN was (2.75 +/- 1.41) ms and the duration of it was (32.16 +/- 20.30) ms; as for the biphasic HSN, the first phase had no latency and the duration was (12.33 +/- 4.42) ms which was shorter than that of the second phase (57.00 +/- 17.19) ms (P < 0.01) and the latency of second phase was (57.00 +/- 17.19) ms. The value of canal paresis in the patients without HSN was lower than that in the patients with HSN.

CONCLUSIONSThe existence of HSN was dependent on the loss of the function horizontal canal and also on the stage of vestibular compensation. The variation of duration of HSN among individuals was great. In the acute stage of unilateral vestibular function loss, there appeared to be prominent HSN, and the direction of HSN is the same as that of spontaneous nystagmus. With the development of vestibular compensation, biphasic nystagmus would appear instead of monophasic HSN and the direction of first phase represent the direction of un-lesioned side. After compensation, HSN would not be elicited. However,when HSN existed, it suggested that the value of CP should exceed 25%. Perverted nystagmus pointed to central abnormality.

Adolescent ; Adult ; Caloric Tests ; Child ; Female ; Head ; physiopathology ; Humans ; Middle Aged ; Nystagmus, Pathologic ; physiopathology ; Paresis ; physiopathology ; Semicircular Canals ; physiopathology ; Young Adult