Post-stroke spasticity, a common sequelae of upper motor neuron lesions, results in motor control deficits and pathological hypertonia that not only reduce patients' activities of daily living but may also cause impairment of adaptive neuroplasticity. Repetitive peripheral magnetic stimulation (rPMS), as a novel non-invasive neuromodulation technique, demonstrates unique clinical potential through targeted modulation of electromagnetic coupling effects in the peripheral neuromuscular system. Although current international studies have validated the therapeutic potential of rPMS for spasticity, significant heterogeneity persists in elucidating its mechanisms of action, optimizing parameter protocols, and standardizing outcome assessment systems. This review innovatively synthesized recent randomized controlled trials (RCTs) and mechanistic evidence, systematically summarizing rPMS-mediated multidimensional intervention paradigms for upper- and lower-limb spasticity. It rigorously examined the correlations between stimulation frequency parameters (low-frequency vs. high-frequency), anatomical targeting (nerve trunk vs. motor point), and clinical outcomes including spasticity severity, motor function, and quality of life. Crucially, the analysis reveals that rPMS may ameliorate spasticity after stroke through dual mechanisms involving local neuroelectrophysiological modulation and central sensorimotor network reorganization, thereby providing a theoretical foundation for developing individualized rPMS clinical protocols and establishing precision treatment strategies.
Humans ; Lower Extremity/physiopathology* ; Upper Extremity/physiopathology* ; Muscle Spasticity/physiopathology* ; Stroke/physiopathology* ; Magnetic Field Therapy/methods* ; Spasm/etiology* ; Stroke Rehabilitation ; Randomized Controlled Trials as Topic

OBJECTIVE: To compare the differences in the clinical effect on post-stroke hand spasm among the combined treatment of penetrating acupuncture and kinesiotherapy, the simple application of penetrating acupuncture and the simple application of kinesiotherapy. METHODS: A total of 105 patients with post-stroke hand spasm were randomized into a penetrating acupuncture group, a kinesiotherapy group and a combined treatment group, 35 cases in each one, of which, 2 cases were dropped out in either the combined treatment group and the penetrating acupuncture group, and 1 case dropped out in the kinesiotherapy group. The routine rehabilitation training, e.g. occupational therapy and Bobath exercise and medication were adopted in all of the three groups. In the penetrating acupuncture group, the penetrating needling technique was exerted from Hegu (LI 4) to Houxi (SI 3) and from Waiguan (TE 5) to Sidu (TE 9) on the affected side. In the kinesiotherapy group, the persistent movement or passive movement was exerted on the wrist joint, the metacarpophalangeal joints and the interphalangeal joints. In the combined treatment group, the penetrating acupuncture (the same as the penetrating acupuncture group) was exerted combined with kinesiotherapy (the same as the kinesiotherapy group). In each group, the treatment was given once a day, 30 min in each time, 6 treatments a week in total, with the interval of 1 day between the courses. The treatment for 2 weeks was as one course and 2 courses were required totally. Before and after treatment, the scores of hand spasm index, hand-wrist motor function and the activity of daily living (ADL) were compared in each group. RESULTS: After treatment, the scores of hand spasm index were reduced as compared with those before treatment in each group (<0.05) and the scores of hand-wrist motor function and ADL were increased significantly as compared with those before treatment in each group (<0.05). After treatment, the reducing degree of the score of hand spasm index in the combined treatment group was greater than the penetrating acupuncture group and the kinesiotherapy group (<0.01), and the increasing degree of the scores of hand-wrist motor function and ADL were higher than either the penetrating acupuncture group or the kinesiotherapy group (<0.01). The improvements in each index were not different statistically between the kinesiotherapy group and the penetrating acupuncture group (>0.05). CONCLUSION Compared with the simple application of either penetrating acupuncture or kinesiotherapy, the combined treatment of them achieves the significant improvements in hand spasm degree, hand wrist motor function and ADL in patients with stroke.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Kinesis ; Spasm ; etiology ; therapy ; Stroke ; complications ; Stroke Rehabilitation ; Treatment Outcome

OBJECTIVE: To observe the improved effects of articular needling at Sifeng (EX-UE 10) on finger spastic paralysis after stroke on the basis of conventional treatment. METHODS: Sixty-four patients were randomly divided into an observation group and a control group, 32 cases in each group. Both groups were treated with conventional drugs, and in the control group, conventional acupuncture was treated. On the basis of the treatment in the control group, articular needling at Sifeng (EX-UE 10) was applied in the observation group. The treatment was given once everyday for 6 days with one day interval, and a total of two weeks were needed. The finger scores in the Fugl-Meyer evaluation scale (FMA), the Brunnstrom motor function rating, and the modified Ashworth spasm rating were observed before and after treatment. RESULTS: After treatment, the Fugl-Meyer scores in the two groups were higher than those before treatment (<0.01). The Fugl-Meyer score in the observation group was higher than that in the control group (<0.01). The results of Brunnstrom motor function rating and the modified Ashworth spasm rating were improved in the two groups (<0.01, <0.05), and the observation group was superior to the control group (<0.01). CONCLUSION The articular needling at Sifeng (EX-UE 10) can effectively improve the condition of finger spastic paralysis.
Acupuncture Points ; Acupuncture Therapy ; Humans ; Muscle Spasticity ; etiology ; therapy ; Spasm ; Stroke ; complications ; Treatment Outcome

A 61-year-old female presented with 4 years history of left-sided hemifacial spasm. Head MRI and angiography indicated left vertebral artery dissecting aneurysm which compressed ipsilateral cranial nerves Ⅶ and Ⅷ. Microvascular decompression was performed. The dissecting aneurysm was pushed apart and the distal part of the parent artery was adhered to the dura on the petrosum. The compressed nerves were totally decompressed. The symptom of facial spasm was completely resolved immediately after surgery and did not recur during 6 months of follow up.
Cerebral Angiography ; Facial Nerve ; pathology ; Female ; Hemifacial Spasm ; surgery ; Humans ; Magnetic Resonance Imaging ; Microvascular Decompression Surgery ; Middle Aged ; Nerve Compression Syndromes ; diagnosis ; etiology ; surgery ; Vertebral Artery Dissection ; diagnostic imaging ; surgery ; Vestibulocochlear Nerve ; pathology

Cerebellar Neoplasms ; complications ; diagnosis ; Child ; Child, Preschool ; Facial Muscles ; diagnostic imaging ; pathology ; Female ; Fourth Ventricle ; diagnostic imaging ; pathology ; Hemifacial Spasm ; diagnosis ; etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography

Coronary Artery Disease ; complications ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; etiology ; Spasm ; complications

OBJECTIVETo study whether acupuncture on the acupoints of the affected extremities was effective or not on the lower extremity spasm in spinal injury, and observe the tolerance of patients to acupuncture.

METHODSThe random controlled trial of single case was adopted among 9 patients. The heavy manipulation and gentle manipulation of acupuncture on the lower extremities, physical therapy as well as corresponding control therapy (acupuncture or other therapy on the upper extremities) were applied to each case separately for 3 cycles of treatment, totally for 29 weeks of treatments. The therapeutic effective outcomes were determined according to the index of clinical spasm, daily spasm frequency and the patient reported outcome.

RESULTSNone of the three therapies made the index of clinical spasm worse in 9 patients (all P > 0.05), and there was no significant statistical difference in comparison among three therapies (P > 0.05). Concerning to the improvement in daily spasm frequency, the result of heavy manipulation therapy was inferior apparently to the other two therapies (P < 0.05). The outcome report indicated that the patients were unwilling to accept the stimulation induced by heavy manipulation.

CONCLUSIONThe spasm induced by spinal injury can not be aggravated in tendency by acupuncture on the affected extremities. Thus, acupuncture is a kind of safe therapy for spasm. But the heavy manipulation of acupuncture may be the factor to impact the patient for the option of acupuncture treatment.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Humans ; Lower Extremity ; injuries ; Male ; Middle Aged ; Spasm ; etiology ; therapy ; Spinal Cord Injuries ; complications

Adult ; Anxiety ; diagnosis ; drug therapy ; psychology ; Botulinum Toxins, Type A ; therapeutic use ; Dystonia ; diagnosis ; drug therapy ; etiology ; Hemifacial Spasm ; diagnosis ; drug therapy ; etiology ; Humans ; Male ; Mastication ; Neuromuscular Agents ; therapeutic use ; Risk Factors

OBJECTIVETo discuss diagnosis and treatment of post traumatic spasmodic flat foot.

METHODSFrom 2002 to 2007, 7 diagnosed patients were recruited and underwent following procedures: under epidural anesthesia or common peroneal nerve block anesthesia, massage was performed on the peroneal muscles for about 5 minutes, then ankle joint was underwent with passive functional exercise. Feeling muscle relaxation, we held the wounded foot in varus and adducted position forcefully, then immobilized it with short leg cast. After 3 weeks of continuous immobilization, the cast was removed and patients were given physical treatment and functional training.

RESULTSSymptoms of these patients such as claudication and pain in foot were improved, the foot deformity was corrected and foot arch restored to normal. After a follow-up of 6 months,no obvious recurrence was observed.

CONCLUSIONThe diagnosis of post traumatic spasmodic flat foot is based on the careful inquiry of traumatic history,physical examination and X-ray results. Manipulative reduction under common peroneal nerve block anesthesia and cast immobilization is a simple and effective method to treat this disease.

Adolescent ; Adult ; Anesthesia ; Female ; Flatfoot ; diagnosis ; etiology ; therapy ; Foot Injuries ; complications ; Humans ; Male ; Middle Aged ; Spasm ; diagnosis ; etiology ; therapy

Female ; Hemifacial Spasm ; etiology ; Humans ; Male ; Mastoiditis ; complications ; Middle Aged