A clinical study to assess the influence of acupuncture at “Wang’s Jiaji” acupoints on limb spasticity in patients in convalescent stage of ischemic stroke: study protocol for a randomized controlled trial

Abstract

Background Stroke is characterized by high morbidity, high mortality, and high disability. Spasticity, one of the most common complications after stroke, may reduce the potential success of rehabilitation and has a detrimental effect on stroke patients’ daily function and quality of life. Moreover, the long-term management of spasticity is a financial burden to patients and increases societal costs. The current treatments, mainly including physical therapy, oral drugs, drug injection therapy, and surgical interventions, have been used to reduce spasticity. However, every conventional approach has its limitations. Acupuncture at the “Wang’s Jiaji” acupoints, based on the experience of the famous old doctor of traditional Chinese medicine (TCM) Le Ting Wang in treating post-stroke limb spasm, has been widely practiced in our department. This intervention has effectively avoided the controversy around acupuncture at local acupoints on the limbs, and is easy to apply without side effects. Our previous studies had found that acupuncture at the “Wang’s Jiaji-points” can reduce the occurrence and severity of spasticity occurring after stroke in the early stage (the first 21 days). In this study, we chose patients in the convalescent stage, 1–6 months after stroke, so as to study the efficacy and the specific intervention time of “Wang’s jiaji” in the convalescent stage after stroke. Methods This is a randomized, controlled, and single-blind study. Patients in the convalescent stage within 1–6 months of ischemic stroke will be selected as subjects. A total of 100 subjects will be randomly assigned to two groups. The acupuncture group will be given acupuncture treatment five times a week; the medicine group will be given 10mg baclofen three times a day. These two groups will continue to receive current usual care for the prevention and treatment of cerebrovascular diseases, but drugs that affect muscle tone will not be allowed. The treatment will last for 2 weeks. The primary outcome measurement is the simplified Fugl-Meyer Assessment. The secondary outcome measurements are the Modified Ashworth Scale, Modified Barthel Scale, and the H-reflex, F response, and H/M ratios of electromyography. All outcome measurements are assessed at baseline, 2 weeks, 4 weeks, and 12 weeks after first treatment except the electromyography, which is assessed at baseline and 2 weeks after first acupuncture. Discussion This trial aims to evaluate the effects and the specific intervention time of “Wang’s Jiaji” acupoints on spasticity after stroke. Trial registration ISRCTN registry, ISRCTN31511176 . Registered on 29 August 2017. Version number of protocol 2016-2-1161 Version date of protocol: 2016-1 Electronic supplementary material The online version of this article (10.1186/s13063-019-3464-7) contains supplementary material, which is available to authorized u...

A randomized double-blind controlled study protocol on the efficacy and safety of Sangdantongluo granule in the treatment of post-stroke spasticity

“…TCM is a generally accepted treatment with minimal side effects for PSS patients in China. There are increasing quantities of clinical studies on the treatment of PSS with TCM, such as orally Chinese herbal formulas, Chinese massage, acupuncture, medicated bath and so on [ [16] , [17] , [18] ]. The mechanism is related to modulation of gamma-aminobutyric acid and glutamate levels, reducing inflammatory response, and decreasing muscular tension [ [19] , [20] , [21] ].…”

A randomized double-blind controlled study on the efficacy and safety of Sangdantongluo granule in the treatment of post-stroke spasticity

“…TCM is a generally accepted treatment with minimal side effects for PSS patients in China. There are increasing quantities of clinical studies on the treatment of PSS with TCM, such as orally Chinese herbal formulas, Chinese massage, acupuncture, medicated bath and so on [16][17][18]. The mechanism is related to modulation of gamma-aminobutyric acid and glutamate levels, reducing inflammatory response, and decreasing muscular tension [19][20][21].…”

Effect of the neurodynamic mobilization technique combined with electroacupuncture on functional recovery and GAP-43 expression after sciatic nerve injury in rabbits

“…Electroacupuncture (EA), a combination of acupuncture and a continuous low-frequency current, may be a simple method of indirectly applying electrical stimulation to deep tissue (Wei, Zhao, and Schachner 2018;Inoue et al 2003). Furthermore, Jiaji acupoints are located on the bilateral spinous processes of the lumbar spine, 5 mm lateral to the posterior midline in rabbits (Wang et al 2016), which is very similar to the distribution of the posterior and anterior rami of the spinal nerve and the sympathetic trunk (Xing et al 2017;Li et al 2019). Previous studies have shown that Jiaji-EA promotes cortical somatosensory responses and locomotor recovery in rats after spinal cord injury (Wu et al 2012;Wei, Zhao, and Schachner 2018), indicating that Jiaji-EA establishes a connection between peripheral and central nerves and exerts therapeutic effects on functional impairments in neurological diseases.…”