scholarly journals Immediate Effect of Dry Needling at Myofascial Trigger Point on Hand Spasticity in Chronic Post-stroke Patients: A Multicenter Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Zengqiao Zhang ◽  
Wu Wang ◽  
Yongjia Song ◽  
Tianjun Zhai ◽  
Yan Zhu ◽  
...  

Background: Hand spasticity after stroke influences the rehabilitation of hand function. Immediate and effective relief of spasticity potentially creates conditions for later rehabilitation training, which has far-reaching significance in the smooth transition of patients to the recovery period.Objective: To evaluate the immediate effect of dry needling (DN) at myofascial trigger point on hand spasticity in stroke patients.Methods: This was a prospective, evaluator blind, multicenter, randomized controlled study. A total of 210 participants were randomly divided into DN group (DN, N = 70), sham dry needling group (SDN, N = 70), and control group (N = 70). Participants in the DN group were treated with DN at myofascial trigger point five times (30 min each time) every week for 4 weeks. Subjects in the SDN group were manipulated the same way as in the DN group, except that the acupuncture site was located in the area adjacent to the myofascial trigger point, which constituted a SDN. Routine rehabilitation treatment was performed for participants in the two groups and in the control group. The primary evaluation index was the immediate effect of hand spasticity relief. Secondary evaluation indicators included the cumulative effect of hand spasticity relief from baseline to week 4, and the changes in flexion angles of the wrist, thumb, and fingers 2–5 in the rest position before, immediately after, and 4 weeks after intervention.Results: The immediate effective rate of spasticity relief (thumb, fingers 2–5, and wrist) of patients with different degrees of spasticity in the DN group was higher than that in the control and SDN groups (thumb, χ2 = 55.833, P < 0.001; fingers 2–5, χ2 = 68.096, P < 0.001; wrist, χ2 = 49.180, P < 0.001) (P < 0.05). The effective rate of spasticity relief from baseline to 4 weeks in the DN group exceeded that in the control group and SDN groups (thumb, χ2 = 8.806, P = 0.012; fingers 2–5, χ2 = 8.087, P = 0.018; and wrist, χ2 = 8.653, P = 0.013) (P < 0.05). No difference in immediate and cumulative effect was found between the control group and SDN group. The change of joints flexion angles in resting position before and after each treatment in the DN group was higher than that in the control and SDN groups (P < 0.05), but it was not significantly different between the control group and SDN group. At 4 weeks, although the change in the DN group was higher than that in the control group and SDN group, this difference was not statistically significant (P > 0.05).Conclusion: Dry needling can relieve varying degrees of hand spasticity instantly in post-stroke.Trial Registration:www.chictr.org.cn, ChiCTR1900022379.

PM&R ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1311-1320 ◽  
Author(s):  
Aitor Martín-Pintado-Zugasti ◽  
Josué Fernández-Carnero ◽  
Jose Vicente León-Hernández ◽  
Cesar Calvo-Lobo ◽  
Hector Beltran-Alacreu ◽  
...  

2021 ◽  
Author(s):  
Xin Xue ◽  
Xue-Xing Jin ◽  
Kai-Liang Luo ◽  
Xin-Hao Liu ◽  
Li Zhang ◽  
...  

Abstract Background: Statistics show that every year, 5.4 million people in the world suffer a stroke. Post-stroke cognitive impairment (PSCI) is one of the most common complications after stroke with a rate of 75%, which leads to decreased functions for independent living and reduced quality of life (QOL). Exercise training has been reported to be useful to improve the cognitive functions of post-stroke patients. Yijinjing, a traditional Chinese Qigong exercise characterized by an integration of mind and body in moderate exercise intensity, can improve cognitive functions of PSCI patients. This study aims to explore the feasibility and effectiveness of the Yijinjing exercise in this regard.Methods: A single-blind, randomized controlled trial will be employed with evaluations at three and six months. 72 PSCI patients will be recruited and randomly assigned to the Yijinjing exercise intervention group or the control group (1:1). Participants in the control group will receive routine rehabilitation therapies, including occupational therapy, physical therapy, acupuncture therapy, and health education 5 times a week for 3 months. The intervention group will receive a 12-week routine rehabilitation therapy combined with the Yijinjing exercise intervention for 40 minutes each session and 3 sessions a week. The primary outcome of cognition will be measured by the Montreal Cognitive Assessment scale (MoCA). Secondary outcomes include executive function, memory function, visuospatial function, sleep quality, gait and motor function, activity of daily living (ADL), and quality of life (QOL).Discussion: Current evidence has reported the effectiveness of traditional Chinese exercise in improving the post-stroke population’s motor functions. This research is a randomized controlled trial that evaluates traditional Chinese exercise’s effectiveness for PSCI patients. It is expected to expand the traditional Chinese exercise scope and provide a new treatment approach for stroke populations with cognitive impairments.Trail registration: Chinese Clinical Trial Registry, ChiCTR1900026532. Registered on 13 October 2019.


2021 ◽  
Vol 10 (11) ◽  
pp. 2381
Author(s):  
Tae-sung In ◽  
Jin-hwa Jung ◽  
May Kim ◽  
Kyoung-sim Jung ◽  
Hwi-young Cho

Objective: Pelvic alignment asymmetry in stroke patients negatively affects postural control ability. This study aimed to investigate the effect of posterior pelvic tilt taping on pelvic inclination, muscle strength, and gait ability in stroke patients. Methods: Forty stroke patients were recruited and randomly divided into the following two groups: the posterior pelvic tilt taping (PPTT) group (n = 20) and the control group (n = 20). All participants underwent sitting-to-standing, indoor walking, and stair walking training (30 min per day, 5 days per week, for 6 weeks). The PPTT group applied posterior pelvic tilt taping during the training period, while the control group did not receive a tape intervention. Pelvic inclination was measured using a palpation meter (PALM). A hand-held dynamometer and the 10-meter walk test were used to measure muscle strength and gait ability. Results: Significantly greater improvements in the pelvic anterior tilt were observed in the PPTT group than in the control group (p < 0.05). Muscle strength in the PPTT group was significantly increased compared to the control group (p < 0.05). Significantly greater improvements in gait speed were observed in the PPTT group than the control group. Conclusions: According to our results, posterior pelvic tilt taping may be used to improve the anterior pelvic inclination, muscle strength, and gait ability in stroke patients.


Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xin Xue ◽  
Xue-Ming Jin ◽  
Kai-Liang Luo ◽  
Xin-Hao Liu ◽  
Li Zhang ◽  
...  

Abstract Background Statistics show that every year, 5.4 million people in the world suffer a stroke. Post-stroke cognitive impairment (PSCI) is one of the most common complications after stroke with a rate of 75%, which leads to decreased functions for independent living and reduced quality of life (QOL). Exercise training has been reported to be useful to improve the cognitive functions of post-stroke patients. Yijinjing, a traditional Chinese Qigong exercise characterized by an integration of mind and body in moderate exercise intensity, can improve cognitive functions of PSCI patients. This study aims to explore the feasibility and effectiveness of the Yijinjing exercise in this regard. Methods A single-blind, superiority, randomized controlled trial will be employed with evaluations at 3 and 6 months. Seventy-two PSCI patients will be recruited and randomly assigned to the Yijinjing exercise intervention group or the control group (1:1). Participants in the control group will receive routine rehabilitation therapies, including occupational therapy, physical therapy, acupuncture therapy, and health education 5 times a week for 3 months. The intervention group will receive a 12-week routine rehabilitation therapy combined with the Yijinjing exercise intervention for 40 min each session and 3 sessions a week. The primary outcome of cognition will be measured by the Montreal Cognitive Assessment scale (MoCA). Secondary outcomes include executive function, memory function, visuospatial function, sleep quality, gait and motor function, activity of daily living (ADL), and quality of life (QOL). Discussion Current evidence has reported the effectiveness of traditional Chinese exercise in improving the post-stroke population’s motor functions. This research is a randomized controlled trial that evaluates traditional Chinese exercise’s effectiveness for PSCI patients. It is expected to expand the traditional Chinese exercise scope and provide a new treatment approach for stroke populations with cognitive impairments. Trial registration Chinese Clinical Trial Registry ChiCTR1900026532. Registered on 13 October 2019.


2021 ◽  
Vol 11 (3) ◽  
pp. 640-649
Author(s):  
Kyung-Hun Kim ◽  
Sang-Hun Jang

Background: Sensory motor impairment, the most common neuromuscular condition in stroke patients, often contributes to muscle weakness and imbalance. Objective: The purpose of this research was to investigate the effects of cognitive sensory-motor training (CSMT) on the muscle strength and balance ability in post-stroke patients. Methods: Thirty-five participants after stroke were randomly assigned to the CSMT (n = 17) or control group (n = 18). All participants received 30 min of training each time, five times per week, for six weeks. Lower extremity muscle strength of tibialis anterior (LEMTA) was evaluated using a digital muscular dynamometer. The Medical Research Council (MRC) scale was used to evaluate muscle strengths of the hip joint, knee joint, and ankle joint. For balance ability test, the center of pressure (COP) movement distance and limited of stability (LOS) were measured using BioRescue. Results: LEMTA, MRC scale, balance ability were significantly more improved in the CSMT group than in the control group (p < 0.05). Conclusions: Our findings indicate that CSMT is beneficial and effective for improving muscle strength of the lower extremity and balance ability of post-stroke patients.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Anders West ◽  
Sofie Simonsen ◽  
Alexander Zielinsky ◽  
Niklas Cyril ◽  
Marie Schønsted ◽  
...  

Introduction: Stroke is a major cause of acquired cerebral disability among adults, frequently accompanied by depression. New ways of intervention to prevent post stroke depression is therefore needed. The blue light spectrum is the strongest zeitgeber (time-giver) and is known to stabilize the circadian rhythm. Patients admitted for rehabilitation are often lacking the blue light in daytime due to the long indoor admission; furthermore, they are often exposed to blue light in the evenings, as blue light is contained in standard lightning. Hypothesis: Circadian light will reduce depressive mood in stroke patients admitted for rehabilitation. Methods: The study is a prospective parallel longitudinal randomized controlled study (quasi randomization). Stroke patients in need of rehabilitation were included at the acute stroke unit and randomized to either the intervention unit (IU)(circadian lighting) or the control unit (CU)(standard lighting). The circadian light was installed in the entire IU (Cromaviso, Denmark). Examination was done in the acute unit and at discharge after at least 2 weeks in the IU/CU. Change in depressive mood was measured by the Hamilton Rating Scale for Depression (HAM-D 6 ) and The Major Depression Inventory scale (MDI). Results: Patients were included over a year (N=90), 6 did not reach randomization, 45 were randomized to the IU, and 39 to the CU. A sample of 59 and 62 patients were able to answer the HAM-D 6 (N=30IU;N=29CU) and MDI (N=30IU;N=29CU) score, respectively. Both scores were significantly lower in the intervention group at discharged compared with the control group (ANCOVA, antidepressants medicine was included as a confounder, HAM-D 6 , P=0.018, Estimate=-2.25;SEM=0.92, MDI, P=0.009, Estimate=-4.72;SEM=1.74). Conclusion: Our findings show for the first time circadian light as a beneficial intervention on depressive mood on long-term hospitalized patients in a real hospital setting. The circadian lightning should be considered as an integrated segment in the environment of rehabilitation units.


2019 ◽  
Vol 37 (3) ◽  
pp. 151-163 ◽  
Author(s):  
Aida Martín-Rodríguez ◽  
Esther Sáez-Olmo ◽  
Daniel Pecos-Martín ◽  
César Calvo-Lobo

Objective: To determine the changes produced by trigger point dry needling (TrP-DN) of sternocleidomastoid in patients with neck pain, and to observe how it might modify cervical motor control (CMC). Design: Single-centre, randomised, double-blinded clinical trial. Setting: Participants were recruited through advertising. The duration of the study was 6 months. Subjects: Thirty-four subjects with non-specific neck pain, aged over 18 years with an active myofascial trigger point in sternocleidomastoid, participated in the study. They were randomly assigned to treatment or control groups. Methods: TrP-DN inside or (1.5 cm) outside of the active myofascial trigger point of sternocleidomastoid. Main outcome measures: CMC, visual analogue scale and cervical range of motion were assessed before treatment, immediately post treatment, and 24 h, 1 week and 1 month after the intervention; the neck disability index was evaluated before treatment and 1 month later. Results: With a confidence interval of 99%, TrP-DN of sternocleidomastoid was associated with a decrease in pain after 1 week and CMC improved 1 month after the intervention (p < 0.001), when compared with baseline measurements, within the experimental group; there were no statistically significant differences between experimental and control groups. Conclusion: The effects of TrP-DN inside and outside of active myofascial trigger points did not differ in this study. Both interventions were associated with a similar temporal effect, specifically a reduction in neck pain at 1 week and an increase CMC at 1 month. However, these findings should be interpreted with caution due to the lack of a contemporaneous untreated control group.


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