Research Article| Volume 276, ISSUE 1-2, P143-147, January 15, 2009

Effect of acupuncture treatment on spastic states of stroke patients



      The control of spasticity is often a significant problem in the management of patients with stroke. The aim of this study was to evaluate the effect of acupuncture treatment on the spastic states of stroke patients.


      An outpatient Acupuncture Department in the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine.


      One hundred and thirty-one patients, mean (SD) age of 59 (12) years, with spastic hemiplegia were included at mean (SD) month of 17 (7) months after stroke.


      Participants received two 30-day treatment regimens: combined stimulating surface projection zone of decussation of pyramid and traditional acupuncture treatment, and traditional acupuncture treatment only.

      Main outcome measures

      Differences in the modified Ashworth scale (MAS), Fugl–Meyer Assessment (FMA), Barthel Index (BI), and the electromyographic activity of the affected extremity between arms.


      The average (±SD) upper extremity Ashworth score significantly decreased, from 3.08±0.77 before treatment to 1.82±0.65 after acupuncture intervention (wrist joint, P<0.05), and from 2.72±0.59 to 1.32±0.71 (elbow joint, P<0.05) for treatment group. There were significant differences noted between the treatment group and control group after administration. Lower extremity treatment responses were similar to upper extremity responses. However, both groups showed similar improvement in FMA (upper extremity) and FMA (lower extremity). However, the improvements of FMA (total), BI, and F/M ratio were better in treatment group than in control group.


      These results suggested that acupuncturing surface projection zone of decussation of pyramid was effective in reducing spastically increased muscle tone and motor neuron excitability in spastic hemiplegia, and could improve spastic states of stroke patients, thus providing a safe and economical method for treating stroke patients.


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        • Meythaler J.M.
        • McCary A.
        • Hadley M.N.
        Intrathecal baclofen for spastic hypertonia in adult brain injury.
        Perspect Neurosurg. 1996; 7: 99-107
        • Saulino M.
        • Jacobs B.W.
        The pharmacological management of spasticity.
        J Neurosci Nurs. 2006; 38: 456-459
        • Hesse S.
        • Werner C.
        Poststroke motor dysfunction and spasticity: novel pharmacological and physical treatment strategies.
        CNS Drugs. 2003; 17: 1093-1107
        • Meythaler J.M.
        • Guin-Renfroe S.
        • Johnson A.
        • Brunner R.M.
        Prospective assessment of tizanidine for spasticity due to acquired brain injury.
        Arch Phys Med Rehabil. 2001; 82: 1155-1163
        • Meythaler J.M.
        • Guin-Renfro S.
        • Law C.
        • Grabbe P.A.
        • Hadley M.N.
        Continuously infused intrathecal baclofen (ITB) for spasticity/dystonia in older children, adolescents and adults with cerebral palsy.
        Arch Phys Med Rehabil. 2000; 82: 155-161
        • Ford B.
        • Green P.
        • Louis E.D.
        • Petzinger G.
        • Bressman S.B.
        • Goodman R.
        • et al.
        Use of intrathecal baclofen in the treatment of patients with dystonia.
        Arch Neurol. 1996; 53: 1241-1246
        • Wong A.M.K.
        • Su T.Y.
        • Tang F.T.
        • Cheng P.T.
        • Liaw M.Y.
        Clinical trial of electrical acupuncture on hemiplegic stroke patients.
        Am J Phys Med Rehabil. 1999; 78: 117-122
        • Sallstrom S.
        • Kjendahl A.
        • Osten P.E.
        • Stanghelle J.H.
        • Borchgrevink C.F.
        Acupuncture in the treatment of stroke patients in the subacute stage: a randomized, controlled study.
        Complementary Ther Med. 1996; 4: 193-197
        • Shi X.
        • Yang Z.
        • Zhang C.
        • Zhou J.
        • Han J.
        • Wu L.
        • et al.
        Clinical observations on acupuncture treatment of pseudobulbar palsy—a report of 325 cases.
        J Tradit Chin Med. 1999; 19: 27-31
        • Bian J.L.
        • Zhang C.H.
        • Li J.B.
        • Zhang Y.
        • Ding S.Q.
        • He J.
        • et al.
        Observation on therapeutic effect of activating brain function to cause resuscitation needling method on deglutition disorders after stroke.
        Zhongguo Zhen Jiu. 2005; 25: 307-308
        • Shen P.F.
        • Kong L.
        • Shi X.M.
        Study on clinical therapeutic effect of activating brain and regaining consciousness needling method on poststroke depression and the mechanism.
        Zhongguo Zhen Jiu. 2005; 25: 11-13
        • Meythaler J.M.
        • McCary A.
        • Hadley M.N.
        Prospective study on the use of continuously infused intrathecal baclofen for spasticity due to acquired brain injury: a preliminary report.
        J Neurosurg. 1997; 87: 415-419
        • Meythaler J.M.
        • Renfroe S.G.
        • Grabb P.A.
        • Hadley M.N.
        Long-term continuously infused intrathecal baclofen for spastic/dystonic hypertonia in traumatic brain injury: 1-year experience.
        Arch Phys Med Rehabil. 1999; 80: 13-19
        • Bohannon R.W.
        • Smith M.B.
        Interrater reliability of a modified Ashworth scale of muscle spasticity.
        Phys Ther. 1987; 67: 206-207
        • Albright L.A.
        • Barron W.B.
        • Fasick M.P.
        • Polinko P.
        • Janosky J.
        Continuous intrathecal baclofen infusion for spasticity of cerebral origin.
        JAMA. 1993; 270: 2475-2477
        • Knuttson E.
        • Lindblom U.
        • Martensson A.
        Plasma and cerebrospinal fluid levels of baclofen (Lioresal) at optimal therapeutic responses in spastic paresis.
        J Neurol Sci. 1974; 23: 473-484
        • Grabb P.A.
        • Guin-Renfroe S.
        • Meythaler J.M.
        Midthoracic catheter tip placement for intrathecal baclofen administration in children with quadriparetic spasticity.
        Neurosurgery. 1999; 45: 833-837
        • Meythaler J.M.
        • DeVivo M.J.
        • Hadley M.N.
        Prospective study on the use of bolus intrathecal baclofen for spastic hypertonia due to acquired brain injury.
        Arch Phys Med Rehabil. 1996; 77: 461-466
        • Lance J.
        Symposium synopsis.
        in: Feldman R. Young R. Koella W. Spasticity: disordered motor control. Year Book Medical Publishers, Chicago1980: 485-494
        • Lamontagne A.
        • Malouin F.
        • Richards C.L.
        • Dumas F.
        Evaluation of reflex- and nonreflex-induced muscle resistance to stretch in adults with spinal cord injury using hand-held and isokinetic dynamometry.
        Phys Ther. 1998; 78 (discussion 976–8): 964-975
        • Mukherjee M.
        • McPeak L.K.
        • Redford J.B.
        • Sun C.
        • Liu W.
        The effect of electro-acupuncture on spasticity of the wrist joint in chronic stroke survivors.
        Arch Phys Med Rehabil. 2007; 88: 159-166
        • Wong A.M.
        • Su T.Y.
        • Tang F.T.
        • Cheng P.T.
        • Liaw M.Y.
        Clinical trial of electrical acupuncture on hemiplegic stroke patients.
        Am J Phys Med Rehabil. 1999; 78: 117-122
        • Lee J.H.
        • Beitz A.J.
        Electroacupuncture modifies the expression of c-fos in the spinal cord induced by noxious stimulation.
        Brain Res. 1992; 577: 80-91
        • Lo Y.L.
        • Cui S.L.
        • Fook-Chong S.
        The effect of acupuncture on motor cortex excitability and plasticity.
        Neurosci Lett. 2005; 384: 145-149
        • Meissner W.
        • Weiss T.
        • Trippe R.H.
        • Hecht H.
        • Krapp C.
        • Miltner W.H.
        Acupuncture decreases somatosensory evoked potential amplitudes to noxious stimuli in anesthetized volunteers.
        Anesth Analg. 2004; 98: 141-147
        • Inoue I.
        • Chen L.
        • Zhou L.
        • Zeng X.
        • Wang H.
        Reproduction of scalp acupuncture therapy on strokes in the model rats, spontaneous hypertensive rats-stroke prone (SHR-SP).
        Neurosci Lett. 2003; 333: 191-194
        • Milanov I.G.
        F-wave for assessment of segmental motoneurone excitability.
        Electromyogr Clin Neurophysiol. 1992; 32: 11-15
        • Dressnandt J.
        • Auer C.
        • Conrad B.
        Influence of baclofen upon the alpha-motoneuron in spasticity by means of F-wave analysis.
        Muscle Nerve. 1995; 18: 103-107
        • Milanov I.
        • Georgiev D.
        Mechanisms of tizanidine action on spasticity.
        Acta Neurol Scand. 1994; 89: 274-279