The effect of electro-acupuncture on spasticity of the wrist joint in chronic stroke survivors

Objective: To quantitatively assess the change in spasticity of the impaired wrist joint in chronic stroke patients after electro-acupuncture treatment. Design: Crossover design. Setting: University medical center research laboratory. Participants: Seven chronic stroke subjects (age, 63.14 +/- 7.01y). Intervention: Participants received two 6-week treatment regimens: combined electro-acupuncture and strengthening twice a week, and strengthening twice a week only. Muscle strength and spasticity of the wrist joint were quantified by using the Biodex multijoint System 3 Pro. Electro-acupuncture was given through a commercial electro-acupuncture device. Main Outcome Measures: Velocity sensitivity of averaged speed-dependent reflex torque (VASRT); segmented averaged speed-dependent reflex torque (SASRT); Modified Ashworth Scale (MAS) scores; and integrated electromyographic activity of the affected wrist flexors during passive stretch of the affected wrist joint. Results: VASRT was reduced significantly in the combined treatment group (P=.02) after the 6-week period, but not in the strengthening-only group (P=.23); however, no significant immediate effect of electro-acupuncture was observed (P >.05). MAS scores also showed a significant reduction (P <.01). SASRT did not differ significantly across different positions of the joint or across velocity; however, significant differences were present between the 2 treatment groups (P <.05) for each position and at all the velocities except at 20 degrees/s. Integrated electromyographic activity showed a trend for reduction ater the combined treatment. Conclusions: A combination of electro-acupuncture and muscle strengthening exercise for 6 weeks significantly reduced spasticity. The effect of spasticity reduction was consistent across different joint positions and different velocities of passive stretch.