April 5, 2020
Acupuncture restores hand function in patients with hemiplegia. Foshan Jianxiang Hospital (Guangdong, China) researchers conclude that active motion acupuncture significantly improves outcomes for patients with hand dysfunction due to hemiplegia. The researchers document improvements in motor function, reductions in spasticity, and overall improvements in activities of daily living. 
Primary assessment instruments were the MAS (Modified Ashworth Scale), Fugl-Meyer Assessment, and ADL (Activities of Daily Living Scale). Two groups were compared. One group received physical rehabilitation training and another group received identical physical rehabilitation training plus acupuncture. The integrative medicine acupuncture group outperformed the physical rehabilitation monotherapy group across all parameters.
The study included 70 patients with varying degrees of hand dysfunction due to hemiplegia. The severity of the patients’ conditions was graded according to Brunnstrom’s Stages of Motor Recovery. In brief, the scale is comprised of:
For inclusion in the study, patients were required to have hand dysfunction graded 1–5 on the above scale and provide informed consent to participate. Exclusion criteria included serious organ dysfunction, hematopoietic disorders, and severe kidney or primary liver dysfunction.
Patients were randomly assigned to the acupuncture integrative medicine group or the rehabilitation training monotherapy control group. The acupuncture group was comprised of 21 male and 14 female patients, ages 33–81 years (mean age 55.8 years). The control group was comprised of 19 male and 16 female patients, ages 37–83 years (mean age 56.5 years). There were no statistically significant differences in baseline characteristics between the two groups (p>0.05).
Acupuncture and Rehabilitation Training
All patients received basic rehabilitation training according to the severity of their condition. Those with stage 1–2 conditions were guided to perform limb positioning exercises with bedside assistance and passive movement. Patients with stage 3–4 conditions performed activities of daily living and spasm reduction training. Patients with stage 5 conditions performed upper limb strength and activities of daily living training. Patients allocated to the acupuncture group also received exercise acupuncture therapy depending on the severity of their condition. Patients in the flaccid paralysis stage were treated using the following acupoints:
After eliciting deqi at Neiguan, the needle was stimulated using a lifting-thrusting, twisting-rotating technique. Approximately 60 rotations were applied per minute for a total of 3 minutes. Needles at the remaining acupoints were retained without further stimulation after eliciting deqi. All needles were retained for 30 minutes. During this time, the acupuncturist assisted the patient in passive flexion and extension of the fingers of the affected hand. The patient was allowed to take the lead in this movement if they were able to do so.
The point selection involved classic main channel acupoints PC6 and PC7 and two Master Tung system acupoints. Chongzi (22.01) is located on the thenar eminence, approximately 1 cun below the skin fold between the first and second metacarpal bones. Chongxian (22.02) is located between the first and second metacarpal bones, 2 cun below the skin fold, on the palmar surface of the hand. Chongxian (22.02) is located on the ventral aspect of the hand and is directly opposite Linggu (22.05), which is on the dorsal aspect of the hand. Patients in the spasticity stages were treated using the following acupoints:
The needles were stimulated using an intermittent lifting-thrusting, twisting-rotating technique while guiding the patient in passive and active flexion and extension of the affected hand.
Outcome measures for the study included the MAS (Modified Ashworth Scale), Fugl-Meyer Assessment, and ADL (Activities of Daily Living Scale). The MAS is a scale used to assess spasticity in patients with central nervous system lesions. A higher score is indicative of increased spasticity. Mean pre-treatment MAS scores were 1.71 in the control group and 1.70 in the acupuncture group. Following treatment, these scores fell to 0.62 and 0.42, respectively. Significantly greater improvements were seen in the acupuncture group (p<0.05).
The Fugl-Meyer Assessment is designed to gauge recovery in hemiplegic patients. A higher score is indicative of greater recovery. Mean pre-treatment Fugl-Meyer scores were 21.55 in the control group and 22.06 in the acupuncture group. Following treatment, these scores increased to 23.31 and 35.87, respectively. Significantly greater improvements were seen in the acupuncture group (p<0.05).
ADL scores are used to assess a patient’s ability to perform tasks such as dressing, toileting, and hygiene, independently. A higher score is indicative of greater independence. Mean pre-treatment ADL scores were 37.8 in the control group and 38.1 in the acupuncture group. Following treatment, these scores increased to 52.4 and 74.1, respectively. Significantly greater improvements were seen in the acupuncture group (p<0.05).
The study focused on the application of local acupuncture points for the treatment of hand dysfunction due to hemiplegia. The results indicate that this approach to patient care improves outcomes for patients receiving physical rehabilitation training.
Folk medicines and herbal products have been used for millennia to combat a whole range of ailments, at times to the chagrin of modern scientists who have struggled to explain their medicinal benefits.
Although elderberry's flu-fighting properties have long been observed, the group performed a comprehensive examination of the mechanism by which phytochemicals from elderberries combat influenza infections.
"What our study has shown is that the common elderberry has a potent direct antiviral effect against the flu virus," said Dr Golnoosh Torabian.
"It inhibits the early stages of an infection by blocking key viral proteins responsible for both the viral attachment and entry into the host cells."
The researchers used commercially farmed elderberries which were turned into a juice serum and were applied to cells before, during and after they had been infected with the influenza virus.
The phytochemicals from the elderberry juice were shown to be effective at stopping the virus infecting the cells, however to the surprise of the researchers they were even more effective at inhibiting viral propagation at later stages of the influenza cycle when the cells had already been infected with the virus.
"This observation was quite surprising and rather significant because blocking the viral cycle at several stages has a higher chance of inhibiting the viral infection," explained Dr Peter Valtchev.
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