Background: The aim of this study was to assess the efficiency and safety of acupuncture in core symptomatic improvement of children with autism spectrum disorder (ASD). Methods: We searched the following databases: Cochrane Library, PubMed, Embase, Medline, China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Science and Technology Periodical (VIP) and Chinese Biological Medicine (CBM), from 1 January 2012 to 25 September 2022. The Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Autism Treatment Evaluation Checklist (ATEC) were adopted as outcome indicators. Three reviewers independently assessed the risk of bias (ROB) and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)assessment. Utilizing Review Manager (RevMan) 5.3 and Stata 12.0, data were analyzed. Results: A total of 38 trials were included, and 2862 participants participated in qualitative synthesis and meta-analysis. Only 1 trial was assessed as having a low ROB, and 37 trials were assessed as having an overall high ROB. The quality of evidence for most indicators were considered very low by the GRADE criteria. The results showed that acupuncture groups might have a higher clinical effective rate than nonacupuncture groups (relative risk [RR] = 1.33,95% confidence interval [CI] = 1.25–1.41; heterogeneity: x2=18.15, P = .64, I2 = 0%). Regarding changes in ABC scores, the acupuncture groups might exhibit greater decrease than nonacupuncture groups (MMD = −6.06, 95%CI = −7.25 to −4.87, P < .00001; heterogeneity: x2 =73.37, P = .03, I2 = 77%). In terms of changes in CARS score, acupuncture group may benefit more than nonacupuncture group (MMD = −3.93, 95%CI = 4.90 to −2.95, P < .00001; heterogeneity: x2=234.47, P < .00001, I2 = 90%). Additionally, in terms of ATEC score, acupuncture groups showed more benefit than nonacupuncture groups (MMD = −10.24, 95%CI = −13.09 to −7.38, P < .00001; heterogeneity: x2=45.74, P = .04, I2 = 85%). Both subgroup analysis and sensitivity analysis are existing heterogeneity. Only 1 RCT study involved adverse events with mild symptoms that did not interfere with treatment and evaluation. Conclusion: Children with ASD may benefit from acupuncture because of its effectiveness and safety. Nevertheless, given the low quality of the evidence for the assessed outcomes and the high ROB of analyzed trials, the results should be regarded with caution.

Purpose-Research of rehabilitation for postoperative dysfunction of Spinal dural arteriovenous fistula, especially perimedullary arteriovenous fistula, are still rare. This literature is a young patient with hemiplegia after embolization regained limb motor function by using extracorporeal shock wave to reduce muscle tension and PNF technique to enhance muscle strength and strengthen neural control. Methods-A 3-year and 11 months old girl fell down while riding a scooter and accidentally detected cervical spinal canal vascular malformation by brain MRI. The final diagnosis was perimedullary arteriovenous fistula with subarachnoid hemorrhage, C3-4 level. Total cerebrovascular angiography + spinal angiography + aortic arch angiography +C3-4 level perimedullary arteriovenous fistula interventional embolization was completed. The muscle strength of the right limb decreased after surgery, and the muscle strength of the right limb improved after dilation, vasodilation, and hormone shock therapy. At our initial assessment, we found that the patient could not lift the upper limb to hold a cup and could not stand. After 2 weeks of PNF technique combined with extracorporeal shock wave therapy, Manual Muscle Testing was used to evaluate the progress of muscle strength, modified Ashworh scale was used to evaluate muscle tension, and Barthel index was used to evaluate the dependence degree of daily life. The Time Up and Go Test and the Gaitwatch 3D Gait Analysis and Evaluation System are used to evaluate gait. Results-After 2 weeks of treatment, her motor function has been greatly recovered, she can lift the upper limbs, and walk independently. the score of the modified Ashworth scale(MAS) on Triceps Surae decreased from 2/5 to 1/5. Barthel index increased from 25/100 to 85/100. Deltoid strength increased from 1/5 to 3/5, Triceps strength increased from 1/5 to 4/5, Iliopsoas strength increased from 2/5 to 3/5, Quadriceps strength increased from 2/5 to 4/5, and tibialis anterior strength increased from 0/5 to 2/5. In gait, the hip joint and pelvis have almost the same movement trajectory as the left side in the stance phase and swing phase, but the ankle joint still has foot drop at the beginning and end of gait. Conclusions-PNF technique combined with extracorporeal shock wave could effectively improve the muscle tone, muscle strength, and gait of hemiplegia patients after upper cervical perimedullary arteriovenous fistula embolization. This literature reports a very rare case of hemiplegia after upper cervical perimedullary arteriovenous fistula embolization, which was able to walk independently after 2 weeks of rehabilitation.

Background: This study aims to observe the effects of extracorporeal shock wave therapy combined with Wuqinxi exercise on cervical motor function in patients with subacute mechanical neck pain. Methods: 70 participants with subacute mechanical neck pain were randomly assigned into an intervention or control groups.The intervention group was treated with extracorporeal shock wave therapy and Wuqinxi exercise,while the control group was received ultrasound therapy,for 4 weeks.The Visual Analogue Scale(VAS),Neck Disability Index(NDI) and Maximal Isometric Strength(MIS) were used for assessment at baseline,after one session,1st week,and 4th week after intervention.The flexion/extension ratio(F/E R)was calculated through MIS.The range of motion was measured at baseline and 4th week after intervention. Results: 63 participants (intervention group n=32, control group n=31) completed the study.Intervention group showed more significant improvement in the Neck Disability Index after intervention[5.69, 95% confidence interval (CI): 3.05 to 8.31,p<0.001].The improvement was more significant in intervention group on the Visual Analogue Scale[1.99，95% confidence interval (CI):1.03 to 2.93,p<0.05].Neck muscle strength recovered better in intervention group.Flexion/Extention Strength Ratio decreased more significant in intervention group [0.24，95% confidence interval (CI): 0.13 to 0.35,p<0.05].At the same time, intervention group showed greater increase in range of motion(p<0.05),except healthy side rotation (p=0.096). Conclusions: Extracorporeal shock wave therapy combined with Wuqinxi exercise can relieve pain, increase joint range of motion and muscle strength better than ultrasound therapy.It can significantly improve the motor function of cervical spine. Trial registration: Registration Number:ChiCTR2200064781(17/10/2022)