Acupuncture and constraint-induced movement therapy for a patient with chronic stroke

Abstract

Rationale:Spasticity is a widespread problem in chronic stroke. To date, no study has reported the long-term (up to 1 year) outcomes of acupuncture in combination with constraint-induced movement therapy in patients with chronic stroke. This report describes the successful addition of acupuncture on spasticity and arm function in a patient with chronic stroke and arm paresis.Patient concerns:At screening, the patient was unable to voluntarily extend her interphalangeal or metacarpophalangeal joints beyond the 10 degrees required for constraint-induced movement therapy. However, the BTX type A injection couldn’t be used as she had ever suffered a severe allergic reaction in the injection of BTX type A for facial anti-wrinkle.Diagnoses:A 40-year-old female experienced arm paresis after an infarction in the right posterior limb of the internal capsule 2 years before the intervention.Interventions:The BTX type A injection couldn’t be used as she had ever suffered a severe allergic reaction in the injection of BTX type A for facial anti-wrinkle, so the patient received 1 hour of acupuncture as an alternative therapy before 5 hours of constraint-induced movement therapy for 12 weekdays.Outcomes:All outcome measures (Modified Ashworth Scale, Fugl-Meyer Assessment, Action Research Arm Test, Motor Activity Log) substantially improved over the 1-year period. Moreover, during the observation period, the patient's muscle tone and arm function did not worsen.Lessons:As a result of a reduction in spasticity, a reduction of learned nonuse behaviors, or use-dependent plasticity after the combined therapy, the arm functions include volitional movements and coordination or speed of movements in the paretic arm have been improved. However, we can not rule out the possibility of an influence of the passage of time or the Hawthorne effect. The costs of the treatment of stroke may be reduced, if this combined therapy proved useful in future controlled studies.

Pheophorbide a Derivatives Exert Antiwrinkle Effects on UVB-Induced Skin Aging in Human Fibroblasts

“…Botulinum toxin and several synthetic products have been effectively used to prevent wrinkles, but these induce adverse events, such as allergic reactions [ 11 ], muscle weakness, and flu-like symptoms [ 12 ]. Naturally derived compounds have attracted much attention in the field of cosmetics due to their hypoallergenic and fast-absorbing properties.…”

Different acupuncture therapies for spastic paralysis after stroke

“…[ 5 ] Relevant articles revealed the possible etiologies that mainly injured the upper motor neurons, resulting in a significant increase in muscle tension. [ 6 , 7 ] If failure to take active treatment may cause Joint deformation, muscular atrophy, and pain, which may affect the rehabilitation of the limbs and the quality of life. [ 8 ]…”

Fisioterapia Neurofuncional

“…Para pacientes pós-AVE, existe um conjunto terapêutico amplo, sendo aplicadas diversas abordagens fisioterapêuticas, dentre essas técnicas destacam-se: a terapia do movimento induzida por restrição, conceito Neuroevolutivo (método Bobath), Facilitação Neuromuscular Proprioceptiva (método Kabat), estimulação Transcraniana por Corrente Contínua (ETCC), Terapia Espelhada, Acupuntura, Treino Mental (TM), entre outras (SILVA; TAMASHIRO; ASSIS, 2010;SIQUEIRA;BARBOSA, 2013;SEOK et al, 2016;FIGLEWSKI et al, 2017;JIN, et al, 2017;TAKEBAYASHI et al, 2017;JU;.…”

“…Já a segunda consiste na ampliação de áreas de representação cortical de partes estimulando novas sinapses a partir do treinamento intensivo. (VAZ et al, 2008;JIN et al, 2017). Este estudo tem como objetivo avaliar a eficácia da Terapia de Movimento Induzido por Restrição em pacientes pós-AVC.…”