Evoking the Withdrawal Reflex via Successive Needle‐Pricking on the Plantar and Dorsal Aspect of the Foot Increases the FMA of the Lower Limb for Poststroke Patients in Brunnstrom Stage III: A Preliminary Study

Abstract

The withdrawal reflex is a defensive reaction to nociceptive stimuli and can be used to regulate locomotor gait during rehabilitation. We investigated the effect of successive needle-pricking of the plantar and dorsal foot surfaces on poststroke lower limb function. Thirty-five hemiplegic patients, within one month after primary stroke, with an affected lower limb (Brunnstrom stage III) were randomly divided into intervention and control groups. Both groups received routine drug treatment, rehabilitation training, and upper limb acupuncture treatment on the hemiplegic side. The control group also received routine acupuncture on the hemiplegic side of the lower limb, while the intervention group received successive needle-pricking on the sole and instep of both the unaffected and affected side feet. Outcomes were assessed before inception (D0) and after three (D3) and six (D6) treatment days, using Brunnstrom stage (Ueda assessment), total Fugl–Meyer lower extremity assessment (FMA-LE) and its subscores (FMA-LE-ss), active lower limb range of motion (AROM-LL), Modified Ashworth Scale Score (MAS-LL), and manual muscle testing (MMT-LL). The Brunnstrom stage was better in the intervention group than in the control group at both D3 and D6 P<0.01. The total FMA-LE score and sections B, C, D, and G FMA-LE-ss were significantly better in the intervention group than in the control group at D3 and D6 P<0.05. The AROM-LL hip and knee flexion and hip extension improved more in the intervention group than in the control group P<0.05. In the intervention group, MAS-LL hip flexion significantly improved at D6 P<0.01. Improvement in lower limb joints on the MMT-LL in the intervention group exceeded that in the control group at D6 P<0.01. Successive needle-pricking on the plantar and dorsal foot aspects of Brunnstrom stage III in poststroke patients contributed to rapid lower limb motor function improvement via the withdrawal reflex. This trial is registered with ChiCTR1900020633.

Poor Spontaneous Recovery of Aphemia Accompanied by Damage to the Anterior Segment of the Left Arcuate Fasciculus: A Case Report

“…He was unable to produce sound. The manual muscle testing (MMT, modified Lovett muscle test) [ 8 , 9 ] scores were 0/5 for the right upper limb, 4/5 for the right lower limb, and 5/5 for the left leg. His National Institutes of Health Stroke Scale (NIHSS) [ 10 ] score was 15, including 4 for upper limbs, 1 for lower limbs, 2 for language, and 2 for articulation.…”

Using the Flexor Reflex in a Chronic Stroke Patient for Gait Improvement: A Case Report

“…Two preceding studies that focused on FR activation had been performed in subacute stroke patients. One of these studies had also used the Incedo R system (4); in the other publication, successive needle pricking on plantar and dorsal parts of the foot had been applied (7).…”