Abstract:With the trend of aging population getting more obvious, stroke has already been a major public health problem worldwide. As a main disabling motor impairment after stroke, spasticity has unexpected negative impacts on the quality of life and social participation in patients. Moreover, it brings heavy economic burden to the family and society. Previous researches indicated that abnormality of neural modulation and muscle property corelates with the pathogenesis of poststroke spasticity (PSS). So far, there sti… Show more
“…Meta-analysis showed in 11 trials that acupuncture seemed to be more effective than drugs for treatment of thalamic pain, as assessed by the VAS [mean difference (MD) = −1.06, 95% CI = −1.20 to −0.91, P < 0.00001], the present pain intensity score (MD = −0.27, 95% CI = −0.43 to −0.11, P = .001), the pain rating index (MD = −1.02, 95% CI = −1.41 to −0.63, P < 0.00001), and the total efficiency (RR = 1.31, 95% CI = 1.22 to 1.41, P < 0.00001) 23. Other studies have shown that acupuncture may reduce spasticity and help aphasia in stroke victims 24,25…”
Learning Objectives: After participating in this continuing professional development activity, the provider should be better able to: 1. Explain the incorporation of acupuncture as an adjuvant for relief of cancer pain. 2. Outline how acupuncture can be incorporated into postoperative pain management strategies.
Identify the ability to reduce opioid use by substitution of acupuncture.This is the second of a 2-part series on acupuncture and traditional Chinese medicine (TCM). In the previous issue (Vol. 39, No. 1, August 2023), we discussed the history and context of TCM and acupuncture and discussed its use in pain management, opioid abuse treatment, depression and anxiety, and the cardiovascular system.Part II covers the use of acupuncture in treating other diseases and conditions, including in the following areas:• Pediatrics, such as attention and learning disorders, autism spectrum disorders, and cerebral palsy and muscle dystonia; CME Accreditation Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. Please visit https://cme.lww.com/browse/sources/125. This CME activity expires at 5 pm EST on August 31, 2025. NCPD Accreditation Lippincott Professional Development is accredited as a provider of nursing continuing professional development (NCPD) by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 2.0 contact hours for this NCPD activity. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states. Instructions for earning ANCC contact hours are included on page 8 of the newsletter. This NCPD activity expires on June 5, 2026.
“…Meta-analysis showed in 11 trials that acupuncture seemed to be more effective than drugs for treatment of thalamic pain, as assessed by the VAS [mean difference (MD) = −1.06, 95% CI = −1.20 to −0.91, P < 0.00001], the present pain intensity score (MD = −0.27, 95% CI = −0.43 to −0.11, P = .001), the pain rating index (MD = −1.02, 95% CI = −1.41 to −0.63, P < 0.00001), and the total efficiency (RR = 1.31, 95% CI = 1.22 to 1.41, P < 0.00001) 23. Other studies have shown that acupuncture may reduce spasticity and help aphasia in stroke victims 24,25…”
Learning Objectives: After participating in this continuing professional development activity, the provider should be better able to: 1. Explain the incorporation of acupuncture as an adjuvant for relief of cancer pain. 2. Outline how acupuncture can be incorporated into postoperative pain management strategies.
Identify the ability to reduce opioid use by substitution of acupuncture.This is the second of a 2-part series on acupuncture and traditional Chinese medicine (TCM). In the previous issue (Vol. 39, No. 1, August 2023), we discussed the history and context of TCM and acupuncture and discussed its use in pain management, opioid abuse treatment, depression and anxiety, and the cardiovascular system.Part II covers the use of acupuncture in treating other diseases and conditions, including in the following areas:• Pediatrics, such as attention and learning disorders, autism spectrum disorders, and cerebral palsy and muscle dystonia; CME Accreditation Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. To earn CME credit, you must read the CME article and complete the quiz and evaluation assessment survey on the enclosed form, answering at least 70% of the quiz questions correctly. Please visit https://cme.lww.com/browse/sources/125. This CME activity expires at 5 pm EST on August 31, 2025. NCPD Accreditation Lippincott Professional Development is accredited as a provider of nursing continuing professional development (NCPD) by the American Nurses Credentialing Center's Commission on Accreditation. Lippincott Professional Development will award 2.0 contact hours for this NCPD activity. This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states. Instructions for earning ANCC contact hours are included on page 8 of the newsletter. This NCPD activity expires on June 5, 2026.
“…PSS generally refers to spasticity as part of the neurological component of spastic paresis [ 43 ]. PSS is a complex clinical phenomenon manifested by increased muscle tone and hyperactive reflexes, considered a neurologic problem and an indication of muscle disorder [ 44 ]. The stretch reflex consists of afferent nerve fibers, spinal motor neurons, and efferent nerve fibers, whose excitability is regulated primarily by excitatory and inhibitory signals originating downstream from above the spinal cord [ 45 – 48 ].…”
Section: The Pathophysiological Mechanisms Of Post-stroke Spasticitymentioning
confidence: 99%
“… Fig. 1 Pathophysiology of post-stroke spasticity (PSS) associated with the corticospinal tract, modified from Wang et al [ 44 ]. The stretch reflex arc is mediated by excitatory connections between Ia afferent fibers from muscle spindles and the alpha-motor neurons innervating the same muscles they arise (indicated by the two gray neuron arrow loops in the figure).…”
Section: The Pathophysiological Mechanisms Of Post-stroke Spasticitymentioning
confidence: 99%
“…These drugs act directly on the spinal cord or muscle fibers to reduce muscle hyperexcitability and promote relaxation. Non-pharmacological interventions [ 159 ] include acupuncture techniques [ 44 , 160 ], which are effective in improving spasticity enhancement and motor function; rehabilitation techniques [ 44 , 161 ], including stretching exercises, passive range of motion exercises, and functional training, which can help control spasticity and neuromuscular electrical stimulation [ 162 , 163 ], which can reduce spasticity and improve range of motion in patients with PSS. Assistive devices [ 164 ]: The use of assistive devices can provide external support and improve functional abilities in individuals with spastic paresis.…”
Section: Clinical Treatment Of Post-stroke Spasticitymentioning
Stroke is the third leading cause of death and disability worldwide. Post-stroke spasticity (PSS) is the most common complication of stroke but represents only one of the many manifestations of upper motor neuron syndrome. As an upper motor neuron, the corticospinal tract (CST) is the only direct descending motor pathway that innervates the spinal motor neurons and is closely related to the recovery of limb function in patients with PSS. Therefore, promoting axonal remodeling in the CST may help identify new therapeutic strategies for PSS. In this review, we outline the pathological mechanisms of PSS, specifically their relationship with CST, and therapeutic strategies for axonal regeneration of the CST after stroke. We found it to be closely associated with astroglial scarring produced by astrocyte activation and its secretion of neurotrophic factors, mainly after the onset of cerebral ischemia. We hope that this review offers insight into the relationship between CST and PSS and provides a basis for further studies.
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