Highlights
TCM compress combined with modern rehabilitation is obviously superior to single rehabilitation training, which serves as a safe, simple, fast and effective therapeutic method for motor function rehabilitation of stroke patients.
Editor’s Summary
For stroke patients, combined with non-drug therapy can significant improve the therapeutic effects of conventional medicine treatment. However, the standard of the treatment should be noteworthiness.
Abstract
Background: Spasm is one of the most serious physical impairment after stroke. The external-application of herbs has showed the curative effects on the spasm to some degree. This study was conducted to evaluate the effects of external-application of traditional Chinese medicine (TCM) based on both conventional medicine therapy and rehabilitation therapy in upper limb spasticity after stroke. Methods: A total of 100 patients with upper limb spasm after stroke (stroke occurred less than 1 month), have been recruited in Shunyi Hospital of Beijing Traditional Chinese Medicine Hospital. Patients were randomly allotted to two groups respectively (n = 50, respectively): the control group (conventional medicine therapy and rehabilitation therapy), and the treatment group (external-application of traditional Chinese medicine (TCM) based on conventional medicine therapy and rehabilitation therapy). The two groups were administered once a month for three months. The primary outcome were Modified Ashworth score and Fugl-Meyer assessment for upper limb. Results: Muscle tension and motor function were evaluated before and 4 weeks after treatments. There was a significant improvement in muscle tension and motor function in patients with stroke after the therapy of external-application herbs combined with conventional medicine therapy and rehabilitation therapy (P < 0.05). Conclusion: Patients’ kinematic function can be improved after the external-application of herbs and modern rehabilitation therapy in upper limb.
Core stability training on the basis of conventional rehabilitation therapy can improve the trunk control ability, balance ability, walking function and activity of daily living in patients with stroke hemiplegia.
Core stability exercise, as one of the non-drug therapies, combined with conventional rehabilitation therapy has better effects on rehabilitation in stroke patients with hemiplegia.
Objective: To evaluate the effects of core stability exercise (CST) on rehabilitation in stroke patients with hemiplegia. Methods: Randomly controlled trials about the effects of CST on rehabilitation in stroke patients with hemiplegia were searched in the database, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, CBM and VIP. Search terms include “core stability training / core stability exercise / core stabilization training / core stabilization exercise / core strength training / core strength exercise” and “stroke / brain ischemia / cerebral infarction / cerebral hemorrhage / intracranial thrombosis / brain hemorrhage / cerebrovascular disorder / cerebrovascular accident, cerebrovascular disease / hemiplegia / hemiparesis / stroke rehabilitation”. Study screening, data extraction and quality assessment were conducted by two researchers independently. Data was analyzed using RevMan 5.3 software. Results: Totally 11 studies and 704 patients were included with 352 patients in experiment group and 352 in control group.Results of meta-analysis showed that combination of CST and conventional rehabilitation had better effects on trunk control [MD = 10.44, 95% CI (8.83-12.04), P < 0.001], banlace [MD = 5.6, 95% CI (4.81-6.39), P < 0.001], activities of daily living [MD = 12.06, 95% CI (7.65-16.46), P < 0.001], ambulation functional [MD = 0.72, 95% CI (0.32-1.12), P < 0.001] and walking speed [MD = 3.39, 95% CI (2.03-4.76), P < 0.001] than conventional rehabilitation, but there is no clear difference on walking stride [MD = 2.52, 95% CI (-0.25-5.29), P = 0.07] between two groups. Conclusion: CST together with conventional rehabilitation can better improve trunk control, banlace, activities of daily living, ambulation functional and walking speed in stroke patients compared with conventional rehabilitation, but can not make the walking stride better significantly. However, since the conclusion of this meta-analysis was drawn based on middle quality RCTs, future high quality researchs should be conducted to confirm its positive intervention effects.
The present study highlights that the short-term and long-term efficacy of acupuncture on constipation after stroke is better than that of treatment with lactulose oral solution.
Compared with lactulose oral solution, the acupuncture is shown as a safe method with no side effects and is a long-lasting and highly feasible treatment method suitable for constipation after stroke.
Objective: To observe the differences in therapeutic effects of acupuncture and lactulose oral solution on constipation after stroke. Method: Sixty patients with constipation after stroke were divided into an acupuncture group and a western medicine group by a random number method, with 30 cases in each group. Based on the the conventional treatment and rehabilitation for function recovery, the acupuncture group was treated at the selected the bilateral acupoints: Daheng (SP15), Fujie (SP14), Zhigou (TE6), Zhaohai (KI6), Yingxiang (LI20), and Shaoshang (LU11) while the western medicine group was treated with 30 ml of lactulose oral solution. The clinical symptoms score and clinical efficacy of the treatment provided for constipation in both groups were recorded pre-treatment, at one week of treatment, after treatment for two weeks, and one month after discharge respectively. Results: The clinical symptom scores of constipation in the two groups after one week of treatment, two weeks of treatment, and one month of treatment were significantly lower than those before treatment (P < 0.001). The treatment efficacy in the acupuncture group showed significant improvement when compared with the western medicine group, at one week, two weeks and one month (1.03 ± 1.19 vs 1.43 ± 1.19, P > 0.05 ; 0.73 ± 1.01 vs 1.33 ± 1.18, P < 0.05; 0.53 ± 0.82 vs 1.27 ± 1.14, P < 0.05, respectively). The efficacy rate was statistically significant at two weeks after treatment and one month after follow-up (86.67% vs 70%,P < 0.05; 93.33% vs 73.33%, P < 0.05, respectively). Conclusion: The short-term and long-term efficacy of acupuncture on constipation after stroke is better than that of treatment with lactulose oral solution. This method is safe, free of side effects, durable, has high feasibility, and is suitable for clinical application.
