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acupuncture:evaluation:neuro-psychiatrie:07. spasticite de l hemiplegique [04 Feb 2025 17:32] Nguyen Johan |
acupuncture:evaluation:neuro-psychiatrie:07. spasticite de l hemiplegique [17 Oct 2025 13:32] (Version actuelle) Nguyen Johan [1.2.5. Zhang 2017 (technique des méridiens tendino-musculaires) ☆] |
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| ==== Special Acupuncture Techniques ==== | ==== Special Acupuncture Techniques ==== | ||
| + | === Comparison of Acupuncture techniques === | ||
| + | == Zhu 2024 == | ||
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| + | Zhu GC, Chen KM, Belcastro F. Comparing the effects of different acupoint-stimulating therapies in mitigating post-stroke spasticity and motor dysfunction in older stroke survivors: A network meta-analysis of randomized trials. Maturitas. 2024 Sep;187:108040. https://doi.org/10.1016/j.maturitas.2024.108040 | ||
| + | ^Background| Acupoint-stimulating therapies have often been used to manage stroke-related spasticity and motor dysfunction. However, the effects of different acupoint-stimulating therapies in older stroke survivors have been unclear.| | ||
| + | ^Methods| This systematic review and network meta-analysis compared the effects of different acupoint-stimulating therapies in managing spasticity and motor dysfunction in older stroke survivors. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched 7 databases for studies published up to July 2023. Inclusion criteria were: (1) older adults with strokes; (2) treatments were acupoint-stimulating therapies; (3) a control group did not receive acupoint-stimulating therapy, or the study compared different acupoint-stimulating therapies; and (4) outcomes included spasticity and motor function. Methodological quality was assessed with Risk-of-bias tool for randomized trials version 2, while R and Metainsight were used to conduct the network meta-analysis| | ||
| + | ^Results| We analyzed **27 studies** and the results showed that non-invasive electroacupuncture and warm acupuncture were more effective in reducing spasticity than conventional acupuncture (standardized mean difference and 95 % confidence intervals = 1.35/1.19 [0.57; 2.13/0.54; 1.83]) and invasive electroacupuncture (standardized mean difference and 95 % confidence intervals = 0.96/0.80 [0.12; 1.80/0.08; 1.51]). Conventional acupuncture and invasive electroacupuncture were effective in improving motor function (standardized mean difference and 95 % confidence intervals = 0.99/1.41 [0.42; 1.56/0.54; 2.28]). However, there was significant inconsistency for the effects of invasive electroacupuncture between studies. | | ||
| + | ^Conclusions|Our findings suggest that for older stroke survivors with spasticity, non-invasive electroacupuncture and warm acupuncture are appropriate, whereas conventional acupuncture is more appropriate for patients aiming for motor recover.| | ||
| === Fire needle === | === Fire needle === | ||
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| ^ Conclusions|**Acupuncture at meridian sinew is effective in the treatment of spastic paralysis after stroke**. The total clinical effect and the improvement in muscular tone with acupuncture at meridian sinew are better than those with normal acupuncture technique. The quality of the included literature is not high generally. Hence, it is necessary to have more clinical studies with high-quality and strict design. | | ^ Conclusions|**Acupuncture at meridian sinew is effective in the treatment of spastic paralysis after stroke**. The total clinical effect and the improvement in muscular tone with acupuncture at meridian sinew are better than those with normal acupuncture technique. The quality of the included literature is not high generally. Hence, it is necessary to have more clinical studies with high-quality and strict design. | | ||
| + | ==== Mechanistic systematic reviews==== | ||
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| + | === You 2025 === | ||
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| + | You L, Hu M, Li J, Tan J, Guo F, Kong Y. The mechanism of electroacupuncture treatment for post-stroke spasticity: A systematic review and meta-analysis. Behav Brain Res. 2025 Oct 14:115873. https://doi.org/10.1016/j.bbr.2025.115873 | ||
| + | ^Objective|To assess whether electroacupuncture (EA) is an effective treatment for post-stroke spasticity (PSS) and to examine the mechanisms by which it modulates PSS, combining clinical and mechanistic evidence to clarify its therapeutic value and biological basis.| | ||
| + | ^Methods|Databases searched included PubMed, Web of Science, Embase, Medline, and SinoMed. Study quality was assessed using the SYRCLE bias risk assessment tool and CAMARADES checklist. Meta-analyses were performed with Stata 15.0 and Rstudio. Primary outcomes were Zea Longa and Modified Ashworth Scale (MAS) scores; secondary outcomes included Bederson score, electrophysiological measures, cerebral infarction and edema, and biomarkers such as IL-6, TNF-α, MDA, GABA, Glu, GABA-T, GAD67, BDNF, TrkB, GPX4, GSH, and related mRNA indicators.| | ||
| + | ^Results|Twenty animal studies (n = 388) were included, with quality scores ranging from 4 to 8 (mean 6.1). Meta-analysis showed significant improvement in Zea Longa score (MD = –1.05, 95% CI –1.30 to –0.80, P < 0.001) and MAS score (MD = –1.06, 95% CI –1.43 to –0.69, P < 0.001). EA significantly enhanced neurological recovery, reduced limb spasticity, improved balance, and decreased infarct size and edema. It downregulated IL-6, TNF-α, MDA, Glu, and GABA-T, while upregulating GSH, GABA, GAD67, BDNF, TrkB, GPX4, SLC7A11, and their corresponding mRNA levels. Publication bias was detected for MAS, and protocol heterogeneity (waveform, acupoints, duration) contributed to variability.| | ||
| + | ^Conclusion|EA alleviates PSS through modulation of neurotransmitters, suppression of microglia-mediated neuroinflammation, reduction of oxidative stress, and enhancement of synaptic plasticity and neuronal development. These findings support EA’s therapeutic potential for PSS, warranting further high-quality mechanistic and clinical studies.| | ||
| ===== Overviews of Systematic Reviews ===== | ===== Overviews of Systematic Reviews ===== | ||
