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      Therapeutic efficacy of acupuncture combined with neuromuscular joint facilitation in treatment of hemiplegic shoulder pain

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          Abstract

          BACKGROUND

          Stroke is a type of cerebrovascular disease with high prevalence, mortality, and onset of disability. As a neurodevelopmental therapy, neuromuscular joint facilitation (NJF) is widely used in the treatment of orthopedic and neurological disorders in the clinical practice. It is mainly used for central nervous system diseases or orthopedic diseases, movement disorders, and pain rehabilitation. According to related studies, NJF can also be used as a rehabilitation treatment in patients with hemiplegic shoulder pain (HSP).

          AIM

          To investigate the clinical efficacy of acupuncture combined with NJF in patients with HSP.

          METHODS

          Forty patients with HSP were randomly divided into a treatment group and a control group. The treatment group was treated with acupuncture combined with NJF and the control group was treated with acupuncture alone. All patients were assessed by using the visual analogue scale (VAS), Fugl-Meyer assessment (FMA), Barthel index (BI), and passive range of motion (PROM) before and after the training. All the clinical data were analyzed using SPSS 20.0 statistical software.

          RESULTS

          There was no statistical difference in the general characteristics between the two groups. In the terms of duration of treatment, age, and pre-treatment indicators, the two groups were comparable ( P > 0.05). After the treatment, VAS, PROM, BI, and FMA scores were significantly improved in the two groups of patients ( P < 0.05). The VAS, PROM and FMA scores were significantly higher in the treatment group than in the control group ( P < 0.05). However, there was no significant difference in BI scores between the two groups ( P > 0.05).

          CONCLUSION

          Both acupuncture alone and acupuncture combined with NJF in the treatment of HSP are effective, and can improve the clinical symptoms of patients. Acupuncture combined with NJF can improve the upper limb motor function, relieve pain, and increase joint mobility in patients with HSP. The combination therapy is better than acupuncture alone. However, there is no significant difference in improving the score of patients’ self-care ability.

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          Most cited references30

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          Major causes of death among men and women in China.

          With China's rapid economic development, the disease burden may have changed in the country. We studied the major causes of death and modifiable risk factors in a nationally representative cohort of 169,871 men and women 40 years of age and older in China. Baseline data on the participants' demographic characteristics, medical history, lifestyle-related risk factors, blood pressure, and body weight were obtained in 1991 with the use of a standard protocol. The follow-up evaluation was conducted in 1999 and 2000, with a follow-up rate of 93.4 percent. We documented 20,033 deaths in 1,239,191 person-years of follow-up. The mortality from all causes was 1480.1 per 100,000 person-years among men and 1190.2 per 100,000 person-years among women. The five leading causes of death were malignant neoplasms (mortality, 374.1 per 100,000 person-years), diseases of the heart (319.1), cerebrovascular disease (310.5), accidents (54.0), and infectious diseases (50.5) among men and diseases of the heart (268.5), cerebrovascular disease (242.3), malignant neoplasms (214.1), pneumonia and influenza (45.9), and infectious diseases (35.3) among women. The multivariate-adjusted relative risk of death and the population attributable risk for preventable risk factors were as follows: hypertension, 1.48 (95 percent confidence interval, 1.44 to 1.53) and 11.7 percent, respectively; cigarette smoking, 1.23 (95 percent confidence interval, 1.18 to 1.27) and 7.9 percent; physical inactivity, 1.20 (95 percent confidence interval, 1.16 to 1.24) and 6.8 percent; and underweight (body-mass index [the weight in kilograms divided by the square of the height in meters] below 18.5), 1.47 (95 percent confidence interval, 1.42 to 1.53) and 5.2 percent. Vascular disease and cancer have become the leading causes of death among Chinese adults. Our findings suggest that control of hypertension, smoking cessation, increased physical activity, and improved nutrition should be important strategies for reducing the burden of premature death among adults in China. Copyright 2005 Massachusetts Medical Society.
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            Post Stroke Pain: Identification, Assessment, and Therapy

            Background: Pain is a common complication after stroke and is associated with the presence of depression, cognitive dysfunction, and impaired quality of life. It remains underdiagnosed and undertreated, despite evidence that effective treatment of pain may improve function and quality of life. Summary: We provide an overview of the means for clinical assessment and risk factors for the development of post-stroke pain, then review the newest available literature regarding the commonest post-stroke pain syndromes, including central post-stroke pain, complex regional pain syndrome, musculoskeletal pain including shoulder subluxation, spasticity-related pain, and post-stroke headache, as well as the available epidemiology and current treatment options. Key Messages: In the best interests of optimizing quality of life and function after stroke, clinicians should be aware of pain as a common complication after stroke, identify those patients at highest risk, directly inquire as to the presence and characteristics of pain, and should be aware of the options for treatment for the various pain syndromes.
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              The Intervention Effects of Different Treatment for Chronic Low Back Pain as Assessed by the Cross-sectional Area of the Multifidus Muscle

              [Purpose] The purpose of this this study was to examine the immediate effects of intervention of proprioceptive neuromuscular facilitation (PNF), neuromuscular joint facilitation (NJF) and NJF+pelvic floor muscle (PFM) exercise. [Subjects] Thirteen young people (5 males, 8 females) who had chronic low back pain on one side for more than 6 months. [Methods] Subjects were asked to lie on their sides with the painful side uppremost. The subjects received PNF, and NJF, NJF+PFM exercise treatments. The changes in the cross-sectional area of the multifidusmuscle were measured using ultrasonography. [Results] The cross-sectional area of the multifidus muscle of NJF+PFM group showed the largest increases on both the sides with and without pain. [Conclusion] Our results show that chronic low back pain can be improved by a combination of PFM exercise and the NJF pattern.
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                Author and article information

                Contributors
                Journal
                World J Clin Cases
                WJCC
                World Journal of Clinical Cases
                Baishideng Publishing Group Inc
                2307-8960
                6 December 2019
                6 December 2019
                : 7
                : 23
                : 3964-3970
                Affiliations
                Department of Rehabilitation, Nanjing University of Chinese Medicine, Nanjing 210028, Jiangsu Province, China
                Department of Rehabilitation, Nanjing Red Cross Hospital, Nanjing 210028, Jiangsu Province, China
                Department of Rehabilitation Physiotherapy, Jiangsu Provincial Hospital of Integration of Chinese and Western Medicine, Nanjing 210028, Jiangsu Province, China. shanchuanbaobei@ 123456163.com
                Author notes

                Author contributions: Wei YH and Du DC contributed equally to this manuscript; Wei YH, Du DC, and Jiang K designed the research and wrote and revised the manuscript.

                Corresponding author: Ke Jiang, MD, Chief Physician, Department of Rehabilitation Physiotherapy, Jiangsu Provincial Hospital of Integration of Chinese and Western Medicine, No. 100, Cross Street, Hongshan Road, Nanjing 210028, Jiangsu Province, China. shanchuanbaobei@ 123456163.com

                Article
                jWJCC.v7.i23.pg3964
                10.12998/wjcc.v7.i23.3964
                6906577
                31832398
                489088f9-53f0-43bd-9c3f-a94b8dbe59f5
                ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                : 8 September 2019
                : 19 October 2019
                : 23 November 2019
                Categories
                Observational Study

                acupuncture,neuromuscular joint facilitation,hemiplegic shoulder pain,visual analogue scale,fugl-meyer assessment,therapy

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