Electroacupuncture versus conventional acupuncture of scalp motor area for post-stroke wrist dyskinesia and its effect on muscle function: a randomized, controlled clinical trial

doi:10.19852/j.cnki.jtcm.2025.04.014

Abstract

Abstract:

OBJECTIVE: To evaluate the efficacy of electroacupuncture (EA) at scalp motor area for treating post-stroke wrist dyskinesia and its influence on the function of wrist movement-related agonistic muscles.

METHODS: A randomized, single-blind, controlled clinical trial was conducted. Sixty-six patients undergoing post-stroke wrist dyskinesia were enrolled and randomized 1 : 1 to EA or control group. Patients in the control group received manual acupuncture in the scalp motor area (MS 6) on the lesion side. The same acupoint was selected to accept EA stimulation in the EA group. All patients were treated six times a week for three weeks. The primary outcome was the Chinese Stroke Scale (CSS) score. The secondary outcomes included upper limb-related Barthel Index (BI) score, active range of motion (AROM) of the wrist joint, and root mean square (RMS) of the four agonistic muscles associated with wrist motion on the hemiplegic side of patients, i. e., the extensor carpi radialis longus (ECRL), extensor digitorum (ED), flexor carpi radialis (FCR) and flexor carpi ulnaris (FCU). The above indicators were measured before and after three weeks of treatment.

RESULTS: After 3-week treatment, the CSS score and AROM of wrist dorsiflexion of the EA group were better than those in the control group (P = 0.038, P = 0.047). The differences between the two groups of BI scores and AROM of wrist flexion were not significant (P > 0.05). All RMS of the EA group were higher than those in the control group (ECRL: P = 0.047, ED: P = 0.048, FCR: P = 0.049, FCU: P = 0.047). The total effective rate in the EA group was 87.50% (28/32), which was higher than that in the control group (77.42%, 24/31, P = 0.048).

CONCLUSION: EA stimulation of the scalp motor area can promote the recovery of the strength and function of the agonistic muscles related to wrist movement and effectively improve post-stroke wrist dyskinesia.

Key words: stroke, wrist joint, movement disorders, electroacupuncture, electromyography, randomized controlled trial

ZHENG Ruwen, DONG Xu, WANG Tianyi, FENG Liyuan, ZHANG Hongyan, HUO Hong, ZHANG Ying, ZHANG Qianshi, ZHU Xingyan, WANG Dongyan. Electroacupuncture versus conventional acupuncture of scalp motor area for post-stroke wrist dyskinesia and its effect on muscle function: a randomized, controlled clinical trial[J]. Journal of Traditional Chinese Medicine, 2025, 45(4): 852-859.

Figures/Tables 4

References 28.

1.	Prevention RoS, Group TiCW. Brief report on stroke prevention and treatment in China, 2021. Zhong Guo Nao Xue Guan Bing Za Zhi 2023; 20: 783-93.
2.	Tang Z, Liu T, Liu Y, et al. Different doses of intermittent theta burst stimulation for upper limb motor dysfunction after stroke: a study protocol for a randomized controlled trial. Front Neurosci 2023; 17: 1259872.
3.	Tang Q, Yang X, Sun M, et al. Research trends and hotspots of post-stroke upper limb dysfunction: a bibliometric and visualization analysis. Front Neurol 2024; 15: 1449729.
4.	Zhao Q, Jia G, Jia L, et al. Effects of electromyography bridge on upper limb motor functions in stroke participants: an exploratory randomized controlled trial. Brain Sci 2022; 12: 870.
5.	Xu Y, Wu C, Yu W, et al. Systematic review and Meta-analysis of brain plasticity associated with electroacupuncture in experimental ischemic stroke. J Tradit Chin Med 2024; 44: 859-70. DOI
6.	Huang YJ, Huang CS, Leng KF, Sung JY, Cheng SW. Efficacy of scalp acupuncture in patients with post-stroke hemiparesis: Meta-analysis of randomized controlled trials. Front Neurol 2021; 12: 746567.
7.	Lu SY, Wang DY, Yang HY, Ma CC, Chen C, Zhao YN. Effect of scalp electro-acupuncture on metabonomics of urine in rats with cerebra infarction. Zhen Jiu Lin Chuang Za Zhi 2021; 37: 52-9.
8.	Ma CC, Wang DY. Effect of head electroacupuncture with different frequency on the expression of NRG-1 in rats with cerebral infarction. Liaoning Zhong Yi Yao Da Xue Xue Bao 2021; 23: 54-8.
9.	Ji Y. Clinical observation of electroacupuncture combined with scalp acupuncture in the treatment of ischemic stroke. Nanjing: Nanjing University of Chinese Medicine; 2017: 20-5.
10.	Wu MH, Shi Y. Internal medicine of Traditional Chinese Medicine. Beijing: China Press of Traditional Chinese Medicine, 2021: 145-52.
11.	Neurology CSo, Neurology CDGotCSo. Chinese guidelines for diagnosis and treatment of acute intracerebral hemorrhage 2019. Zhong Hua Shen Jing Ke Za Zhi 2019; 52: 994-1005.
12.	Neurology CSo, Neurology CDGotCSo. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018. Zhong Hua Shen Jing Ke Za Zhi 2018; 51: 666-82.
13.	Region WHOWP. WHO standard acupuncture point locations in the western pacific region. Geneva: World Health Organization, 2008: 174, 214.
14.	Tao ZR. Reliability, validity and sensitivity of Chinese scale for clinical neurological deficit of stroke patients. Di Er Jun Yi Da Xue Xue Bao 2009; 30: 283-5.
15.	Buurman BM, van Munster BC, Korevaar JC, de Haan RJ, de Rooij SE. Variability in measuring (instrumental) activities of daily living functioning and functional decline in hospitalized older medical patients: a systematic review. J Clin Epidemiol 2011; 64: 619-27. DOI PMID
16.	Huang XL, Yan TB. Rehabilitation medicine. Beijing: People's Medical Publishing House, 2018: 46-8.
17.	Sung JH, Baek SH, Park JW, Rho JH, Kim BJ. Surface electromyography-driven parameters for representing muscle mass and strength. Sensors (Basel) 2023; 23: 5490.
18.	Society CN. Scoring criteria for the degree of clinical neurological deficits in stroke patients (1995). Zhong Hua Shen Jing Ke Za Zhi 1996; 29: 62-4.
19.	Wang SY, Wang J, Liu K, et al. The shortcut pathway between scalp acupuncture and brain. Zhen Ci Yan Jiu 2020; 45: 947-53.
20.	Chen G. Study on the localization of head needle motor area based on 3D printing technology. Harbin: Heilongjiang University of Chinese Medicine; 2022: 33-7.
21.	Tang J, Xi X, Wang T, Wang J, Li L, Lyu Z. Analysis of corticomuscular-cortical functional network based on time-delayed maximal information spectral coefficient. J Neural Eng 2023; 20: 10.1088/1741-2552/acf7f7.
22.	Lin D, Gao J, Lu M, et al. Scalp acupuncture regulates functional connectivity of cerebral hemispheres in patients with hemiplegia after stroke. Front Neurol 2023; 14: 1083066.
23.	Lang Y, Li KS, Yang JY, Cui FY, Bai W, Liang CX. Effect of acupuncture at the anterior oblique parietotemporal line on gray matter remodeling in patients with hemiplegia of cerebral infarction. Zhen Ci Yan Jiu 2020; 45: 141-7.
24.	Chen YL, Ouyang L, Meng LL, et al. Electroacupuncture ameliorates blood-brain barrier disruption after ischemic stroke through histone acetylation regulation at the matrix metalloproteinase 9 and tissue inhibitor of metalloproteinase 2 genes. J Tradit Chin Med 2024; 44: 734-44. DOI
25.	Chen C. Effects of different frequency of scalp electroacupuncture on motor function and expression of VEGF protein in ischemic region in rats with cerebral infarction. Harbin: Heilongjiang University of Chinese Medicine, 2020: 23-37.
26.	Cao BQ, Tan F, Fang MF, Huo QW. Effects of electroacupuncture on neurological rehabilitation and serum NLRP3 and lL-18 levels in patients with anterior cerebral infarction. Shanghai Zhen Jiu Za Zhi 2022; 41: 1071-6.
27.	Meng L, Yang S, Zhong QH, et al. Clinical study of rehabilitation robot gloves combined with electroacupuncture to treat patients with phlegm-stasis blocking collaterals stroke hand dysfunction. Hunan Zhong Yi Yao Da Xue Xue Bao 2022; 42: 387-92.
28.	Yin LB. The analysis of parameters of electroacupuncture device (EAD) and relevant factors. Guangzhou: Guangzhou University of Chinese Medicine, 2010: 64-88.

Parameter	EA group (n=32)	Conventional scalp acupuncture group (n=31)	P value
Age (years)	64.0 (53.5, 67.7)	65.0 (57.0, 69.0)	0.335^a
Sex (male/female, n)	20/12	22/9	0.476^b
Disease duration (days)	74.5 (56.5, 105.0)	82.00 (66.0, 132.0)	0.169^a
Hemiplegic side (left/right, n)	17/15	19/12	0.513^b
CSS (points)	6.5±1.3	6.6±1.6	0.893^c
Upper limb-related BI (points)	25.0 (20.0, 30.0)	25.0 (20.0, 30.0)	0.943^a
AROM of wrist dorsiflexion (°)	35.0±11.2	32.9±10.6	0.441^c
AROM of wrist flexion (°)	48.6±10.8	46.7±10.5	0.482^c
RMS of ECRL (μV)	80.5±28.9	83.5±21.5	0.647^c
RMS of ED (μV)	44.3 (28.4, 65.6)	55.3 (33.1, 75.4)	0.343^a
RMS of FCR (μV)	11.2 (8.7, 15.1)	12.1 (9.6, 15.9)	0.523^a
RMS of FCU (μV)	45.9±22.5	49.0±19.2	0.552^c

Parameter	EA group (n=32)	Conventional scalp acupuncture group (n=31)	P value
Age (years)	64.0 (53.5, 67.7)	65.0 (57.0, 69.0)	0.335^a
Sex (male/female, n)	20/12	22/9	0.476^b
Disease duration (days)	74.5 (56.5, 105.0)	82.00 (66.0, 132.0)	0.169^a
Hemiplegic side (left/right, n)	17/15	19/12	0.513^b
CSS (points)	6.5±1.3	6.6±1.6	0.893^c
Upper limb-related BI (points)	25.0 (20.0, 30.0)	25.0 (20.0, 30.0)	0.943^a
AROM of wrist dorsiflexion (°)	35.0±11.2	32.9±10.6	0.441^c
AROM of wrist flexion (°)	48.6±10.8	46.7±10.5	0.482^c
RMS of ECRL (μV)	80.5±28.9	83.5±21.5	0.647^c
RMS of ED (μV)	44.3 (28.4, 65.6)	55.3 (33.1, 75.4)	0.343^a
RMS of FCR (μV)	11.2 (8.7, 15.1)	12.1 (9.6, 15.9)	0.523^a
RMS of FCU (μV)	45.9±22.5	49.0±19.2	0.552^c

Parameter	EA group (n = 32)				Conventional scalp acupuncture group (n = 31)					t/Z value	P value^b
Parameter	Baseline	After 3 weeks	t/Z value	P value^a		Baseline	After 3 weeks	t/Z value	P value^a	t/Z value	P value^b
CSS (points)	6.5 (6.0, 7.0)	4.0 (3.0, 5.0)	4.923	<0.001	7.0 (6.0, 7.0)		4.0 (4.0, 5.0)	4.610	<0.001	2.079	0.038
Upper limb-related BI (points)	25.0 (20.0, 30.0)	32.5 (30.0, 35.0)	4.906	<0.001	25.0 (20.0, 30.0)		30.0 (30.0, 35.0)	4.862	<0.001	0.515	0.606
AROM of wrist dorsiflexion (°)	35.0±11.2	44.4±10.7	12.056	<0.001	32.9±10.6		39.1±10.4	20.747	<0.001	2.023	0.047
AROM of wrist flexion (°)	48.5 (41.6, 58.7)	56.7 (51.5, 66.4)	4.937	<0.001	46.7±10.5		54.4±9.8	10.265	<0.001	1.805	0.076

Parameter	EA group (n = 32)				Conventional scalp acupuncture group (n = 31)					t/Z value	P value^b
Parameter	Baseline	After 3 weeks	t/Z value	P value^a		Baseline	After 3 weeks	t/Z value	P value^a	t/Z value	P value^b
CSS (points)	6.5 (6.0, 7.0)	4.0 (3.0, 5.0)	4.923	<0.001	7.0 (6.0, 7.0)		4.0 (4.0, 5.0)	4.610	<0.001	2.079	0.038
Upper limb-related BI (points)	25.0 (20.0, 30.0)	32.5 (30.0, 35.0)	4.906	<0.001	25.0 (20.0, 30.0)		30.0 (30.0, 35.0)	4.862	<0.001	0.515	0.606
AROM of wrist dorsiflexion (°)	35.0±11.2	44.4±10.7	12.056	<0.001	32.9±10.6		39.1±10.4	20.747	<0.001	2.023	0.047
AROM of wrist flexion (°)	48.5 (41.6, 58.7)	56.7 (51.5, 66.4)	4.937	<0.001	46.7±10.5		54.4±9.8	10.265	<0.001	1.805	0.076

Parameter	EA group (n=32)				Conventional scalp acupuncture group (n=31)					t/Z value	P value^b
Parameter	Baseline	After 3 weeks	t value	P value^a		Baseline	After 3 weeks	t/Z value	P value^a	t/Z value	P value^b
RMS of ECRL (μV)	80.5±28.9	111.2±37.8	6.708	<0.001	83.5±21.5		94.0±28.8	3.122	0.004	2.032	0.047
RMS of ED (μV)	48.2±22.2	74.9±23.4	6.194	<0.001	55.4 (33.1, 75.4)		62.0 (45.9, 79.4)	2.312	0.021	2.020	0.048
RMS of FCR (μV)	13.4±6.9	17.9±6.7	4.025	<0.001	12.8±4.4		15.0±5.2	2.228	0.033	1.966	0.049
RMS of FCU (μV)	45.9±22.6	67.8±21.3	5.761	<0.001	49.0±19.2		56.9±21.5	2.634	0.013	2.030	0.047

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