Journal of Korean Medicine Rehabilitation (한방재활의학과학회지)

The society of Korean Medicine Rehabilitation (한방재활의학과학회)
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An Analysis of Domestic Research Trends of Korean Medicine Treatments for Spasticity with Suggestions for Choosing Assessment Tools

경직에 대한 한의치료 국내 연구 동향 고찰 및 평가도구 선택에 대한 제언

  • Jiwon Kim (Department of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Youngkeun Woo (Department of Physical Therapy, College of Medical Science, Jeonju University) ;
  • Woochul Shin (Department of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Jae-Heung Cho (Department of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Won-Seok Chung (Department of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Mi-Yeon Song (Department of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Hyungsuk Kim (Department of Clinical Korean Medicine, Graduate School, Kyung Hee University)
  • 김지원 (경희대학교 대학원 임상한의학과) ;
  • 우영근 (전주대학교 의과학대학 물리치료학과) ;
  • 신우철 (경희대학교 대학원 임상한의학과) ;
  • 조재흥 (경희대학교 대학원 임상한의학과) ;
  • 정원석 (경희대학교 대학원 임상한의학과) ;
  • 송미연 (경희대학교 대학원 임상한의학과) ;
  • 김형석 (경희대학교 대학원 임상한의학과)
  • Received : 2024.09.19
  • Accepted : 2024.10.02
  • Published : 2024.10.31
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Abstract

Objectives The purpose of this study is to examine how research on spasticity has been conducted and to suggest tools for evaluating spasticity in the Korean medicine field. Methods We searched databases (Oriental Medicine Advanced Searching Integrated System, KoreaMed, KMbase, ScienceON, Research Information Sharing Service, Korean studies Information Service System) on the 2nd of May 2024 to find related literatures. Results Eighteen studies were finally included. Of these, 13 articles were published before 2011. Electroacupuncture was the most common intervention in 10 cases. Eight studies had control group. By type of study, randomized controlled trials were the most common, with 6 studies (33.3%). The modified Ashworth scale (MAS) was the most commonly used tool for evaluating treatment outcomes, with 17 cases. Conclusions In this study, we investigated literatures concerning current status of Korean medicine treatment for spasticity in Korea. It seems that electroacupuncture treatment is effective in patient treatment with spasticity. In addition, the use of modified Tardieu scale is more recommended than MAS as an evaluation index for spasticity, and the additional use of numeric rating scale for spasticity, which is evaluated by patients themselves, is recommended.

Keywords

References

  1. Carr JH, Shepherd RB, Ada L. Spasticity: research findings and implications for intervention. Physiotherapy. 1995;81(8):421-9. https://doi.org/10.1016/S0031-9406(05)66716-8
  2. Korean Stroke Society. Stroke. 2nd ed. Seoul: Panmuneducation. 2015:533.
  3. Urban PP, Wolf T, Uebele M, Marx JJ, Vogt T, Stoeter P, Bauermann T, Weibrich C, Vucurevic GD, Schneider A, Wissel J. Occurence and clinical predictors of spasticity after ischemic stroke. Stroke. 2010;41(9):2016-20. https://doi.org/10.1161/STROKEAHA.110.581991
  4. Zeng H, Chen J, Guo Y, Tan S. Prevalence and risk factors for spasticity after stroke: a systematic review and meta-analysis. Frontiers in Neurology. 2021;11:616097.
  5. Wissel J, Manack A, Brainin M. Toward an epidemiology of poststroke spasticity. Neurology. 2013;80(3 Suppl 2):S13-9. https://doi.org/10.1212/WNL.0b013e3182762448
  6. Lundstrom E, Smits A, Borg J, Terent A. Four-fold increase in direct costs of stroke survivors with spasticity compared with stroke survivors without spasticity: the first year after the event. Stroke. 2010;41(2):319-24. https://doi.org/10.1161/STROKEAHA.109.558619
  7. Chang E, Ghosh N, Yanni D, Lee S, Alexandru D, Mozaffar T. A review of spasticity treatments: pharmacological and interventional approaches. Critical Reviews in Physical and Rehabilitation Medicine. 2013;25(1-2):11-22. https://doi.org/10.1615/CritRevPhysRehabilMed.2013007945
  8. Smyth MD, Peacock WJ. The surgical treatment of spasticity. Muscle & Nerve. 2000;23(2):153-63. https://doi.org/10.1002/(SICI)1097-4598(200002)23:2<153::AID-MUS3>3.0.CO;2-4
  9. Halpern D, Meelhuysen FE. Phenol motor point block in the management of muscular hypertonia. Archives of Physical Medicine and Rehabilitation. 1996;47(10):659-64.
  10. Korean Acupuncture and Moxibustion Medicine Association Textbook Compilation Committee. The acupuncture and moxibustion medicine. 1st ed. Seoul:JipMunDang. 1988:1288.
  11. Yang JH. Editing and annotation of acupuncture and moxibustion. 1st ed. Seoul:Daesungmunhwasa. 1984:425-33.
  12. Kim MW, Ki SH, Han CH, Nam HW, Song YK. A study on the application of chuna therapy to patients with post-stroke spasticity based on Korean reseach. The Journal of Chuna Manual Medicine for Spine & Nerves. 2022;17(1):61-72.
  13. Kim JS, Shin SW, Lee EJ, Shin BC, Lee MS, Lim SM, Nam DW, Moon SK. Clinical practice guideline on acupuncture for post-stroke spasticity. Journal of Korean Medicine. 2015;36(1):1-8. https://doi.org/10.13048/jkm.15001
  14. Paek CH, So SW, Kim HS, Ahn KH, Nam SS, Park SK. Antispastic effect of transcutaneous electrical nerve stimulation and acupuncture in the stroke patients. Journal of Korean Academy of Rehabilitation Medicine. 1997;21(6):1088-97.
  15. Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Physical Therapy. 1987;67(2):206-7.
  16. Fleuren JF, Voerman GE, Erren-Wolters CV, Snoek GJ, Rietman JS, Hermens HJ, Nene AV. Stop using the Ashworth scale for the assessment of spasticity. Journal of Neurology, Neurosurgery, and Psychiatry. 2010;81(1):46-52. https://doi.org/10.1136/jnnp.2009.177071
  17. Gregson JM, Leathley M, Moore AP, Sharma AK, Smith TL, Watkins CL. Reliability of the tone assessment scale and the modified Ashworth scale as clinical tools for assessing poststroke spasticity. Archives of Physical Medicine and Rehabilitation. 1999;80(9):1013-6. https://doi.org/10.1016/S0003-9993(99)90053-9
  18. Sloan RL, Sinclair E, Thompson J, Taylor S, Pentland B. Inter-rater reliability of the modified Ashworth scale for spasticity in hemiplegic patients. International Journal of Rehabilitation Research. 1992;15(2):158-61. https://doi.org/10.1097/00004356-199206000-00009
  19. Lee SH, Chung SH, Lee JS, Kim SS, Shin HD. A Literature review of spasticity assessment methods. J Korean Med Rehabil. 2000;10(2):121-37.
  20. Pandyan AD, Johnson GR, Price CI, Curless RH, Barnes MP, Rodgers H. A review of the properties and limitations of the Ashworth and modified Ashworth scales as measures of spasticity. Clinical Rehabilitation. 1999;13(5)373-83. https://doi.org/10.1191/026921599677595404
  21. Gracies JM. Evaluation de la spasticite: apport de l'echelle de tardieu. Motricite cerebrale. 2001;22:1-16.
  22. Dietz V. Spastic movement disorder. Spinal Cord. 2000;38(7):389-93. https://doi.org/10.1038/sj.sc.3101030
  23. Tardieu G, Shentoub S, Delarue R. A la recherche d'une technique de mesure de la spasticite. Revue Neurologique. 1954;91:143-4.
  24. Boyd RN, Graham HK. Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with cerebral palsy. European Journal of Neurology. 1999;6(Suppl 4):S23-35. https://doi.org/10.1111/j.1468-1331.1999.tb00031.x
  25. Mehrholz J, Wagner K, Meissner D, Grundmann K, Zange C, Koch R, Pohl M. Reliability of the modified Tardieu scale and the modified Ashworth scale in adult patients with severe brain injury: a comparison study. Clinical Rehabilitation. 2005;19(7):751-9. https://doi.org/10.1191/0269215505cr889oa
  26. Lance JW. Pathophysiology of spasticity and clinical experience with baclofen. In: Feldman RG, Young RR, Koella WP, eds. Spasticity: disordered motor control. Chicago:Year Book. 1980:185-204.
  27. Wartenberg R. Pendulousness of the legs as a diagnostic test. Neurology. 1951;1(1):18-24. https://doi.org/10.1212/WNL.1.1.18
  28. Biering-Sorensen F, Nielsen JB, Klinge K. Spasticity-assessment: a review. Spinal Cord. 2006;44(12):708-22. https://doi.org/10.1038/sj.sc.3101928
  29. Gracies JM, Bayle N, Vinti M, Alkandari S, Vu P, Loche CM, Colas C. Five-step clinical assessment in spastic paresis. European Journal of Physical and Rehabilitation Medicine. 2010;46(3):411-21.
  30. Hugos CL, Cameron MH. Assessment and measurement of spasticity in MS: state of the evidence. Current Neurology and Neuroscience Reports. 2019;19(10):79.
  31. Farrar JT, Troxel AB, Stott C, Duncombe P, Jensen MP. Validity, reliability, and clinical importance of change in a 0-10 numeric rating scale measure of spasticity: a post hoc analysis of a randomized, double-blind, placebo-controlled trial. Clinical Therapeutics. 2008;30(5):974-85. https://doi.org/10.1016/j.clinthera.2008.05.011
  32. Sunnerhagen KS, Olver J, Francisco GE. Assessing and treating functional impairment in poststroke spasticity. Neurology. 2013;80(3 Suppl 2):S35-44. https://doi.org/10.1212/WNL.0b013e3182764aa2
  33. World Health Organization. International classification of functioning, disability and health (ICF) [Internet]. 2018 [cited 2024 Oct 2]. Available from: URL: www.who.int/classifications/icf/en/.
  34. National Evidence-based Healthcare Collaborating Agency. Analysis of medical use status and factors related to medical use in stroke patients. Seoul:National Evidence-based Healthcare Collaborating Agency. 2012.
  35. Health Insurance Review & Assessment Service. Cerebrovascular disease treatment status. Seoul:Health Insurance Review & Assessment Service. 2023.
  36. Statistics Korea. Survey on Korean medicine use and herbal medicine consumption. Daejeon:Statistics Korea. 2023.
  37. Health Insurance Review & Assessment Service Bigdata Open portal. Frequent disease statistics [Internet]. Health Insurance Review & Assessment Service; 2010-2023 Jan-Dec[cited 2024 Oct 2]. Available from: URL: https://opendata.hira.or.kr/op/opc/olapHifrqSickInfoTab1.do.
  38. Zhao JG, Cao CH, Liu CZ, Han BJ, Zhang J, Li ZG, Yu T, Wang XH, Zhao H, Xu ZH. Effect of acupuncture treatment on spastic states of stroke patients. Journal of the Neurological Sciences. 2009;276(1-2):143-7. https://doi.org/10.1016/j.jns.2008.09.018
  39. Wong AM, Su TY, Tang FT, Cheng PT, Liaw MY. Clinical trial of electrical acupuncture on hemiplegic stroke patients. American Journal of Physical Medicine & Rehabilitation. 1999;78(2):117-22. https://doi.org/10.1097/00002060-199903000-00006
  40. Mukherjee M, McPeak LK, Redford JB, Sun C, Liu W. The effect of electro-acupuncture on spasticity of the wrist joint in chronic stroke survivors. Archives of Physical Medicine and Rehabilitation. 2007;88(2):159-66. https://doi.org/10.1016/j.apmr.2006.10.034
  41. Deare JC, Zheng Z, Xue CC, Liu JP, Shang J, Scott SW, Littlejohn G. Acupuncture for treating fibromyalgia. The Cochrane Database of Systematic Reviews. 2013;2013(5):CD007070.
  42. Goulet C, Arsenault AB, Bourbonnais D, Laramee MT, Lepage Y. Effects of transcutaneous electrical nerve stimulation on H-reflex and spinal spasticity. Scandinavian Journal of Rehabilitation Medicine. 1996;28(3):169-76. https://doi.org/10.2340/165019771996169176
  43. You JH, Kim YS, Kang SK. Antispastic effect of electroacupuncture on spasticity in stroke patients. The Journal of Korean Acupuncture & Moxibustion Society. 1999;17(2):209-20.
  44. Park JY, Kim JG, Kim SJ, Lee WS, Kim YC, Jung MG. Clinical study on Soyang-Kyong negative acupuncture effect of spasticity or rigidity. The Journal of Internal Korean Medicine. 2000;21(5):845-50.
  45. Kim YS. Antispastic effects of electroacupuncture, TENS and NMES in stroke patient. The Journal of Korean Acupuncture & Moxibustion Society. 2000;17(2):209-20.
  46. Park YH, Shin HD, Kim SS, Jung SH, Lee JS. Antispastic effect of taping on spasticity in stroke patients. J Korean Med Rehabil. 2001;11(1):159-71.
  47. Sim WJ, Jung SH, Kim SS, Shin HD, Lee JS. Which is more effective for elbow spasticity after stroke, the electroacupuncture on Yin or Yang meridians? J Korean Med Rehabil. 2003;13(1):95-111.
  48. Moon SK, Whang YK, Park SU, Ko CN, Kim YS, Bae HS, Cho KH. Antispastic effect of electroacupuncture and moxibustion in stroke patients. The American Journal of Chinese Medicine. 2003;31(3):467-74. https://doi.org/10.1142/S0192415X03001077
  49. Sim WJ, Moon SH, Ryu HJ, Jung SH, Kim SS, Lee JS. The effects of the muscles along meridians release therapy to spastic patients after stroke. J Korean Med Rehabil. 2004;14(1):63-75.
  50. Park SW, Lee MG, Lee SW, Kang BG, Son JW, Park SM, Lee I, Moon BS. The effect of electroacupuncture by Yin and Yang meridians on leg spasticity of stroke patients. The Journal of Internal Korean Medicine. 2006;27(2):371-8.
  51. Cho JH, Chung SH, Lee JS, Kim SS. MEMG analysis on antispastic effect of electroacupuncture and transcutaneous electrical nerve stimulation. J Korean Med Rehabil. 2006;16(2):131-43.
  52. Lee SW, Yun JM, Son JW, Kang BG, Park SM, Yun HJ, Kim DJ, Kim TJ, Lee I, Shin YI, Moon BS. The effect of electroacupuncture on upper-extremity spasticity of stroke patients. The Journal of Internal Korean Medicine. 2007;28(3):492-501.
  53. Noh JH, Park JA, Youn HM, Jang KJ, Song CH, Ahn CB, Kim CH. The effect of hominis placenta pharmacopuncture on leg spasticity of stroke patients (a pilot study, double blind, randomized, controlled clinical trial). Journal of Pharmacopuncture. 2009;12(4):97-110. https://doi.org/10.3831/KPI.2009.12.4.097
  54. Noh JH, Park JA, Cho SW, Youn HM, Jang KJ, Song CH, Ahn CB, Kim CH. Effect of bee-venom acupuncture on upper limb spasticity of stroke patients. The Journal of Korean Acupuncture & Moxibustion Society. 2010;27(4):115-25.
  55. Baek KM, Kwon DR, Park GY. Study of the effects of sa-am acupuncture on upper limb spasticity in patients with chronic post-stroke hemiparesis using real-time sonoelastography. The Journal of Internal Korean Medicine. 2014;35(1):1-11.
  56. Cho MK, Lee I, Kwon JN, Shin BC, Ko SH, Ko HY, Shin YI, Hong JW. Antispastic effect of electroacupuncture on upper extremity in stroke patients by t-reflex study: a single-blind, randomized controlled, preliminary study. Journal of Korean Medicine. 2015;36(4):8-18. https://doi.org/10.13048/jkm.15029
  57. Kim JH, Kim SB, Jeong YK, Cho KH, Jung WS, Kwon SW, Mun SK. A case of post-stroke spasticity patient treated with low-frequency electroacupuncture. The Journal of the Society of Stroke on Korean Medicine. 2017;18(1):47-54.
  58. Yoon SH, Jo HG, Song MY. Post-stroke spasticity treated by miniscalpel-acupuncture: three case report. J Korean Med Rehabil. 2018;28(1):145-52. https://doi.org/10.18325/jkmr.2018.28.1.145
  59. Lim SM, Go E, Lee J, Lee GE, Kim EJ, Son C. Improving upper limb spasticity in patients with stroke by electroacupuncture therapy: a pre-and post-treatment study. Journal of Acupuncture and Meridian Studies. 2023;16(6):248-54. https://doi.org/10.51507/j.jams.2023.16.6.248