Integrative medicine rehabilitation for post-stroke limb spasticity: A multicenter randomized controlled trial

Objective: This study aimed to determine whether integrative medicine rehabilitation (IMR) that combines conventional rehabilitation (CR) with Tui Na and traditional Chinese external medicine Baimai-ruangao is more effective than CR alone for the treatment of post-stroke limb spasticity. Design: Multicenter randomized controlled intervention trial involving 16 hospitals across ten cities in China. Subject: 444 patients with post-stroke limb spasticity were randomly assigned toIMR group (n=222) or CR group (n=222). Methods: Tui Na was performed for patients with post-stroke limb spasticity. Traditional Chinese external medicine Baimai-ruangao as the massage medium was applied on the skin surface. The treatment course was 1 month. Muscle tone in the spastic muscles (elbow flexors, wrist flexors, finger flexors, knee extensors, ankle plantar flexors) was evaluated using the Modified Ashworth Scale (MAS), and the primary endpoint was the change in MAS score from baseline to 4 weeks. Results: The IMR group showed a significantly better reduction in the MAS scores for five muscle groups than the CR group after the 4-week intervention. Improvements were sustained at the 3-month and 6-month follow-up. Patients with a baseline muscle tone score of 1+ to 4 on the MAS for the affected limb showed the greatest benefit of IMR. No adverse reaction was observed in the IMR group. Conclusion: The combination of CR and IMR is safe and more effective than CR alone for alleviating post-stroke limb spasticity.