Effectiveness and safety of electroacupuncture in patients with upper limb spasticity after brain injury: a randomized controlled trial

Objective: To explore the effectiveness and safety of electroacupuncture (EA) as an adjunct to conventional rehabilitation (CR) in patients with upper limb spasticity after brain injury. Methods: This study was a single-blind, prospective, two-group parallel randomized controlled trial. Eligible patients were randomly divided into an intervention group and a control group. Participants in the control group received CR only, whereas those in the intervention group received CR supplemented with EA, administered five times weekly for 2 weeks. Modified Ashworth scale (MAS), shear modulus of biceps brachii muscle (BBM), Fugl-Meyer motor scale (FMMS), Barthel index (BI) and safety were assessed at baseline and after 2 weeks of treatment. Results: A total of 64 patients were randomized, with 58 included in the final (per protocol) analysis. The baseline data of the two groups were comparable. Following the 2-week treatment period, improvements were observed in both groups compared to baseline. However, no significant differences were noted between the two groups in MAS ( Z = −1.692, p = 0.091), BBM shear modulus short axis of 0° elbow flexion (mean difference (MD) −1.079, 95% confidence interval (CI) −2.786 to 0.628), long axis of 0° elbow flexion (MD −0.499, 95% CI −1.699 to 0.700), short axis of 90° elbow flexion (MD −0.005, 95% CI −0.933 to 0.923), long axis of 90° elbow flexion (MD −0.845, 95% CI −1.355 to 1.113), FMMS (MD −0.890, 95% CI −2.243 to 0.462) or BI (MD 0.024, 95% CI −2.955 to 3.002) scores. One participant reported an itchy sensation at the acupuncture site, with no other adverse events observed during or after the trial. Conclusion: EA was not effective when added to CR as a 2-week intervention for upper limb spasticity after brain injury, but appears to be a safe intervention in this population. Trial registration number: ChiCTR2200060819 (Chinese Clinical Trial Registry)