Mukul Mukherjee, PhD, Lisa K. McPeak, MD, John B

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The Effect of Electro-Acupuncture on Spasticity of the Wrist Joint in Chronic Stroke Survivors Mukul Mukherjee, PhD, Lisa K. McPeak, MD, John B. Redford, PhD, Chao Sun, MD, Wen Liu, PhD Archives of Physical Medicine and Rehabilitation Volume 88, Issue 2, Pages 159-166 (February 2007) DOI: 10.1016/j.apmr.2006.10.034 Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 1 The position of the subject during testing and training. The dashed square is enlarged and the position of the hand holding the dynamometer wrist attachment is shown. Legend: A, dynamometer; B, wrist attachment; C, crank shaft; D, axis of wrist joint rotation. Archives of Physical Medicine and Rehabilitation 2007 88, 159-166DOI: (10.1016/j.apmr.2006.10.034) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 2 (A) Data from a stroke subject showing the reflexive torque generated by the subject in response to passive motion of the wrist joint at baseline angular velocity (5°/s) and at 45° and 75°/s. The neutral position for wrist flexion and extension is denoted as 180°. Average reflexive torque values are determined in each of the 5 segments shown in the figure (I to V) and is used in determining the velocity sensitivity of ASRT. (B) Integrated electromyographic (EMG) data of the same subject for the 3 angular velocities (5°, 45°, 75°/s). Archives of Physical Medicine and Rehabilitation 2007 88, 159-166DOI: (10.1016/j.apmr.2006.10.034) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 3 The immediate effects of the acupuncture (acu) treatment. Mean VASRT values before and immediately after the acupuncture treatment for each of the 6 weeks of treatment is shown. Archives of Physical Medicine and Rehabilitation 2007 88, 159-166DOI: (10.1016/j.apmr.2006.10.034) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 4 The VASRT values at each of the 3 time points before and after the 2 treatment regimens for each of the 7 subjects. These time points were the 1st, 13th, and the 25th visits. Solid lines represent the combined treatment (AS) and broken lines represent the strengthening treatment (S). Archives of Physical Medicine and Rehabilitation 2007 88, 159-166DOI: (10.1016/j.apmr.2006.10.034) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 5 (A) VASRT values before and after the combined acupuncture and muscle strengthening treatment (pre AS and post AS, respectively) and before and after only the strengthening exercise treatment (pre S and post S, respectively).*P<.05. (B) Mean MAS scores of wrist flexors before and after the combined treatment (pre AS and post AS, respectively) and before and after only the strengthening exercise treatment (pre S and post S, respectively). †P<.01. Archives of Physical Medicine and Rehabilitation 2007 88, 159-166DOI: (10.1016/j.apmr.2006.10.034) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 6 SASRT values during passive wrist extension at 4 different angular velocities before (black bars) and after (hatched bars) 6 weeks of the combined treatment (AS). Archives of Physical Medicine and Rehabilitation 2007 88, 159-166DOI: (10.1016/j.apmr.2006.10.034) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig 7 Mean integral electromyographic activity of the wrist flexors during passive wrist extension at 5 different joint angular velocities before and after 6 weeks of the combined AS treatment. Archives of Physical Medicine and Rehabilitation 2007 88, 159-166DOI: (10.1016/j.apmr.2006.10.034) Copyright © 2007 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions