Effectiveness Of Jiao’s Scalp Acupuncture For Freezing Of Gait In Parkinson’s Disease:a Randomized Clinical Trial

ObjectiveThe purpose of this trial was to analyze the clinical efficacy of Jiao’s scalp acupuncture in the treatment of freezing of gait(FOG)in patients with Parkinson’s Disease(PD),including the efficacy of motor symptoms,non-motor symptoms,quality of life,the natural oscillation frequency(F)and dynamic stiffness(S)of lower limb muscles.Methods46 patients of PD with FOG were randomly divided into treatment group and control group for 12 weeks,23 patients in each group.All patients were given convential western medicine treatment.Patients in the treatment group were acupunctured the dance tremor area,the upper 1/5 movement area and balance area.Patients in the control group were only given convential western medicine treatment.The scores of Freezing of Gait Questionnaire(FOGQ),Movement Disorder Society Sponsored Revision of the Unified Parkinson’s Disease Rating Scale(MDS-UPDRS),Parkinson’s Disease Questionnaire-39(PDQ-39)and Hoehn-Yahr stage were collected before and after treatment.The F and S of rectus femoris muslces,tibialis anterior muscles and medial and Lateral gastrocnemius muscles were collected by MyotonPRO detector.Chi-square test was used for the effective rate of FOGQ and MDS-UPDRS,while parameter test or non-parametric test was for the measurement data of FOGQ,MDS-UPDRS,PDQ-39,F and S.Results1.Comparison of baseline data:there was no significant difference in age,gender,course of disease,H-Y stage,cognitive assessment,mental state assessment and baseline level of levodopa dosage between the two groups(P>0.05),and there was no significant difference in FOGQ score,MDS-UPDRS score,UPDRS-1 score,UPDRS-2 score,UPDRS-3 score,UPDRS-4 score and PDQ-39 score between the two groups(P>0.05).There was no significant difference in F and S of rectus femoris muslces,tibialis anterior muscles and medial and lateral gastrocnemius muscles at baseline between the two groups(P>0.05).2.Analysis of clinical scales:(1)The effective rate of FOGQ score in the treatment group was 17.4%,while it was 13.0%in the control group.The difference between groups was not statistically significant(P>0.05);the FOGQ scores of two groups were not improved compared with those before treatment(P>0.05).(2)The effective rate of MDS-UPDRS score in the treatment group was 43.5%,while 34.8%in the control group.There was no significant difference between groups(P>0.05).The total score of UPDRS in the two groups did not change significantly after acupuncture treatment(P>0.05),but the difference values before and after treatment between the groups was statistically significant(P<0.05).After acupuncture intervention,the UPDRS-1 score,UPDRS-4 score and PDQ-39 score decreased in the treatment group(P<0.001 or P<0.05),while there was no significant change in the control group(P>0.05).The difference values were statistically significant(P<0.05).But there was no statistically significant difference between groups after intervention(P>0.05).(4)After treatment,there was no significant change in the scores of UPDRS-2 and UPDRS-3 between groups(P>0.05).3.Changes in the parameters of the lower limb muscles by MyotonPRO detector:(1)In terms of rectus femoris muslces:①after treatment,the bilateral F decreased in the treatment group(P<0.05),and there was no significant change in both sides of the control group(P>0.05).As for comparison between the groups,the righ F after treatment and its difference values before and after intervention were statistically significant(P<0.05).The difference values of F on the left side was statistically significant(P<0.05).The remaining differences were not statistically significant(P>0.05).②After intervention,the bilateral S of the treatment group decreased(P<0.05),and there was no significant change in both sides of the control group(P>0.05).As for comparisons between the groups in both sides,the S after treatment and its difference values showed statistical significance(P<0.05).(2)In terms of tibialis anterior muscles:①compared within groups after treatment,the F on the left side of the control group increased(P<0.05),and the difference in the remaining comparisons was not statistically significant(P>0.05).Compared between groups in bilateral muscles,there was no statistically significant difference in F after treatment and the difference values in F before and after treatment(P>0.05).②There was no significant difference in bilateral tibialis anterior muscles between the two groups(P>0.05).(3)In terms of the medial gastrocnemius muscles:①the comparison within and between groups of F on both sides was not statistically significant(P>0.05).②As for comparison within the group after treatment,the S in the left side of the control group increased(P<0.05),and the remaining difference was not statistically significant(P>0.05).Compared between groups in bilateral muscles,there was no statistically significant difference in S after treatment and the difference values in S before and after treatment(P>0.05).(4)In terms of he lateral gastrocnemius muscles:The comparison within and between groups of F and S on both sides was not statistically significant(P>0.05).Conclusion1.The Jiao’s scalp acupuncture treatment had a certain effect on non-motor symptoms,quality of life and motor complication,but did not improve the motor symptoms of PD with FOG.2.The Jiao’s scalp acupuncture treatment had an effect on the F and S in the rectus femoris muscles,but had no obvious effect on the tibialis anteriors muscles,medial and lateral gastrocnemius muscles.3.There are several limitations in this study,including the selection bias in the trial design,small sample size,limited research time,the lack of placebo group and so on.The trial data and results need further studies to verified.