| BackgroundLaser acupuncture combines both traditional Chinese Acupuncture theory and low-energy level laser therapy. Currently, clinical application of laser acupuncture has become a trend, laser acupuncture treatment of pain due to soft tissue injuries, sports injuries, arthritis, musculoskeletal disorders, are well-known effective treatment internationally. Recent studies on laser acupuncture have included advanced brain imaging in adult, such as stroke. However, domestic and foreign literature on laser acupuncture therapy on cerebral palsy is relatively limited. Its effects are not well understood and no standardized clinical protocol has been established. For children with cerebral palsy, undergoing traditional acupuncture treatment is painful and rather distress with hardship. Laser acupuncture, however, is completely painless. This is a great way to treat Pediatric patients who may have needle-phobia. In this clinical research, we are going to observe if laser acupuncture therapy can replace the traditional acupuncture therapy. So as to benefit more cerebral palsy children.ObjectiveIn this study, a randomized single-blind controlled trial, under the basis of rehabilitation therapies, traditional acupuncture, laser acupuncture, and traditional acupuncture combined with laser acupuncture therapy have been performed. The purpose of the study is to explore more modern, new ways to treat Pediatric cerebral palsy in a pain-free environment.MethodsUsing randomized single-blinded controlled trial method,120 cases of 1 to 4-year-old children with cerebral palsy had been selected from September, 2013 to March,2014. The sources of cases were collected from our hospital out-patient and in-patient, and Hong Kong Empress L’Oriental Medicine Clinic. The final results of a total of 105 cases were put into the statistics, after 15 cases were disqualified. Group A 36 cases, Group B 34 cases, Group C 35 cases, three groups of cases were undergoing the basis for rehabilitation therapy in physiotherapy, occupational therapy, speech and behavioral education, audio-visual education, feeling comprehensive training, etc). Besides the above basis of therapies, Group A cases had been treated with traditional acupuncture also, whereas Group B cases had been treated with both traditional and laser acupuncture, last, Group C cases had been treated with laser acupuncture.3 sessions of treatments had been performed, in which each session of treatment consisted of 10 times traditional or/and laser acupuncture, which were proceeding in every other day.20 days a session, followed by 10 days’rest, then the other.Gesell developmental quotient, Gross Motor Function Measure (GMFM), emotional quotient (EQ), and sleep quality assessment, fMRI were used to compared the result before and after treatments. Thereby we could use result to verify if the clinical effect of laser acupuncture was good enough to replace traditional acupuncture therapy on cerebral palsy. Data of the measurements collected were recorded in excel Microsoft document, and output to SPSS 21.0 for data analysis.Results1、Three groups of ages, weights and head circumference between cases were analyzed before the trial. The results suggested that they had no statistical significance (P>0.05).2、After trials, three groups of data had been analyzed. In Gesell scale of the development quotient, we found that only fine motor DQ, was statistically significant (P<0.05); whereas social adaptation DQ, motor DQ, language behavior DQ, personal-social DQ scores were not statistically significant (P>0.05). The three groups of gross motor function (GMFM) were also compared, out of five items, only A zone, B zone, and total scores between Group A and C, Group B and C were statistically significant (P<0.05).One-way ANOVA test on three groups GMFM scale scores before and after treatment had been performed. There was no statistically significant (P>0.05) three groups in zone A. Whereas in zone B, and the total scores showed statistically significant (P<0.05). More, we found that Group B had the most improvement of the motor functions when comparing to the others.Three groups of emotional EQ, and sleep quality were compared after trials using group ANOVA test, Group A showed no statistically significant (P>0.05) before and after trials, while Group B and C showed statistically significant (P>0.05).Last, we also compared the brain FMRI images before and after trial. We have found that A, B, C three groups fMRI statistical parametric mapping before and after treatment in children were statistical significant (p<0.01). Group A vs B (PA-B=0.001), Group A vs C (PA-C=0.001), were both statistically significant (p<0.001), this revealed that laser acupuncture is most effective in enhancing the restoration of brain tissues, whereas traditional acupuncture is the least effective when comparing to laser acupuncture, and the combined therapy; and group B vs C (PB-C=0.015, p>0.01), which is not statistically significant, i. e. effect of B=C>A, B.In the fMRI images of children in group B than gray matter boundary significantly in group A and C are clearly high, while the basic gray matter clearly surpasses the boundaries of Group C Group A relatively high degree. We found that Group B’s FMRI images showed a significantly improvement on the clarity sharpness of high gray matter boundaries than in the Group A and C. Whereas, Group C has a relatively clarity on the gray matter boundaries of then Group A.ConclusionIn conclusion, traditional acupuncture plays an important role on treating cerebral palsy, and it is irreplaceable by laser acupuncture regarding to its effect on gross motor, fine-motor, coordination movement muscle function, in spite of the complementary benefits effect by using laser acupuncture. Although laser acupuncture cannot be a substitute for traditional acupuncture, its effect on improving the emotional and sleep quality are significant.Last but not the least, it is suggested that laser acupuncture combined with traditional acupuncture therapy gives a significant brain tissue repair possibility, as both therapy may improve the impact on brain lesions, and stimulate the brain nerve compensatory function. fMRI results in addition to the traditional acupuncture affirmed the importance of motor function rehabilitation of this disease, but also prompted the laser acupuncture combined traditional acupuncture may fix their brain tissue, and benefit brain tissue lesions. Despite both can enhance brain nerve stimulation compensatory function, laser acupuncture has a more prominent role, which enables brain cells to produce, while traditional acupuncture alone improve peripheral microcirculation, casuing increase the blood flow in the brain indirectly. Thus, laser acupuncture results come faster, more direct, indicating the two methods can complement each other.Laser acupuncture and traditional acupuncture therapy are all having their own advantages in efficacy of cerebral palsy treatment. It is surely worth to give laser acupuncture a trail as to improve the technological level of our hospital as well. |
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