Survivors want cures, NOT just therapies that don't work to 100% recovery. Will you stop trying to force your fucking tyranny of low expectations upon survivors?
Non-Pharmacological Therapies for Post-Stroke Spastic Paralysis: A Bibliometric Analysis of Global Research from 2000 to 2024
Authors Zhang Z , Yin L, Huang J, Wang Q, Sun S, Tan S
Received 21 November 2024
Accepted for publication 6 December 2024
Published 14 December 2024 Volume 2024:17 Pages 5949—5965
DOI https://doi.org/10.2147/JMDH.S507752
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Ziyi Zhang,1,2,* Lili Yin,2,* Jingjie Huang,1,2,* Qiuxuan Wang,1,2 Shanshan Sun,1,2 Shuoshuo Tan1,2
1Tianjin University of Traditional Chinese Medicine, Tianjin, 300000, People’s Republic of China; 2National
Clinical Research Center of Chinese Medicine Acupuncture, First
Teaching Hospital of Tianjin University of Traditional Chinese Medicine,
Tianjin, 300193, People’s Republic of China
*These authors contributed equally to this work
Correspondence:
Lili Yin, National Clinical Research Center of Chinese Medicine
Acupuncture, First Teaching Hospital of Tianjin University of
Traditional Chinese Medicine, Tianjin, 300193, People’s Republic of
China, Email kintelili@163.com
Objective: This
study aims to explore the research landscape, hot topics, and future
trends of non-pharmacological therapies for post-stroke spastic
paralysis globally from 2000 to 2024 through a bibliometric analysis.
Methods:
We conducted a search in the Web of Science Core Collection database to
analyze literature related to non-pharmacological therapies for
post-stroke spastic paralysis published between 2000 and 2024. Tools
including CiteSpace, VOSviewer, Bibliometrix, Scimago, and R language
were used to identify and analyze countries, institutions, journals,
references, keywords, as well as the most commonly used therapies and
acupuncture points. The results were presented in the form of knowledge
maps.
Results: The bibliometric analysis identified a
total of 297 publications. Over the study period, the number of
publications showed an overall upward trend. China had the highest
number of publications. The journal *Archives of Physical Medicine and
Rehabilitation* published the most articles. The most frequently
occurring keywords were “stroke”, “reliability”, and “muscle
spasticity.” The most commonly used therapy was “acupuncture.”.
Conclusion:
From 2000 to 2024, non-pharmacological therapies have shown positive
effects in improving post-stroke spastic paralysis; however, more
rigorously designed large-scale, high-quality randomized controlled
trials are needed to confirm their long-term efficacy and mechanisms.
Moving forward, international and domestic research institutions should
strengthen collaboration to produce more impactful research and further
explore individualized, precision rehabilitation treatment plans.
Keywords: stroke, spasticity, non-pharmacological, global trends, bibliometric analysis
Introduction
Stroke, as the second leading cause of death and the third leading cause of disability worldwide, is a significant public health issue globally.1 Spasticity is typically defined as a velocity-dependent increase in muscle tone caused by excessive excitability of the stretch reflex.2 Studies indicate that approximately 20% to 40% of stroke survivors experience spasticity in their paralyzed limbs.3,4 Spastic hemiplegia (spasticity and weakness on one side of the body) is a hallmark feature of post-stroke motor disorders and represents a critical stage in the rehabilitation of paralyzed limbs.5,6 However, over time, spasticity often worsens, with severe spasticity becoming a major obstacle to the functional recovery of paralyzed limbs.7 This spastic paralysis not only significantly impacts the quality of life for patients but also increases the economic and social burden due to added healthcare costs, treatment expenses, and loss of productivity.8
Currently, the commonly used methods for treating post-stroke spastic paralysis include pharmacological and non-pharmacological therapies. Pharmacological options include antispasticity drugs and botulinum toxin. However, due to adverse reactions and side effects of oral antispasticity medications, which may further impair rather than improve quality of life,9 and the need for personalized, repeated doses of injectable botulinum toxin,10 pharmacological treatments face certain limitations. Therefore, exploring alternative therapies (non-pharmacological therapies) to improve the quality of life for patients with post-stroke spastic paralysis is crucial.
With the further strengthening of international exchange and collaboration, researchers around the world are increasingly focusing on non-pharmacological therapies for the treatment of post-stroke spastic paralysis. Non-pharmacological therapies have three major advantages. First, there is a wide variety of treatment methods available, including acupuncture,11 extracorporeal shock wave therapy,12 neurodevelopmental therapy,13 exercise therapy,14 mirror therapy,15 and robot-assisted rehabilitation training,16 allowing patients to choose treatments flexibly based on their economic conditions and therapeutic needs. Second, many non-pharmacological therapies do not require active patient participation during the treatment process, reducing limitations related to patient adherence and understanding.17 Lastly, in terms of efficacy and safety, non-pharmacological therapies have demonstrated significant effects(BUT OBVIOUSLY NOT 100% RECOVERY OR YOU WOULD MENTION THAT! SO, REALLY ALL THESE ARE FAILURES!) comparable to pharmacological treatments, without relying on the gastrointestinal absorption of drugs into the bloodstream, thereby avoiding potential toxic side effects and drug-induced diseases. Their side effects are minimal, making them safer and more gentle. Relevant studies have confirmed that acupuncture can improve post-stroke motor disorders, spasticity, and pain;18 extracorporeal shock wave therapy has long-lasting effects on both agonist and antagonist muscles;19 transcutaneous electrical nerve stimulation has similar efficacy to baclofen in improving spasticity.20 Neurodevelopmental therapies, such as neuromuscular joint facilitation techniques, can enhance joint range of motion and improve upper limb function.21 Exercise therapy promotes functional recovery of the affected side and reduces muscle spasm.22 Therefore, exploring the current research status, hot topics, and future trends of non-pharmacological therapies in the treatment and rehabilitation of post-stroke spastic paralysis holds significant research value.
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