Effect of Tui Na on upper limb spasticity after stroke: a randomized clinical trial

Ann Clin Transl Neurol. 2019 Mar 19;6(4):778-787. doi: 10.1002/acn3.759. eCollection 2019 Apr.


Objective: To investigate the efficacy and safety of Tui Na for treating spasticity of the upper limbs of stroke patients.

Design: A prospective, multicenter, blinded, randomized controlled intervention study.

Subjects: Stroke patients with upper limb spasticity who were treated between December 2013 and February 2017 in 16 participating institutions in China were randomly assigned to receive either Tui Na plus conventional rehabilitation (Tui Na group, n = 222,) or conventional rehabilitation only (control group, n = 222).

Methods: Eligible adult patients (aged 18-75 years) were enrolled 1-12 months after stroke and randomly allocated in a 1:1 ratio to the two groups. Outcome assessors were blinded to treatment allocation. Muscle tone in the spastic muscles was evaluated using the Modified Ashworth Scale (MAS), and the primary endpoint was the change in MAS score over 4 weeks of treatment.

Results: Among patients who had experienced stroke 1-3 months before treatment, the Tui Na group experienced significantly greater reductions in MAS scores for three muscle groups than did the control group after 4 weeks of treatment. These improvements were sustained at the 3- and 6-month follow-ups. However, among patients who suffered from stroke 4-6 months and 7-12 months before treatment, the change in MAS with treatment did not differ significantly between those who did and those who did not receive Tui Na. No Tui Na-related adverse events during treatment were reported the groups.

Conclusion: Tui Na was effective and safe for alleviating poststroke spasticity within 1-3 months after stroke onset.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Botulinum Toxins, Type A / adverse effects
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Spasticity / chemically induced
  • Muscle Spasticity / therapy*
  • Neuromuscular Agents / adverse effects
  • Neuromuscular Agents / therapeutic use
  • Outcome Assessment, Health Care
  • Prospective Studies
  • Stroke / physiopathology
  • Stroke / therapy*
  • Stroke Rehabilitation* / methods
  • Treatment Outcome
  • Upper Extremity / physiopathology*
  • Young Adult


  • Neuromuscular Agents
  • Botulinum Toxins, Type A