The Effect of Cupping on Spasticity and Function of the Lower Extremity During Rehabilitation After Stroke

NCT ID: NCT06653855

Last Updated: 2024-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-31

Study Completion Date

2026-01-31

Brief Summary

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Physical therapists use dry static cupping for the treatment of many conditions, including spasticity for patients post-stroke. While research better describes the effects of dry static cupping for patients with orthopedic conditions, information is lacking on central conditions, such as stroke and resulting spasticity.

Detailed Description

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Cupping is an ancient alternative medicine. A common form of cupping, called dry static cupping, involves creating negative pressure inside a therapeutic cup. The cup is then placed on the skin, creating a light suction effect. In Eastern Medicine, cupping has been used to treat a variety of diseases. More recently, in Western society, cupping has been used after injury, and among other effects, has been found to improve blood volume and tissue oxygenation to an area. These effects have originally been thought to be peripheral in nature, occurring at the cupping site, hence, why cupping has been used for treatment for conditions like carpal tunnel syndrome, spinal pain, knee osteoarthritis, and other musculoskeletal conditions.

However, a recent systematic review found cupping to be beneficial for rehabilitation after stroke. These conclusions raise the question of a possible mechanism for cupping to improve impairments related to the central nervous system, such as spasticity after stroke. However, many of the studies to date have serious methodological flaws that limit the direct causation of cupping to the reduction of spasticity. As well, the majority of studies only involve the upper extremity. No study has yet looked at the therapeutic effects of dry static cupping on lower extremity spasticity reduction after stroke.

Conditions

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Stroke Gait Rehabilitation

Keywords

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Cupping Spasticity stroke rehabilitation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors
The physical therapist providing the standard physical therapy treatment and the outcomes assessment will be masked to group allocation. However, the therapist administering the cupping and placebo cupping treatments will not be masked to group allocation.

Study Groups

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Cupping group

This group (arm) will receive the dry static cupping intervention, along with the standard physical therapy treatment.

Group Type ACTIVE_COMPARATOR

Dry Static Cupping

Intervention Type OTHER

A myofascial decompression cupping set with a precision pressure pump will be used to perform dry static cupping to the adductor and hamstring muscle groups of the affected limb, using a negative pressure of 300mmHg for eight minutes each.

Standard physical therapy treatment

Intervention Type OTHER

Treatment will consist of typical physical therapy interventions performed for patients with spasticity of the lower extremity after stroke. These may include, but not be limited to:

* Balance exercise
* Therapeutic exercise
* Neuromuscular/muscular coordination exercise
* Manual (hands on) therapy
* Gait training

The treating physical therapist is left with the autonomy of the standard physical therapy treatment (within the above stated groups of interventions) because patients with the diagnosis of stroke do not all present with the same type or level of impairment. Furthermore co-morbidities (e.g., hypertension) and/or functional level (wheelchair bound vs. independent ambulator) may necessitate different treatment strategies. Therefore, while the general categories of treatment will remain the same across all study patients, it is expected that the treating physical therapist provides patient-specific interventions.

Placebo cupping group

This group (arm) will receive a placebo-form of cupping (low, and non-therapeutic pressure amount in the cups), along with the standard physical therapy treatment.

Group Type SHAM_COMPARATOR

Placebo cupping

Intervention Type OTHER

The same protocol will be used as stated for the Dry static cupping intervention, with the only difference being that the cup will be pumped to 50mmHg instead of 300mmHg.

Standard physical therapy treatment

Intervention Type OTHER

Treatment will consist of typical physical therapy interventions performed for patients with spasticity of the lower extremity after stroke. These may include, but not be limited to:

* Balance exercise
* Therapeutic exercise
* Neuromuscular/muscular coordination exercise
* Manual (hands on) therapy
* Gait training

The treating physical therapist is left with the autonomy of the standard physical therapy treatment (within the above stated groups of interventions) because patients with the diagnosis of stroke do not all present with the same type or level of impairment. Furthermore co-morbidities (e.g., hypertension) and/or functional level (wheelchair bound vs. independent ambulator) may necessitate different treatment strategies. Therefore, while the general categories of treatment will remain the same across all study patients, it is expected that the treating physical therapist provides patient-specific interventions.

Interventions

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Dry Static Cupping

A myofascial decompression cupping set with a precision pressure pump will be used to perform dry static cupping to the adductor and hamstring muscle groups of the affected limb, using a negative pressure of 300mmHg for eight minutes each.

Intervention Type OTHER

Placebo cupping

The same protocol will be used as stated for the Dry static cupping intervention, with the only difference being that the cup will be pumped to 50mmHg instead of 300mmHg.

Intervention Type OTHER

Standard physical therapy treatment

Treatment will consist of typical physical therapy interventions performed for patients with spasticity of the lower extremity after stroke. These may include, but not be limited to:

* Balance exercise
* Therapeutic exercise
* Neuromuscular/muscular coordination exercise
* Manual (hands on) therapy
* Gait training

The treating physical therapist is left with the autonomy of the standard physical therapy treatment (within the above stated groups of interventions) because patients with the diagnosis of stroke do not all present with the same type or level of impairment. Furthermore co-morbidities (e.g., hypertension) and/or functional level (wheelchair bound vs. independent ambulator) may necessitate different treatment strategies. Therefore, while the general categories of treatment will remain the same across all study patients, it is expected that the treating physical therapist provides patient-specific interventions.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 30-80
* Acute stroke (within 6 months of stroke), with spasticity \& hemiparesis of LE
* Referred by doctor for rehabilitation for a stroke-related condition
* Attending Ascension Rehabilitation of Joliet for rehabilitation
* Able to read or verbally understand English or Spanish

Exclusion Criteria

* Absent sensation of the areas to be cupped
* Significant cognitive impairment
* Pregnancy
* Prescription anticoagulant medications
* Blood clotting disorder
* Uncontrolled hypertension
* Uncontrolled diabetes
* Open wounds within the cupping area
* Current DVT
* Hematoma over the cupping area
* Fracture over the cupping area
* Active cancer within the cupping area
* Current use of Baclofen
* Current use of Botox
* Current use of an anti-spasticity medication
Minimum Eligible Age

30 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Governors State University

OTHER

Sponsor Role collaborator

Scott Getsoian

INDUSTRY

Sponsor Role lead

Responsible Party

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Scott Getsoian

Physical Therapist

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Ascension Rehabilitation of Joliet

Joliet, Illinois, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Scott Getsoian

Role: CONTACT

Phone: 815-735-9261

Email: [email protected]

Laura Nurczyk

Role: CONTACT

Phone: 815-741-7114

Email: [email protected]

Facility Contacts

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Laura Nurczyk

Role: primary

Kathlene Getsoian

Role: backup

Scott Getsoian

Role: backup

References

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Kim M, Han C ho. The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials. J Korean Med. 2021;42(4):75-101. doi:10.13048/jkm.21039

Reference Type BACKGROUND

Choi TY, Ang L, Ku B, Jun JH, Lee MS. Evidence Map of Cupping Therapy. J Clin Med. 2021 Apr 17;10(8):1750. doi: 10.3390/jcm10081750.

Reference Type BACKGROUND
PMID: 33920643 (View on PubMed)

Pontes NS, Barbosa GM, Almeida Silva HJ, Scattone Silva R, Souza CG, Lins CAA, de Souza MC. Effects of dry cupping on pain, function and quality of life in women with knee osteoarthritis: a protocol for a sham-controlled randomised trial. BMJ Open. 2020 Dec 24;10(12):e039857. doi: 10.1136/bmjopen-2020-039857.

Reference Type BACKGROUND
PMID: 33361075 (View on PubMed)

Shen WC, Jan YK, Liau BY, Lin Q, Wang S, Tai CC, Lung CW. Effectiveness of self-management of dry and wet cupping therapy for low back pain: A systematic review and meta-analysis. Medicine (Baltimore). 2022 Dec 23;101(51):e32325. doi: 10.1097/MD.0000000000032325.

Reference Type BACKGROUND
PMID: 36595746 (View on PubMed)

Michalsen A, Bock S, Ludtke R, Rampp T, Baecker M, Bachmann J, Langhorst J, Musial F, Dobos GJ. Effects of traditional cupping therapy in patients with carpal tunnel syndrome: a randomized controlled trial. J Pain. 2009 Jun;10(6):601-8. doi: 10.1016/j.jpain.2008.12.013. Epub 2009 Apr 19.

Reference Type BACKGROUND
PMID: 19380259 (View on PubMed)

Kim JI, Lee MS, Lee DH, Boddy K, Ernst E. Cupping for treating pain: a systematic review. Evid Based Complement Alternat Med. 2011;2011:467014. doi: 10.1093/ecam/nep035. Epub 2011 Jun 23.

Reference Type BACKGROUND
PMID: 19423657 (View on PubMed)

Al-Bedah A, Aboushanab TS, Alqaed M, et al. Classification of Cupping Therapy: A Tool for Modernization and Standardization. J Complement Altern Med Res. 2016;1(1):1-10. doi:10.9734/JOCAMR/2016/27222

Reference Type BACKGROUND

Qureshi NA, Ali GI, Abushanab TS, El-Olemy AT, Alqaed MS, El-Subai IS, Al-Bedah AMN. History of cupping (Hijama): a narrative review of literature. J Integr Med. 2017 May;15(3):172-181. doi: 10.1016/S2095-4964(17)60339-X.

Reference Type BACKGROUND
PMID: 28494847 (View on PubMed)

Other Identifiers

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RIL20240041

Identifier Type: -

Identifier Source: org_study_id