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Abstract
Background and Objectives: Falije Nisfi is a disease causing loss of sensations and movements in longitudinal half of the body. It is the commonest form of paralysis, occurring due to cerebrovascular accident or stroke. The most common and widely recognized impairment caused by stroke is motor impairment, which can be regarded as a loss or limitation of function in muscle control or movement or a limitation in mobility. Despite the advancements in technology and drug development, the figures in terms of deaths and disability caused by stroke grossly suggest the limitations in its management. Unani system of medicine asserts to possess treatment for motor recovery in Falije Nisfi. Almost all ancient Unani physicians have advocated Tanqia and Ta’deel as treatment of Falij caused by Balghami Khilt. Hence, it was decided to conduct a clinical trial to find out the efficacy of the regimens of Tanqia and Ta’deel in the management of Falije Nisfion scientific parameters.
Methods: The study was conducted as a single blind, randomized and standard controlled clinical trial. 40 patients of ischaemic stroke considered eligible for the study were randomized into two groups, comprising 20 patients in test and 20 in control group. Tanqia was achieved by using Nuskha munzij and Mushile balgham. Nuskha munzije balgham, consisting of Badyan, 5 grams; Bekh Badyan, 5 grams; Maveez Munaqqa, 5 grams; Ustukhuddoos, 5 grams; Inabussalab, 5 grams; Bekh Kibr, 5 grams and Persiaoshan, 5 grams was given for 12 days along with 25 grams of Gulqand in the form of Joshanda, (decoction) orally once in the morning before breakfast daily. The ingredients of Mushile Balgham, consisting of Ustukhuddoos, 5 grams; Barg Sana, 10 grams; Turbud, 3 grams; Maghz faloos, 7 tola and Roghan Zard, 5 grams were mixed with the ingredients of Munzije Balgham and given for the next two days consecutively in the form of Joshandaorally.
After Tanqia, phase of Ta’deel, aiming at restoration and normalization of organ, was started employing Massage on spinal column and paralyzed limbs for 15 minutes with Roghan Malkangani for a total duration of 14 days; thus, completing the whole treatment on 28thday.
Control group was given tablet Piracetam Hydrochloride, 800 mg twice a day. Both, group A and B also received tablet Aspirin, 75 mg and tablet lisinopril, 2.5 mg, once daily for 28 days. The assessment of efficacy of treatment in test and control groups was carried out on the basis of a reliable and valid scale “Stroke Rehabilitation Assessment of Movement (STREAM)” especially designed for evaluation of motor functions. Pre and post treatment values of STREAM were subjected to statistical analysis within and between the groups using Paired ‘t’ test, Wilcoxon matched pairs signed rank test, and Kruskal-Wallis test with Dunn’s multiple comparison test.
Results:There was significant improvement in STREAM scores for voluntary movements of upper limb (P<0.01), lower limb (P<0.01), Basic mobility (P<0.01), and total score (P<0.01), in Group A as compared to Group B. No obnoxious side effect was observed in test group during and after the study and overall compliance to the treatment was satisfactory.
