Background: Although various conventional approaches have been employed to reduce spasticity in neurological rehabilitation, only a few studies have shown scientific evidence for its effectiveness. Thus, we introduced a different concept (Ueda method) of rehabilitation therapy that can complement the limitations of conventional therapy.
Objects: This study aimed to investigate the immediate effects of the application of the Ueda method on patients with spasticity after stroke via an electrophysiological study.
Methods: We conducted a randomized double-blind pilot study in two rehabilitation hospitals involving 30 stroke patients who were randomly allocated to the Ueda (n = 15) and convention (n = 15) groups. Electromyographic data of six examined muscles in both upper extremities of all patients were recorded. The A-ApA index and activation ratios of upper extremity muscles were evaluated and compared between the groups to confirm post-intervention changes in upper-extremity flexor spasticity and flexion synergies. Repeated-measures analysis of variance was conducted to confirm the therapeutic effect (2 × 2) as a function of group (Ueda vs. convention) and time (pre-/post-intervention) on all outcome measures (p < 0.05).
Results: In the Ueda group, the mean A-ApA index values differed significantly before and after the intervention (p = 0.041), indicating a weak evidence level; however, the effect size was medium (d = –0.503). The interaction effects of the A-ApA index between the Ueda and convention groups and between pre-intervention and post-intervention stages were significant (p = 0.012). The effect size was large (np 2 = 0.220). In the Ueda group, the activation ratios of the anterior deltoid fiber significantly decreased after the intervention in all reaching tasks.
Conclusion: The Ueda method reduces upper-extremity flexor spasticity and changes its synergy in stroke patients and should be considered a rehabilitation therapy for spastic stroke patients.

INTRODUCTION
MATERIALS AND METHODS
    1. Study Design
    2. Participants
    3. Intervention
    4. Materials
    5. Measurements
    6. Data Processing
    7. Statistical Analysis
RESULTS
DISCUSSION
CONCLUSIONS
FUNDING
ACKNOWLEDGEMENTS
CONFLICTS OF INTEREST
AUTHOR CONTRIBUTIONS
ORCID
REFERENCES

• Young Hyoun Rha(Department of Physical Therapy, Busan Veterans Hospital) Corresponding author
• Keun Hee Lee(Department of Physical Therapy, Pediatric Motor Development Center)
• Jun Bum Shin(Department of Physical Therapy, ONEXT Rehabilitation Laboratory Center)
• Kang Hui Park(Department of Physical Therapy, Dongju College)
• Byung Sun Kim(Department of Physical Therapy, Gwanghye General Hospital)
• Jae Chan Ha(Department of Physical Therapy, Dong-A University Hospital, Busan, Korea)