Mukherjee Mukul, McPeak Lisa K, Redford John B, Sun Chao, Liu Wen
Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS 66160-7601, USA.
Arch Phys Med Rehabil. 2007 Feb;88(2):159-66. doi: 10.1016/j.apmr.2006.10.034.
To quantitatively assess the change in spasticity of the impaired wrist joint in chronic stroke patients after electro-acupuncture treatment.
Crossover design.
University medical center research laboratory.
Seven chronic stroke subjects (age, 63.14+/-7.01y).
Participants received two 6-week treatment regimens: combined electro-acupuncture and strengthening twice a week, and strengthening twice a week only. Muscle strength and spasticity of the wrist joint were quantified by using the Biodex multijoint System 3 Pro. Electro-acupuncture was given through a commercial electro-acupuncture device.
Velocity sensitivity of averaged speed-dependent reflex torque (VASRT); segmented averaged speed-dependent reflex torque (SASRT); Modified Ashworth Scale (MAS) scores; and integrated electromyographic activity of the affected wrist flexors during passive stretch of the affected wrist joint.
VASRT was reduced significantly in the combined treatment group (P=.02) after the 6-week period, but not in the strengthening-only group (P=.23); however, no significant immediate effect of electro-acupuncture was observed (P>.05). MAS scores also showed a significant reduction (P<.01). SASRT did not differ significantly across different positions of the joint or across velocity; however, significant differences were present between the 2 treatment groups (P<.05) for each position and at all the velocities except at 20 degrees /s. Integrated electromyographic activity showed a trend for reduction after the combined treatment.
A combination of electro-acupuncture and muscle strengthening exercise for 6 weeks significantly reduced spasticity. The effect of spasticity reduction was consistent across different joint positions and different velocities of passive stretch.
定量评估慢性脑卒中患者患侧腕关节痉挛在电针治疗后的变化。
交叉设计。
大学医学中心研究实验室。
7名慢性脑卒中受试者(年龄63.14±7.01岁)。
参与者接受两种为期6周的治疗方案:电针联合强化训练,每周两次;仅强化训练,每周两次。使用Biodex多关节系统3 Pro对腕关节的肌肉力量和痉挛进行量化。通过商用电子针疗设备进行电针治疗。
平均速度依赖性反射扭矩的速度敏感性(VASRT);分段平均速度依赖性反射扭矩(SASRT);改良Ashworth量表(MAS)评分;以及患侧腕关节被动伸展时患侧腕屈肌的肌电图综合活动。
6周后,联合治疗组的VASRT显著降低(P = 0.02),而仅强化训练组未降低(P = 0.23);然而,未观察到电针的显著即时效应(P>0.05)。MAS评分也显著降低(P<0.01)。SASRT在关节的不同位置或不同速度之间无显著差异;然而,在每个位置以及除20度/秒外的所有速度下,两个治疗组之间存在显著差异(P<0.05)。联合治疗后,肌电图综合活动呈下降趋势。
电针与肌肉强化运动相结合6周可显著降低痉挛。在不同的关节位置和不同的被动伸展速度下,痉挛降低的效果是一致的。