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电针对慢性卒中幸存者腕关节痉挛的影响。

The effect of electro-acupuncture on spasticity of the wrist joint in chronic stroke survivors.

作者信息

Mukherjee Mukul, McPeak Lisa K, Redford John B, Sun Chao, Liu Wen

机构信息

Department of Physical Therapy and Rehabilitation Sciences, University of Kansas Medical Center, Kansas City, KS 66160-7601, USA.

出版信息

Arch Phys Med Rehabil. 2007 Feb;88(2):159-66. doi: 10.1016/j.apmr.2006.10.034.

Abstract

OBJECTIVE

To quantitatively assess the change in spasticity of the impaired wrist joint in chronic stroke patients after electro-acupuncture treatment.

DESIGN

Crossover design.

SETTING

University medical center research laboratory.

PARTICIPANTS

Seven chronic stroke subjects (age, 63.14+/-7.01y).

INTERVENTION

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.

MAIN OUTCOME MEASURES

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

设计

交叉设计。

地点

大学医学中心研究实验室。

参与者

7名慢性脑卒中受试者(年龄63.14±7.01岁)。

干预措施

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。

主要观察指标

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。

结果

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。

结论

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。

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