1Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Clin Rehabil. 2014 Feb;28(2):149-58. doi: 10.1177/0269215513494875. Epub 2013 Jul 31.
To determine whether adding electrical stimulation of upper limb acupoints to conventional rehabilitation during acute stroke could produce greater and longer lasting motor improvements of the arm.
Double-blind, randomized, placebo-controlled trial.
Acute stroke wards, followed by rehabilitation hospitals and subjects' residences.
Seventy-three patients ≤ 46 hours post stroke onset with moderate to severe weakness in the arm contralateral to the side of stroke.
All subjects received conventional rehabilitation. Twenty-nine received additional electrical stimulation, 21 received additional placebo-electrical stimulation and 23 received conventional rehabilitation only, as control. Electrical stimulation or placebo-electrical stimulation was applied to acupoints GB20, LI15, LI11, LI10 and LI4, 60 minutes a day, five days a week, for four weeks.
Primary outcome measures were hand grip and pinch strength, with Action Research Arm Test (ARAT) as secondary outcome measure. These were assessed on the affected arm at recruitment, then 4 (W4), 12 (W12) and 24 weeks (W24) afterwards.
Post-hoc analysis showed that the electrical stimulation group had greater improvements than the control group in hand grip (P = 0.015) and pinch strength (P = 0.007) at W4, with the gains maintained at W12 and W24. In contrast, the placebo-electrical stimulation group did not differ from either the control or the electrical stimulation group. Between-group improvements in ARAT scores from baseline to W24 (by 16.8 in control, 27.6 in placebo-electrical stimulation group and 26.3 in electrical stimulation group) were not significant.
Adding four weeks of electrical stimulation during acute stroke appears to produce greater and longer lasting hand grip and pinch strength improvements than administering conventional rehabilitation alone.
观察在急性脑卒中患者接受常规康复治疗的同时，附加上肢穴位电刺激是否能产生更大、更持久的上肢运动功能改善。
双盲、随机、安慰剂对照试验。
急性脑卒中病房，随后是康复医院和患者的住所。
73 名发病≤46 小时、伴有脑卒中对侧上肢中重度无力的患者。
所有患者均接受常规康复治疗。29 例患者接受附加穴位电刺激，21 例患者接受附加假穴位电刺激，23 例患者仅接受常规康复治疗作为对照组。穴位电刺激或假穴位电刺激每天应用于 GB20、LI15、LI11、LI10 和 LI4 穴位，每次 60 分钟，每周 5 天，共 4 周。
主要结局测量指标为手抓握力和捏力，次要结局测量指标为上肢动作研究测试（ARAT）。在入组时评估患侧上肢，然后在第 4 周（W4）、第 12 周（W12）和第 24 周（W24）评估。
事后分析显示，电刺激组在 W4 时的手抓握力（P = 0.015）和捏力（P = 0.007）改善程度大于对照组，并且在 W12 和 W24 时仍保持改善。相比之下，假穴位电刺激组与对照组或电刺激组之间没有差异。从基线到 W24 时，ARAT 评分的组间改善（对照组为 16.8，假穴位电刺激组为 27.6，电刺激组为 26.3）没有统计学意义。
在急性脑卒中患者接受常规康复治疗的同时，附加 4 周穴位电刺激似乎能产生更大、更持久的手抓握力和捏力改善，优于单独接受常规康复治疗。
