Department of Rehabilitation Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Shenzhen Nanshan People's Hospital), Shenzhen 518052, China.
CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institute of Advanced Technology (SIAT), Chinese Academy of Sciences (CAS) and the SIAT Branch, Shenzhen Institute of Artificial Intelligence and Robotics for Society, Shenzhen 518055, China.
Pain Res Manag. 2021 Nov 19;2021:5329881. doi: 10.1155/2021/5329881. eCollection 2021.
This study aimed to use multidimensional musculoskeletal ultrasound imaging technique to investigate the effect of electroacupuncture (EA) on shoulder subluxation in poststroke patients with hemiplegic shoulder pain.
In this prospective single-blind, randomized, sham-controlled study, thirty-four patients with shoulder subluxation and hemiplegic shoulder pain were recruited and randomly assigned into the EA group or the sham EA (SEA) group. In the EA group, EA was applied to the Jian yu (LI15), Bi nao (LI14), Jian zhen (SI9), and Jian liao (TE14) acupoints. In the SEA group, the EA was applied 15 mm away from the Lou gu (SP7), Di ji (SP8), Jiao xin (KI8), and Zhu bin (KI9) acupoints. Both groups underwent treatment 30 minutes/day, five days a week, for two weeks using dense waves with a frequency of 2/100 Hz. A Visual Analogue Scale (VAS) was used to evaluate the effectiveness of treatment in reducing shoulder pain. Musculoskeletal ultrasound was used to evaluate the changes of measures of shoulder subluxation in multidimensions (i.e., the acromiohumeral distance, AHD; acromion-greater tuberosity, AGT; and acromion-lesser tuberosity, ALT). Both the within- and between-groups treatment effects were assessed.
The pain intensity measured by VAS and shoulder subluxation measured by musculoskeletal ultrasound (i.e., AHD, AGT, and ALT) showed significant ( < 0.05) within-group difference in both groups. The between-group difference appeared in the pain intensity ( < 0.05), while it disappeared in the three measures of shoulder subluxation ( > 0.05).
Using VAS for measuring pain intensity and multidimensional musculoskeletal ultrasound imaging technique for measuring shoulder subluxation, this study finds that the hemiplegic shoulder pain can be improved significantly by the EA while the shoulder subluxation cannot be. Our findings further reveal the analgesic mechanism of EA on hemiplegic shoulder pain following stroke.
本研究旨在采用多维肌骨超声成像技术，探讨电针对脑卒中后偏瘫肩痛伴肩关节半脱位患者的影响。
这是一项前瞻性单盲、随机、假对照研究，共纳入 34 例肩关节半脱位伴偏瘫肩痛的患者，随机分为电针组和假电针组（SEA 组）。电针组在肩髃（LI15）、臂臑（LI14）、肩贞（SI9）和肩髎（TE14）穴位上施以电针，SEA 组在膈俞（SP7）、地机（SP8）、交信（KI8）和筑宾（KI9）穴位上施以 15mm 距离的电针。两组患者均采用疏密波，频率 2/100Hz，每天治疗 30 分钟，每周治疗 5 天，共治疗 2 周。采用视觉模拟评分法（VAS）评估治疗对减轻肩部疼痛的效果。肌骨超声评估多维（肩峰-肱骨头距离、AHD；肩峰-大结节、AGT；肩峰-小结节、ALT）肩关节半脱位的变化。评估组内和组间治疗效果。
VAS 评估的疼痛强度和肌骨超声评估的肩关节半脱位（即 AHD、AGT 和 ALT）在两组中均表现出显著的组内差异（<0.05）。组间差异仅出现在疼痛强度上（<0.05），而在肩关节半脱位的三个测量指标上则消失（>0.05）。
本研究采用 VAS 评估疼痛强度，多维肌骨超声成像技术评估肩关节半脱位，发现电针能显著改善偏瘫肩痛，而不能改善肩关节半脱位。我们的研究结果进一步揭示了电针对脑卒中后偏瘫肩痛的镇痛机制。
