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互动头皮针刺联合悬吊数字化作业疗法治疗脑卒中后上肢运动功能障碍:一项多中心随机对照试验。

Interactive scalp acupuncture combined with suspension digital occupational therapy for upper limb motor dysfunction after stroke: a multi-center randomized controlled trial.

机构信息

Department of Rehabilitation,First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China.

Department of Rehabilitation,Third People's Hospital of Bengbu.

出版信息

Zhongguo Zhen Jiu. 2024 Feb 12;44(2):129-133. doi: 10.13703/j.0255-2930.20230507-k0001.

Abstract

OBJECTIVES

To observe the effects of interactive scalp acupuncture on upper limb motor function and activities of daily living in patients with upper limb motor dysfunction after stroke.

METHODS

One hundred and twenty patients with upper limb motor dysfunction after stroke were randomly divided into an observation group(60 cases, 2 cases dropped out)and a control group(60 cases, 1 case dropped out). Both groups were treated with routine medication and rehabilitation. The observation group was treated with interactive scalp acupuncture combined with suspension digital occupational therapy, interactive scalp acupuncture was applied at middle 2/5 of the parietal and temporal anterior oblique line, middle 2/5 of the parietal and temporal posterior oblique line and second lateral line of parietal of the hemiparalysis contralateral side, 30 min each time.The control group was treated with suspension digital occupational therapy alone. The treatment was given once a day, 5 times a week for 4 weeks in the two groups. The scores of Fugl-Meyer assessment scale of upper extremity(FMA-UE), action research arm test(ARAT), the modified Barthel index (MBI) and surface electromyography(sEMG)signal of the biceps and triceps on the affected side were observed before and after treatment in the two groups, and the clinical efficacy was evaluated.

RESULTS

After treatment, the FMA-UE, ARAT and MBI scores were increased compared with those before treatment in both groups(<0.05), the changes of the observation group were greater than those in the control group(<0.05). After treatment, the integrated electromyography(iEMG)value and root mean square(RMS)value of the biceps and triceps on the affected side during elbow flexion and extension were increased compared with those before treatment in both groups(<0.05), the changes of the observation group were greater than those in the control group(<0.05). The total effective rate was 94.8%(55/58) in the observation group, which was higher than 83.1%(49/59) in the control group(<0.05).

CONCLUSIONS

Interactive scalp acupuncture could improve upper limb motor function and activities of daily living in patients with upper limb motor dysfunction after stroke.

摘要

目的

观察互动头皮针刺对脑卒中后上肢运动功能障碍患者上肢运动功能和日常生活活动能力的影响。

方法

将 120 例脑卒中后上肢运动功能障碍患者随机分为观察组(60 例,2 例脱落)和对照组(60 例,1 例脱落)。两组均给予常规药物和康复治疗。观察组采用互动头皮针刺联合悬吊数字化职业疗法治疗,针刺对侧偏瘫中 2/5 顶颞前斜线、2/5 顶颞后斜线和顶旁 2 线,每次 30 分钟。对照组单独采用悬吊数字化职业疗法治疗。两组均每日治疗 1 次,每周治疗 5 次,共治疗 4 周。观察两组治疗前后上肢 Fugl-Meyer 运动功能评定量表(FMA-UE)、动作研究臂测试(ARAT)、改良 Barthel 指数(MBI)和患侧肱二头肌、肱三头肌表面肌电图(sEMG)信号,并评价临床疗效。

结果

治疗后,两组 FMA-UE、ARAT 和 MBI 评分均高于治疗前(P<0.05),观察组变化大于对照组(P<0.05)。治疗后,两组患侧肱二头肌、肱三头肌在肘屈伸时的综合肌电(iEMG)值和均方根(RMS)值均高于治疗前(P<0.05),观察组变化大于对照组(P<0.05)。观察组总有效率为 94.8%(55/58),高于对照组的 83.1%(49/59)(P<0.05)。

结论

互动头皮针刺可改善脑卒中后上肢运动功能障碍患者的上肢运动功能和日常生活活动能力。

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