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经皮穴位电刺激治疗脑卒中后上肢痉挛:疗效与可行性——一项随机对照试验研究

Transcutaneous electrical acupoint stimulation for upper limb spasticity after stroke: effect and feasibility-a randomised pilot study.

作者信息

Wang Yuting, Zhang Lili, Yin Rui, Zhang Yuqing, Dai Zifeng, Wang Min, Song Jiali, Fan Xiaonong, Zhang Yanan, Yang Sha, Shen Yan, Yang Chen, Song Qian, Sun Sihan, Liu Jian

机构信息

First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, Tianjin, China.

National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, Tianjin, China.

出版信息

BMJ Support Palliat Care. 2025 Feb 26;15(2):237-244. doi: 10.1136/spcare-2024-005174.

Abstract

IMPORTANCE

Limb spasticity is a common issue among stroke patients. Transcutaneous electrical acupoint stimulation (TEAS) is recommended as an alternative therapy for managing upper limb spasticity after stroke; however, its potential effects and feasibility remain uncertain.

OBJECTIVE

To investigate the potential effects and feasibility of TEAS on motor function in patients with upper limb spasticity after stroke.

METHODS

This randomised controlled, double-blined pilot study was conducted in two phases. All the patients were randomly divided into two groups: the TEAS group and the sham TEAS group. The intervention period for both TEAS and sham TEAS was 6 weeks, with each session lasting 30 min and conducted thrice weekly. The outcomes measured were the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) score, the effective improvement rate, the modified Ashworth Scale (MAS), the Wolf Motor Function Test (WMFT), the visual analogue scale (VAS), the Barthel index (BI) and the surface electromyography (sEMG).

RESULTS

All participants completed the course of therapy. Baseline characteristics were comparable across the two groups. Compared with the sham TEAS group, the TEAS group showed significant increases in FMA-UE score (P value=0.013), WMFT score (P value=0.001) and BI score (P value=0.008) at week 6. For integrated electromyogram (p=0.048) and root mean square of the biceps (p=0.033), lower scores were identified in the TEAS group compared with the sham TEAS group with a significant difference at week 6.

CONCLUSION

TEAS was acceptable and feasible in participants with upper limb spasticity after stroke. A pivotal study of this therapy is justified.

摘要

重要性

肢体痉挛是中风患者的常见问题。经皮穴位电刺激(TEAS)被推荐作为中风后上肢痉挛的替代治疗方法;然而,其潜在效果和可行性仍不确定。

目的

探讨经皮穴位电刺激(TEAS)对中风后上肢痉挛患者运动功能的潜在效果和可行性。

方法

这项随机对照双盲试验分两个阶段进行。所有患者随机分为两组:TEAS组和假TEAS组。TEAS组和假TEAS组的干预期均为6周,每次治疗持续30分钟,每周进行三次。测量的结果包括Fugl-Meyer上肢评估(FMA-UE)评分、有效改善率、改良Ashworth量表(MAS)、Wolf运动功能测试(WMFT)、视觉模拟量表(VAS)、Barthel指数(BI)和表面肌电图(sEMG)。

结果

所有参与者均完成了治疗疗程。两组的基线特征具有可比性。与假TEAS组相比,TEAS组在第6周时FMA-UE评分(P值=0.013)、WMFT评分(P值=0.001)和BI评分(P值=0.008)显著增加。对于积分肌电图(p=0.048)和肱二头肌均方根(p=0.033),TEAS组与假TEAS组相比得分更低,在第6周时有显著差异。

结论

经皮穴位电刺激(TEAS)对中风后上肢痉挛患者是可接受且可行的。对该疗法进行关键研究是合理的。

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