Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three st...Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.展开更多
Objective: To explore the promoting function of TCM nursing in the rehabilitation of hemiplegia patients with stroke. Methods: 78 stroke hemiplegic patients admitted from April 2022 to April 2024 were randomly divided...Objective: To explore the promoting function of TCM nursing in the rehabilitation of hemiplegia patients with stroke. Methods: 78 stroke hemiplegic patients admitted from April 2022 to April 2024 were randomly divided into a control group of 38 cases who received routine care, and an experimental group of 40 cases who received routine nursing basis plus traditional Chinese medicine nursing;the nursing effects of the two groups of patients were compared. Results: After 12 days of nursing care, the experimental group showed better psychological status [SAS score (21.71 ± 3.21), SDS score (22.18 ± 2.31)], limb motor function, daily living ability, and neurological function [NIHSS score (12.23 ± 2.21)] than the control group, with significant differences in data (P Conclusion: Traditional Chinese medicine nursing for stroke hemiplegia patients is more conducive to promoting rehabilitation than routine nursing.展开更多
Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiple...Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiplegia.Methods:Seventy-nine stroke and hemiplegia patients admitted to the hospital from June 2021 to June 2023 were selected and randomly divided into a control group(39 cases)using modern rehabilitation training,and an observation group combined with comprehensive TCM rehabilitation therapy(40 cases),over 1 month.The clinical index data of the two groups were compared.Results:There were differences in the clinical index data between the two groups.The total effective rate after 2 treatment in the observation group(92.50%)was higher than that of the control group(74.36%)(χ^(2)=4.727,P<0.05).All central sensitization inventory(CSI)and stroke quality of life(PRO)scores in both groups were lower after treatment,with the observation group having lower scores as compared to the control group(P<0.05).The scores of FMA(upper limbs,lower limbs),Barthel index scores,and Functional Ambulation Categories(FAC)scores of both groups increased after treatment,with the observation group having higher scores as compared to the control group(P<0.05).Conclusion:Comprehensive TCM rehabilitation therapy had a significant therapeutic effect on patients with hemiplegia after stroke.It improved the patient’s spasticity,limb movement,and walking function.Their daily living abilities and quality of life were also enhanced.展开更多
Objective:To explore the effects of acupuncture and tuina combined with rehabilitation therapy on oxidative stress response and motor function in stroke hemiplegia patients.Methods:Sixty stroke hemiplegia patients wer...Objective:To explore the effects of acupuncture and tuina combined with rehabilitation therapy on oxidative stress response and motor function in stroke hemiplegia patients.Methods:Sixty stroke hemiplegia patients were randomly divided into observation and control groups,with 30 cases each.The control group received conventional rehabilitation therapy,while the observation group also underwent acupuncture and tuina.After 8 weeks of treatment,oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)],neurological deficit scores(NIHSS),Fugl-Meyer motor function scores(FMA),and activities of daily living(Barthel Index)were compared between the two groups.Results:Before treatment,there were no significant differences in MDA,NIHSS scores,FMA scores,and Barthel Index between the two groups(P>0.05).After 8 weeks,the observation group had lower MDA and NIHSS scores,but higher SOD,GSH-Px,FMA scores,and Barthel Index compared to the control group,with statistically significant differences(P<0.05).Conclusion:Acupuncture and tuina combined with rehabilitation therapy can effectively improve oxidative stress levels,promote neurological recovery,enhance motor function,and improve daily living activities in stroke hemiplegia patients.This combined therapy is recommended for clinical application.展开更多
Objective:The purpose of this study is to use CiteSpace software to examine the development patterns and hotspots in post-stroke hemiplegia research during the last 20 years.Methods:Articles about post-stroke hemipleg...Objective:The purpose of this study is to use CiteSpace software to examine the development patterns and hotspots in post-stroke hemiplegia research during the last 20 years.Methods:Articles about post-stroke hemiplegia from January 2005 to December 2024 were analyzed in the Web of Science database.CiteSpace software was used to conduct co-citation analysis of the articles about post-stroke hemiplegia as well as cooperative network analyses of authors,countries,and institutions,as well as keyword co-occurrence,clustering,emergence,and time line analyses.The results were displayed in a visual atlas.Result:A total of 2625 papers were obtained,and there were more publications overall.China and the United States had the most number of articles,while Chae,John was the author with the most number of articles.Capital Med University and Ohio State University had the most articles among their agencies.The keywords"stroke"and"rehabilitation"were used the most.The key word analysis indicates that the present study focus is on exercise rehabilitation measures and post-stroke treatment.Conclusion:Using CiteSpace software to analyze the literature on post-stroke hemiplegia,it is discovered that the use of new technologies in the field of mechanical thrombectomy and the effectiveness of rehabilitation techniques like mirror treatment are the key areas of study attention.This study has positive significance for finding safer and more effective treatments for post-stroke hemiplegia.展开更多
Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’bala...Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.展开更多
Objective To evaluate the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. Methods Sixty cases were randomly divid...Objective To evaluate the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. Methods Sixty cases were randomly divided into an acupuncture rehabilitation group （33 cases） and a routine treatment group （27 cases）. Both two groups received rehabilitation exercise, acupuncture rehabilitation group was treated with scalp acupuncture and body acupuncture, and in body acupuncture, Pishu（脾俞 BL 20）, Weishu （胃俞 BE 21）, Zusanli （足三里 ST 36）, Fenglong （丰隆 ST 40）, Xuehai （血海 SP 10）, and accompanying points according to the symptoms were selected; in scalp acupuncture, Baihui （百会 GV 20）, Sishencong （四神聪EX-HN 1）, motor area, vascular dilation and constriction area were selected. Routine treatment group was treated with western drugs, including dehydration with mannitol to reduce intracranial pressure, control blood pressure, and brain cell protective agent was given, triamcinolone acetate solution for shoulder pain or cortisone acetate solution for blocking treatment. The treatment was given once a day, four weeks were one course, and four courses were given in all. The hemorheological indices and the clinical effect of two groups were compared. Results The effective rate of acupuncture rehabilitation group was 90.9% （30/33）, better than that of 70.4% （19/27） in routine treatment group （P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment became lowered than those before the treatment in acupuncture rehabilitation group （all P〈0.05）; whole blood viscosity and plasma viscosity after the treatment was also lowered than those before the treatment in routine treatment group （both P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment in acupuncture rehabilitation group were obviously lowered than those of routine treatment group （all P〈0.05）. Conclusion With good therapeutic effect and better efficacy than routine medical treatment, scalp acupuncture and body acupuncture in combination with rehabilitation exercise can improve the movement, sensation and hemorheology of extremities of patients with hemiplegia and shoulder pain after stroke.展开更多
Objective To observe the clinical effects on upper extremities function recovery of cerebral apoplexy induced hemiplegia by combination of JIN＇s 3-needle technique and motor function trai- ning. Methods Eight-seven c...Objective To observe the clinical effects on upper extremities function recovery of cerebral apoplexy induced hemiplegia by combination of JIN＇s 3-needle technique and motor function trai- ning. Methods Eight-seven cases of cerebral apoplexy induced hemiplegia were randomized into an observation group （44 cases） and a control group （43 cases）. JIN＇s 3-needle technique and motor function training were both adopted for the observation group. Three temporal acupuncture points on the affected side were selected. Three lower arm points, namely Qfichi （曲池 LI 11 ）, Waiguan （外关 TE 5） and Hegu （ 合谷 LI 4） were adopted for flaccid hemiplegia. While 3 upper arm points for relieving spasm, namely Jiquan （极泉HT 1）, Chize （尺泽 LU 5） and Neiguan （内关 PC 6） were chosen for spastic hemiplegia. Motor function training was applied alone for the control group. Treating courses for both groups were 5 weeks. And scores of Brunnstrom and FugI-Meyer assessments of the affected limbs were analyzed. Results Improvement on scores of FugI-Meyer and Brunnstrom assessments were observed for both groups after the treatment（P〈0. 05, P〈0. 01 ）. The post-treatment scores of the observation group was better than that of the control group after the treatment （ P〈0.05, P〈0.01 ）. Conclusion Treat- ment of combination of JIN＇s 3-needle technique with motor function training can obviously improve the motor function of the upper extremities of patients with cerebral apoplexy induced hemiplegia.展开更多
Objective To probe into the optimum therapy for hemiplegia induced by neurosurgical operation. Methods 50 cases were randomized into treatment group （25 cases） and control group （25 cases）. In control group, the r...Objective To probe into the optimum therapy for hemiplegia induced by neurosurgical operation. Methods 50 cases were randomized into treatment group （25 cases） and control group （25 cases）. In control group, the routine western drugs in internal medicine were applied; in treatment group, on the basis of the treatment in control group, acupuncture was supplemented 3 days after the operation. Acupoints were Neiguan （内关 PC 6）, Shuigou （水沟 GV26）, QSchi （ 曲池LI 11）, Hégü （合谷 LI 4）, Sanyinjiao （三阴交 SP 6）, Jiquan （极泉 HT 1）, Weizhong （委中BL 40）, etc. The scalp acupuncture was applied in combination. Such treatment was given for 30 days （once per day）. The functional evaluation was conducted based on neurological functional defect scale （NDS） before and after treatment. Results Acupuncture improved re markably NDS, the total effective rate was 76.0% in treatment group and was 42.4% in control group, indicating significant difference by statistical management （P〈0.05）. Conclusion The therapeutic effect in treatment group is superior to that in control group. The coordinative action is achieved in the combination of acupuncture with western medicine for hemiplegia after neurosurgical operation and the therapeutic effect is much improved.展开更多
Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs, namely collateral shock in the brain. Contralateral needling is the insertion of needles into acupoints on the relative hea...Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs, namely collateral shock in the brain. Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy. However, there is little well-designed and controlled clinical evidence for this practice. This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke. These patients were randomly assigned to three groups： 45 in the contralateral needling group, receiving acupuncture on the unaffected limbs; 45 in the conven- tional acupuncture group, receiving acupuncture on the hemiplegic limbs; and 16 in the control group, receiving routine treatments without acupuncture. Acupuncture at acupoints Chize （LU5） in the upper limb and Jianliao （TEl4） in the lower limb was performed for 45 minutes daily for 30 consecutive days. The therapeutic effective rate, Neurological Deficit Score, Modified Barthel Index and FugI-Meyer Assessment were evaluated. The therapeutic effective rate of contralateral nee- dling was higher than that of conventional acupuncture （46.67% vs. 31.11%, P 〈 0.05）. The neuro- logical deficit score of contralateral needling was significantly decreased compared with conven- tional acupuncture （P 〈 0.01）. The Modified Barthel Index and FugI-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture （both P 〈 0.01）. The present findings suggest that contralateral needling unblocks collaterals and might be more effective than conventional acupuncture in the treatment of hemiplegia following acute ischemic stroke.展开更多
Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we p...Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.展开更多
OBJECTIVE:To evaluate the therapeutic effects of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients.METHODS:One hundred and twenty hemiplegia patients with stage I shoulder-hand syndrome were ra...OBJECTIVE:To evaluate the therapeutic effects of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients.METHODS:One hundred and twenty hemiplegia patients with stage I shoulder-hand syndrome were randomly divided into a group treated with standardized electric acupuncture and massage,and a group treated with rehabilitation therapy for 6 weeks.The primary indices evaluated were pain on passive movement of the shoulder using the numeric pain rating scale(NPRS),and the number of patients with shoulder-hand syndrome at Steinbrocker stage II or III after treatment.The secondary indices were Fugl-Meyer evaluation of functional movement of the upper limb and hand using the modified rankin scale(MRS).RESULTS:At post-treatment evaluation and a 12-week follow-up visit,NPRS score,number of patients with stage II or III shoulder-hand syndrome,and MRS score were all improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).On Fugl-Meyer evaluation,functional movement of the upper limb was also improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).CONCLUSION:Standardized acupuncture-massage therapy may have curative effects on shoulder-hand syndrome in hemiplegia patients.展开更多
OBJECTIVE: To determine whether patients with post-stroke hemiplegia could benefit from long-term treatment with scalp cluster(SC) acupuncture combined with electrical stimulation(ES)and to evaluate the feasibility of...OBJECTIVE: To determine whether patients with post-stroke hemiplegia could benefit from long-term treatment with scalp cluster(SC) acupuncture combined with electrical stimulation(ES)and to evaluate the feasibility of this treatment to improve motor and living abilities.METHODS: Twenty patients were enrolled and divided into two groups: SC acupuncture and SC acupuncture with ES(SC and SC + ES, respectively). All participants also received rehabilitation training.All participants were blindly evaluated using the Fugl-Meyer assessment scale for motor ability, the modified Barthel Index for living ability, and a scale for the degree of neurological deficits. Outcome was assessed at three points before randomized grouping, at the beginning or treatment, and after4 weeks of treatment.RESULTS: Following 4 weeks treatment, all the patients exhibited significant improvements in aspects of motor ability, living ability, and the severity of neurological deficits. The experimental group(SC + ES) scored higher on the Fugl-Meyer assessment scale(68 ± 12) and the modified Barthel Index(49 ± 9) than the control(SC) group(50 ± 13,36 ± 13, respectively).CONCLUSION: When patients with post-stroke hemiplegia are treated using SC acupuncture with ES, motor and living ability can improve more than if they were treated with SC acupuncture alone.展开更多
OBJECTIVE:To evaluate the effectiveness of cycling in combination with electroacupuncture in treatment of poststroke hemiplegia patients at National Hospital of Acupuncture,Vietnam.METHODS:The study was designed as a ...OBJECTIVE:To evaluate the effectiveness of cycling in combination with electroacupuncture in treatment of poststroke hemiplegia patients at National Hospital of Acupuncture,Vietnam.METHODS:The study was designed as a single-centre,outcome-assessor-blinded parallel randomised controlled trial with 120 post-stroke hemiplegia patients randomly assigned into two groups:electroacupuncture plus cycling(CT group) and electroacupuncture(AT group).Patients were assessed before and after the treatment(using muscle grading,modified Rankin,Barthel,Orgorozo scores and electromyography).Statistical Man–Whitney U test,and Fisher’s exact tests were used to compare between CT and AT groups.RESULTS:The results reported statistically significant improvement in motor function in patients suffering from hemiplegia following ischemic stroke in both CT and AT groups.Patients in CT group experienced a greater improvement compared to those in AT group including better muscle contraction(increased frequency and amplitude of electromyography and increased muscle grading scale);increased recovery(Orgogozo scale),increased independency(Barthel scale) and decreased disability(Modified Rankin scale)(P < 0.01).CONCLUSIONS:Combination with cycling training significantly improves the recovery of post-stroke patients treated with electroacupuncture.展开更多
Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-...Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-stroke spastic hemiplegia so as to compare the differences in clinical therapeutic effect between acupuncture therapy and rehabilitation therapy as well as among different therapeutic methods of acupuncture.Methods:A computer-based retrieval was conducted in Chinese and English databases,i.e.CNKI,WanFang,VIP,SinoMed,PubMed,Embase,Web of Science and Cochrane library.The search period limit was from the database establishment to April 17,2020.Data analysis was performed through Revman 5.3,Gemtc 0.14.3 and Stata 14.2.Results:A total of 27 trials were finally eligible,including 1880 patients,943 patients of which were in observation group and 937 patients in control group.In terms of the improvement of effective rate,electroacupuncture,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,warm acupuncture was the highest in probability to be the optimal measure.Regarding the improvement in Fugl-Meyer Assessment(FMA) motor function score,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,fire needling method was the highest in probability to be the optimal measure.In view of the improvement of BI score,fire needling method was better than electroacupuncture and filiform needling method,while,warm acupuncture was better than electroacupuncture,thus,fire needling method may be the optimal measure.For the modified Ashworth muscular tension assessment,there was no significant differences in pairwise comparison among different interventions and warm acupuncture was probably the optimal measure.Conclusion:The overall therapeutic effect of 4 acupuncture therapies is better than rehabilitation therapy on post-stroke spastic hemiplegia,respectively,among which,the therapeutic effect of warm acupuncture and fire needling method is the best.However,because of a limitation of the varieties of acupuncturemoxibustion therapy and the number of included trials,it needs to conduct more rigorous and scientific randomized controlled trials so that this conclusion can be further confirmed.展开更多
There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage.Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior...There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage.Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles,we investigated a potential method of nerve repair using the L4 nerve roots.Rat models of hindlimb hemiplegia after a hypertensive intracerebral hemorrhage were established by injecting autogenous blood into the posterior limb of internal capsule.The L4 nerve root on the healthy side of model rats was transferred and then anastomosed with the L4 nerve root on the affected side to drive the extensor and flexor muscles of the hindlimbs.We investigated whether this method can restore the flexible movement of the hindlimbs of paralyzed rats after hypertensive intracerebral hemorrhage.In a beam-walking test and ladder rung walking task,model rats exhibited an initial high number of slips,but improved in accuracy on the paretic side over time.At 17 weeks after surgery,rats gained approximately 58.2%accuracy from baseline performance and performed ankle motions on the paretic side.At 9 weeks after surgery,a retrograde tracing test showed a large number of fluoro-gold-labeled motoneurons in the left anterior horn of the spinal cord that supports the L4-to-L4 nerve roots.In addition,histological and ultramicrostructural findings showed axon regeneration of motoneurons in the anterior horn of the spinal cord.Electromyography and paw print analysis showed that denervated hindlimb muscles regained reliable innervation and walking coordination improved.These findings suggest that the L4-to-L4 nerve root transfer method for the treatment of hindlimb hemiplegia after hypertensive intracerebral hemorrhage can improve the locomotion of hindlimb major joints,particularly of the distal ankle.Findings from study support that the L4-to-L4 nerve root transfer method can effectively repair the hindlimb hemiplegia after hypertensive intracerebral hemorrhage.All animal experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Nanjing Medical University(No.IACUC-1906009)in June 2019.展开更多
Sufficient hip joint extension range of motion is important in improving the walking speed of patients with spastic hemiplegia. In this study, we developed a piston device for the hip (PDH) that simulates the action o...Sufficient hip joint extension range of motion is important in improving the walking speed of patients with spastic hemiplegia. In this study, we developed a piston device for the hip (PDH) that simulates the action of the piston technique for hip joints (PTH), which is a method for improving hip joint extension range of motion. We then evaluated the efficacy of PDH on 10 spastic hemiplegia patients suffering from a limited range of hip joint extension. Results confirmed rapid improvement of hip joint range of motion and increase in walking speed.展开更多
BACKGROUND Stroke is a common cause of neurological dysfunction,often resulting in hemiplegia.Thus,rehabilitation of limb function in stroke patients is an important step towards accelerating recovery and improving qu...BACKGROUND Stroke is a common cause of neurological dysfunction,often resulting in hemiplegia.Thus,rehabilitation of limb function in stroke patients is an important step towards accelerating recovery and improving quality of life.AIM To investigate whether unilateral strength training in hemiplegic stroke patients could lead to cross-migration,an increase in bilateral muscle strength,and an improvement in lower limb motor function.METHODS We randomly divided 120 patients with hemiplegic stroke into two groups:Eexperimental and control groups,with 60 patients in each group.Both groups received routine rehabilitation treatment,while the experimental group additional-ly received ankle dorsiflexion resistance training on the healthy side for 6 wk.We measured the maximum voluntary contract(MVC),changes in surface electromyography(EMG),and the lower limb motor function using the simplified Fugl Meyer Motor Function Assessment Scale(FMA)before and within 1 wk after training.RESULTS The FMA score in the experimental group improved significantly compared to both their pre-training score and the control group's post-training score(P<0.05).The integrated EMG of the anterior tibialis muscle and pulmonary intestine muscle in the experimental group were significantly different after training than before(P<0.05).Furthermore,the MVC of the anterior tibialis muscle on both the healthy and affected sides and the MVC of the pulmonary intestine muscle on both sides showed significant improvement compared with before training and the control group(P<0.05).CONCLUSION Our findings suggest that ankle dorsiflexion resistance training on the healthy side in hemiplegic stroke patients can increase strength in the opposite tibialis anterior muscle and antagonist's muscle,indicating a cross-migration phenomenon of strength training.Furthermore,this type of training can also improve lower limb motor function,providing a new exercise method for improving early ankle dorsiflexion dysfunction.展开更多
The acupuncturetherapy for hemiplegiapatients is popular insome Asian countries,and it has been graduallyaccepted in the rehabili-tative medical field ofsome developed countries.Although numer-ous clinical and experim...The acupuncturetherapy for hemiplegiapatients is popular insome Asian countries,and it has been graduallyaccepted in the rehabili-tative medical field ofsome developed countries.Although numer-ous clinical and experimental studies have beendone,many doctors usu-展开更多
BACKGROUND： Electrogymnastics can offer a range of proprioceptive, motor, and cutaneous sensation impulses to the central nerve system. The center receives perception of the paralyzed muscle through the aid of these ...BACKGROUND： Electrogymnastics can offer a range of proprioceptive, motor, and cutaneous sensation impulses to the central nerve system. The center receives perception of the paralyzed muscle through the aid of these impulses. During this process, functional reorganization of connecting network between segment and intersegment takes place. OBJECTIVE： To observe the therapeutic efficacy of acupoint electrogymnastics and traditional electroacupuncture on stroke hemiplegia. DESIGN, TIME AND SETTING： A multicenter, randomized, controlled, blinded, clinical study was performed at the College of Acu-moxibustion and Massage in Shanghai University of Traditional Chinese Medicine from May 2004 to September 2006. PARTICIPANTS： A total of 153 patients suffering from stroke hemiplegia, comprising 83 males and 70 females, aged 63-70 years, were admitted to outpatient and inpatient at LongHua Hospital Affiliated Shanghai University of Traditional Chinese medicine, Putuo District Traditional Chinese Medicine Hospital and Changqiao Street Community Health Service Center of Shanghai. METHODS： The patients were randomly divided into treatment （n = 77） and control （n = 76） groups. They were treated with acupoint electrogymnastics and traditional electroacupuncture, respectively. In the treatment group, two pairs of positive and negative JD-2008 type electrodes from a hemiplegia treatment apparatus were directly pasted on the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan （GB34） acupoints of the lower limb, respectively. In the control group, needles were consecutively inserted into the above acupoints. Using the method of lifting-inserting and twisting-rotating, the needle was manipulated with small amplitude of 5-7 mm and a fast frequency of 80-120 times/min when the needle was inserted to a suitable depth. When the sensation of needling was attained, the two pairs of positive and negative electrodes of type G6805-Ⅱelectro-acupuncture apparatus were connected to the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan（GB 34） acupoints of the lower limb, respectively. MAIN OUTCOME MEASURES： The Fugl-Meyer evaluation method was used to assess upper limb movement, lower limb movement, sensory stimulation of all limbs, balance, and joint range of motion. RESULTS： Upper-lower limb motor function, limb sensory function, balance, and joint range of motion were significantly ameliorated following treatment, compared with pre-treatment （P 〈0.01）. There was no significant difference in various indexes between the two groups after treatment （P 〉0.05）. CONCLUSION： Acupoint electrogymnastics and traditional electroacupuncture exhibited similar curative effects in the treatment of stroke hemiplegia.展开更多
文摘Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.
文摘Objective: To explore the promoting function of TCM nursing in the rehabilitation of hemiplegia patients with stroke. Methods: 78 stroke hemiplegic patients admitted from April 2022 to April 2024 were randomly divided into a control group of 38 cases who received routine care, and an experimental group of 40 cases who received routine nursing basis plus traditional Chinese medicine nursing;the nursing effects of the two groups of patients were compared. Results: After 12 days of nursing care, the experimental group showed better psychological status [SAS score (21.71 ± 3.21), SDS score (22.18 ± 2.31)], limb motor function, daily living ability, and neurological function [NIHSS score (12.23 ± 2.21)] than the control group, with significant differences in data (P Conclusion: Traditional Chinese medicine nursing for stroke hemiplegia patients is more conducive to promoting rehabilitation than routine nursing.
文摘Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiplegia.Methods:Seventy-nine stroke and hemiplegia patients admitted to the hospital from June 2021 to June 2023 were selected and randomly divided into a control group(39 cases)using modern rehabilitation training,and an observation group combined with comprehensive TCM rehabilitation therapy(40 cases),over 1 month.The clinical index data of the two groups were compared.Results:There were differences in the clinical index data between the two groups.The total effective rate after 2 treatment in the observation group(92.50%)was higher than that of the control group(74.36%)(χ^(2)=4.727,P<0.05).All central sensitization inventory(CSI)and stroke quality of life(PRO)scores in both groups were lower after treatment,with the observation group having lower scores as compared to the control group(P<0.05).The scores of FMA(upper limbs,lower limbs),Barthel index scores,and Functional Ambulation Categories(FAC)scores of both groups increased after treatment,with the observation group having higher scores as compared to the control group(P<0.05).Conclusion:Comprehensive TCM rehabilitation therapy had a significant therapeutic effect on patients with hemiplegia after stroke.It improved the patient’s spasticity,limb movement,and walking function.Their daily living abilities and quality of life were also enhanced.
文摘Objective:To explore the effects of acupuncture and tuina combined with rehabilitation therapy on oxidative stress response and motor function in stroke hemiplegia patients.Methods:Sixty stroke hemiplegia patients were randomly divided into observation and control groups,with 30 cases each.The control group received conventional rehabilitation therapy,while the observation group also underwent acupuncture and tuina.After 8 weeks of treatment,oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)],neurological deficit scores(NIHSS),Fugl-Meyer motor function scores(FMA),and activities of daily living(Barthel Index)were compared between the two groups.Results:Before treatment,there were no significant differences in MDA,NIHSS scores,FMA scores,and Barthel Index between the two groups(P>0.05).After 8 weeks,the observation group had lower MDA and NIHSS scores,but higher SOD,GSH-Px,FMA scores,and Barthel Index compared to the control group,with statistically significant differences(P<0.05).Conclusion:Acupuncture and tuina combined with rehabilitation therapy can effectively improve oxidative stress levels,promote neurological recovery,enhance motor function,and improve daily living activities in stroke hemiplegia patients.This combined therapy is recommended for clinical application.
基金Research topics in key areas of Tianjin Administration of Traditional Chinese Medicine:"Establishment of quantitative model of Chinese medicine syndrome of swallowing dysfunction after stroke based on multi-dimensional item response theory and acupuncture intervention"(2023003)Hospital funded project of Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital:"To investigate the mechanism of acupuncture regulating endometrial receptivity from IL-10/HOXA10 axis"(2022002).
文摘Objective:The purpose of this study is to use CiteSpace software to examine the development patterns and hotspots in post-stroke hemiplegia research during the last 20 years.Methods:Articles about post-stroke hemiplegia from January 2005 to December 2024 were analyzed in the Web of Science database.CiteSpace software was used to conduct co-citation analysis of the articles about post-stroke hemiplegia as well as cooperative network analyses of authors,countries,and institutions,as well as keyword co-occurrence,clustering,emergence,and time line analyses.The results were displayed in a visual atlas.Result:A total of 2625 papers were obtained,and there were more publications overall.China and the United States had the most number of articles,while Chae,John was the author with the most number of articles.Capital Med University and Ohio State University had the most articles among their agencies.The keywords"stroke"and"rehabilitation"were used the most.The key word analysis indicates that the present study focus is on exercise rehabilitation measures and post-stroke treatment.Conclusion:Using CiteSpace software to analyze the literature on post-stroke hemiplegia,it is discovered that the use of new technologies in the field of mechanical thrombectomy and the effectiveness of rehabilitation techniques like mirror treatment are the key areas of study attention.This study has positive significance for finding safer and more effective treatments for post-stroke hemiplegia.
文摘Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.
文摘Objective To evaluate the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. Methods Sixty cases were randomly divided into an acupuncture rehabilitation group （33 cases） and a routine treatment group （27 cases）. Both two groups received rehabilitation exercise, acupuncture rehabilitation group was treated with scalp acupuncture and body acupuncture, and in body acupuncture, Pishu（脾俞 BL 20）, Weishu （胃俞 BE 21）, Zusanli （足三里 ST 36）, Fenglong （丰隆 ST 40）, Xuehai （血海 SP 10）, and accompanying points according to the symptoms were selected; in scalp acupuncture, Baihui （百会 GV 20）, Sishencong （四神聪EX-HN 1）, motor area, vascular dilation and constriction area were selected. Routine treatment group was treated with western drugs, including dehydration with mannitol to reduce intracranial pressure, control blood pressure, and brain cell protective agent was given, triamcinolone acetate solution for shoulder pain or cortisone acetate solution for blocking treatment. The treatment was given once a day, four weeks were one course, and four courses were given in all. The hemorheological indices and the clinical effect of two groups were compared. Results The effective rate of acupuncture rehabilitation group was 90.9% （30/33）, better than that of 70.4% （19/27） in routine treatment group （P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment became lowered than those before the treatment in acupuncture rehabilitation group （all P〈0.05）; whole blood viscosity and plasma viscosity after the treatment was also lowered than those before the treatment in routine treatment group （both P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment in acupuncture rehabilitation group were obviously lowered than those of routine treatment group （all P〈0.05）. Conclusion With good therapeutic effect and better efficacy than routine medical treatment, scalp acupuncture and body acupuncture in combination with rehabilitation exercise can improve the movement, sensation and hemorheology of extremities of patients with hemiplegia and shoulder pain after stroke.
基金National Science and Technology Pillar Program in the Eleventh Five-Year Plan Period:2006BI12B02-3
文摘Objective To observe the clinical effects on upper extremities function recovery of cerebral apoplexy induced hemiplegia by combination of JIN＇s 3-needle technique and motor function trai- ning. Methods Eight-seven cases of cerebral apoplexy induced hemiplegia were randomized into an observation group （44 cases） and a control group （43 cases）. JIN＇s 3-needle technique and motor function training were both adopted for the observation group. Three temporal acupuncture points on the affected side were selected. Three lower arm points, namely Qfichi （曲池 LI 11 ）, Waiguan （外关 TE 5） and Hegu （ 合谷 LI 4） were adopted for flaccid hemiplegia. While 3 upper arm points for relieving spasm, namely Jiquan （极泉HT 1）, Chize （尺泽 LU 5） and Neiguan （内关 PC 6） were chosen for spastic hemiplegia. Motor function training was applied alone for the control group. Treating courses for both groups were 5 weeks. And scores of Brunnstrom and FugI-Meyer assessments of the affected limbs were analyzed. Results Improvement on scores of FugI-Meyer and Brunnstrom assessments were observed for both groups after the treatment（P〈0. 05, P〈0. 01 ）. The post-treatment scores of the observation group was better than that of the control group after the treatment （ P〈0.05, P〈0.01 ）. Conclusion Treat- ment of combination of JIN＇s 3-needle technique with motor function training can obviously improve the motor function of the upper extremities of patients with cerebral apoplexy induced hemiplegia.
文摘Objective To probe into the optimum therapy for hemiplegia induced by neurosurgical operation. Methods 50 cases were randomized into treatment group （25 cases） and control group （25 cases）. In control group, the routine western drugs in internal medicine were applied; in treatment group, on the basis of the treatment in control group, acupuncture was supplemented 3 days after the operation. Acupoints were Neiguan （内关 PC 6）, Shuigou （水沟 GV26）, QSchi （ 曲池LI 11）, Hégü （合谷 LI 4）, Sanyinjiao （三阴交 SP 6）, Jiquan （极泉 HT 1）, Weizhong （委中BL 40）, etc. The scalp acupuncture was applied in combination. Such treatment was given for 30 days （once per day）. The functional evaluation was conducted based on neurological functional defect scale （NDS） before and after treatment. Results Acupuncture improved re markably NDS, the total effective rate was 76.0% in treatment group and was 42.4% in control group, indicating significant difference by statistical management （P〈0.05）. Conclusion The therapeutic effect in treatment group is superior to that in control group. The coordinative action is achieved in the combination of acupuncture with western medicine for hemiplegia after neurosurgical operation and the therapeutic effect is much improved.
基金partially funded by a grant from Ningxia Science and Technology Support Project,No.2012ZYS207
文摘Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs, namely collateral shock in the brain. Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy. However, there is little well-designed and controlled clinical evidence for this practice. This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke. These patients were randomly assigned to three groups： 45 in the contralateral needling group, receiving acupuncture on the unaffected limbs; 45 in the conven- tional acupuncture group, receiving acupuncture on the hemiplegic limbs; and 16 in the control group, receiving routine treatments without acupuncture. Acupuncture at acupoints Chize （LU5） in the upper limb and Jianliao （TEl4） in the lower limb was performed for 45 minutes daily for 30 consecutive days. The therapeutic effective rate, Neurological Deficit Score, Modified Barthel Index and FugI-Meyer Assessment were evaluated. The therapeutic effective rate of contralateral nee- dling was higher than that of conventional acupuncture （46.67% vs. 31.11%, P 〈 0.05）. The neuro- logical deficit score of contralateral needling was significantly decreased compared with conven- tional acupuncture （P 〈 0.01）. The Modified Barthel Index and FugI-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture （both P 〈 0.01）. The present findings suggest that contralateral needling unblocks collaterals and might be more effective than conventional acupuncture in the treatment of hemiplegia following acute ischemic stroke.
基金supported by a grant from the Supporting Program of the"Eleventh Five-year Plan"for Science&Technology Research of China,Ministry of Science and Technology of China,No.2006BAI12B02a grant from the Scientific Research Fund for Talent Introduction in the Gansu University of Chinese Medicine of China,No.2012-11
文摘Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.
基金Supported by The Fund of Research into Treatment of Diseases with Acupuncturea-clinically Applied Research Task of Sichuan Provincial Tcm Administration in 2008
文摘OBJECTIVE:To evaluate the therapeutic effects of acupuncture and massage for shoulder-hand syndrome in hemiplegia patients.METHODS:One hundred and twenty hemiplegia patients with stage I shoulder-hand syndrome were randomly divided into a group treated with standardized electric acupuncture and massage,and a group treated with rehabilitation therapy for 6 weeks.The primary indices evaluated were pain on passive movement of the shoulder using the numeric pain rating scale(NPRS),and the number of patients with shoulder-hand syndrome at Steinbrocker stage II or III after treatment.The secondary indices were Fugl-Meyer evaluation of functional movement of the upper limb and hand using the modified rankin scale(MRS).RESULTS:At post-treatment evaluation and a 12-week follow-up visit,NPRS score,number of patients with stage II or III shoulder-hand syndrome,and MRS score were all improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).On Fugl-Meyer evaluation,functional movement of the upper limb was also improved in the acupuncture-massage group compared with the rehabilitation group(P<0.05).CONCLUSION:Standardized acupuncture-massage therapy may have curative effects on shoulder-hand syndrome in hemiplegia patients.
基金Supported by Grants from the Natural Science Foundation of Shandong Province(No.ZR2011HL019,ZR2014HL060)
文摘OBJECTIVE: To determine whether patients with post-stroke hemiplegia could benefit from long-term treatment with scalp cluster(SC) acupuncture combined with electrical stimulation(ES)and to evaluate the feasibility of this treatment to improve motor and living abilities.METHODS: Twenty patients were enrolled and divided into two groups: SC acupuncture and SC acupuncture with ES(SC and SC + ES, respectively). All participants also received rehabilitation training.All participants were blindly evaluated using the Fugl-Meyer assessment scale for motor ability, the modified Barthel Index for living ability, and a scale for the degree of neurological deficits. Outcome was assessed at three points before randomized grouping, at the beginning or treatment, and after4 weeks of treatment.RESULTS: Following 4 weeks treatment, all the patients exhibited significant improvements in aspects of motor ability, living ability, and the severity of neurological deficits. The experimental group(SC + ES) scored higher on the Fugl-Meyer assessment scale(68 ± 12) and the modified Barthel Index(49 ± 9) than the control(SC) group(50 ± 13,36 ± 13, respectively).CONCLUSION: When patients with post-stroke hemiplegia are treated using SC acupuncture with ES, motor and living ability can improve more than if they were treated with SC acupuncture alone.
文摘OBJECTIVE:To evaluate the effectiveness of cycling in combination with electroacupuncture in treatment of poststroke hemiplegia patients at National Hospital of Acupuncture,Vietnam.METHODS:The study was designed as a single-centre,outcome-assessor-blinded parallel randomised controlled trial with 120 post-stroke hemiplegia patients randomly assigned into two groups:electroacupuncture plus cycling(CT group) and electroacupuncture(AT group).Patients were assessed before and after the treatment(using muscle grading,modified Rankin,Barthel,Orgorozo scores and electromyography).Statistical Man–Whitney U test,and Fisher’s exact tests were used to compare between CT and AT groups.RESULTS:The results reported statistically significant improvement in motor function in patients suffering from hemiplegia following ischemic stroke in both CT and AT groups.Patients in CT group experienced a greater improvement compared to those in AT group including better muscle contraction(increased frequency and amplitude of electromyography and increased muscle grading scale);increased recovery(Orgogozo scale),increased independency(Barthel scale) and decreased disability(Modified Rankin scale)(P < 0.01).CONCLUSIONS:Combination with cycling training significantly improves the recovery of post-stroke patients treated with electroacupuncture.
基金Supported by National Administration of Traditional Chinese Medicine,Construction Project of Inheritance Studio of National Famous Traditional Chinese Medicine Experts:[2016]No.42.
文摘Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-stroke spastic hemiplegia so as to compare the differences in clinical therapeutic effect between acupuncture therapy and rehabilitation therapy as well as among different therapeutic methods of acupuncture.Methods:A computer-based retrieval was conducted in Chinese and English databases,i.e.CNKI,WanFang,VIP,SinoMed,PubMed,Embase,Web of Science and Cochrane library.The search period limit was from the database establishment to April 17,2020.Data analysis was performed through Revman 5.3,Gemtc 0.14.3 and Stata 14.2.Results:A total of 27 trials were finally eligible,including 1880 patients,943 patients of which were in observation group and 937 patients in control group.In terms of the improvement of effective rate,electroacupuncture,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,warm acupuncture was the highest in probability to be the optimal measure.Regarding the improvement in Fugl-Meyer Assessment(FMA) motor function score,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,fire needling method was the highest in probability to be the optimal measure.In view of the improvement of BI score,fire needling method was better than electroacupuncture and filiform needling method,while,warm acupuncture was better than electroacupuncture,thus,fire needling method may be the optimal measure.For the modified Ashworth muscular tension assessment,there was no significant differences in pairwise comparison among different interventions and warm acupuncture was probably the optimal measure.Conclusion:The overall therapeutic effect of 4 acupuncture therapies is better than rehabilitation therapy on post-stroke spastic hemiplegia,respectively,among which,the therapeutic effect of warm acupuncture and fire needling method is the best.However,because of a limitation of the varieties of acupuncturemoxibustion therapy and the number of included trials,it needs to conduct more rigorous and scientific randomized controlled trials so that this conclusion can be further confirmed.
基金the National Natural Science Foundation of China,No.81171147(to LXL)“Key Medical Talents of Qiangwei Project”Research Foundation of Health Department of Jiangsu Province,No.ZDRCA2016010(to LXL)+3 种基金“Xingwei Project”Key Personal Medical Research Foundation of Health Department of Jiangsu Province,No.RC201156(to LXL)Jiangsu Province’s Key Discipline of Medicine,No.XK201117(to LXL)the Priority Academic Program Development of Jiangsu Higher Education Institutions,PAPD(to LXL)the Natural Science Foundation of Jiangsu Province,No.BK20171064(to BSH).
文摘There is no effective treatment for hemiplegia after hypertensive intracerebral hemorrhage.Considering that the branches of L4 nerve roots in the lumbar plexus root control the movement of the lower extremity anterior and posterior muscles,we investigated a potential method of nerve repair using the L4 nerve roots.Rat models of hindlimb hemiplegia after a hypertensive intracerebral hemorrhage were established by injecting autogenous blood into the posterior limb of internal capsule.The L4 nerve root on the healthy side of model rats was transferred and then anastomosed with the L4 nerve root on the affected side to drive the extensor and flexor muscles of the hindlimbs.We investigated whether this method can restore the flexible movement of the hindlimbs of paralyzed rats after hypertensive intracerebral hemorrhage.In a beam-walking test and ladder rung walking task,model rats exhibited an initial high number of slips,but improved in accuracy on the paretic side over time.At 17 weeks after surgery,rats gained approximately 58.2%accuracy from baseline performance and performed ankle motions on the paretic side.At 9 weeks after surgery,a retrograde tracing test showed a large number of fluoro-gold-labeled motoneurons in the left anterior horn of the spinal cord that supports the L4-to-L4 nerve roots.In addition,histological and ultramicrostructural findings showed axon regeneration of motoneurons in the anterior horn of the spinal cord.Electromyography and paw print analysis showed that denervated hindlimb muscles regained reliable innervation and walking coordination improved.These findings suggest that the L4-to-L4 nerve root transfer method for the treatment of hindlimb hemiplegia after hypertensive intracerebral hemorrhage can improve the locomotion of hindlimb major joints,particularly of the distal ankle.Findings from study support that the L4-to-L4 nerve root transfer method can effectively repair the hindlimb hemiplegia after hypertensive intracerebral hemorrhage.All animal experiments were approved by the Animal Ethics Committee of the First Affiliated Hospital of Nanjing Medical University(No.IACUC-1906009)in June 2019.
文摘Sufficient hip joint extension range of motion is important in improving the walking speed of patients with spastic hemiplegia. In this study, we developed a piston device for the hip (PDH) that simulates the action of the piston technique for hip joints (PTH), which is a method for improving hip joint extension range of motion. We then evaluated the efficacy of PDH on 10 spastic hemiplegia patients suffering from a limited range of hip joint extension. Results confirmed rapid improvement of hip joint range of motion and increase in walking speed.
文摘BACKGROUND Stroke is a common cause of neurological dysfunction,often resulting in hemiplegia.Thus,rehabilitation of limb function in stroke patients is an important step towards accelerating recovery and improving quality of life.AIM To investigate whether unilateral strength training in hemiplegic stroke patients could lead to cross-migration,an increase in bilateral muscle strength,and an improvement in lower limb motor function.METHODS We randomly divided 120 patients with hemiplegic stroke into two groups:Eexperimental and control groups,with 60 patients in each group.Both groups received routine rehabilitation treatment,while the experimental group additional-ly received ankle dorsiflexion resistance training on the healthy side for 6 wk.We measured the maximum voluntary contract(MVC),changes in surface electromyography(EMG),and the lower limb motor function using the simplified Fugl Meyer Motor Function Assessment Scale(FMA)before and within 1 wk after training.RESULTS The FMA score in the experimental group improved significantly compared to both their pre-training score and the control group's post-training score(P<0.05).The integrated EMG of the anterior tibialis muscle and pulmonary intestine muscle in the experimental group were significantly different after training than before(P<0.05).Furthermore,the MVC of the anterior tibialis muscle on both the healthy and affected sides and the MVC of the pulmonary intestine muscle on both sides showed significant improvement compared with before training and the control group(P<0.05).CONCLUSION Our findings suggest that ankle dorsiflexion resistance training on the healthy side in hemiplegic stroke patients can increase strength in the opposite tibialis anterior muscle and antagonist's muscle,indicating a cross-migration phenomenon of strength training.Furthermore,this type of training can also improve lower limb motor function,providing a new exercise method for improving early ankle dorsiflexion dysfunction.
文摘The acupuncturetherapy for hemiplegiapatients is popular insome Asian countries,and it has been graduallyaccepted in the rehabili-tative medical field ofsome developed countries.Although numer-ous clinical and experimental studies have beendone,many doctors usu-
基金Supported by: Project of National Administrative Bureau of Traditional Chinese Medicine and Pharmacy, No. 2003ZL26Pudong New District Project No.PKJ-2004-17
文摘BACKGROUND： Electrogymnastics can offer a range of proprioceptive, motor, and cutaneous sensation impulses to the central nerve system. The center receives perception of the paralyzed muscle through the aid of these impulses. During this process, functional reorganization of connecting network between segment and intersegment takes place. OBJECTIVE： To observe the therapeutic efficacy of acupoint electrogymnastics and traditional electroacupuncture on stroke hemiplegia. DESIGN, TIME AND SETTING： A multicenter, randomized, controlled, blinded, clinical study was performed at the College of Acu-moxibustion and Massage in Shanghai University of Traditional Chinese Medicine from May 2004 to September 2006. PARTICIPANTS： A total of 153 patients suffering from stroke hemiplegia, comprising 83 males and 70 females, aged 63-70 years, were admitted to outpatient and inpatient at LongHua Hospital Affiliated Shanghai University of Traditional Chinese medicine, Putuo District Traditional Chinese Medicine Hospital and Changqiao Street Community Health Service Center of Shanghai. METHODS： The patients were randomly divided into treatment （n = 77） and control （n = 76） groups. They were treated with acupoint electrogymnastics and traditional electroacupuncture, respectively. In the treatment group, two pairs of positive and negative JD-2008 type electrodes from a hemiplegia treatment apparatus were directly pasted on the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan （GB34） acupoints of the lower limb, respectively. In the control group, needles were consecutively inserted into the above acupoints. Using the method of lifting-inserting and twisting-rotating, the needle was manipulated with small amplitude of 5-7 mm and a fast frequency of 80-120 times/min when the needle was inserted to a suitable depth. When the sensation of needling was attained, the two pairs of positive and negative electrodes of type G6805-Ⅱelectro-acupuncture apparatus were connected to the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan（GB 34） acupoints of the lower limb, respectively. MAIN OUTCOME MEASURES： The Fugl-Meyer evaluation method was used to assess upper limb movement, lower limb movement, sensory stimulation of all limbs, balance, and joint range of motion. RESULTS： Upper-lower limb motor function, limb sensory function, balance, and joint range of motion were significantly ameliorated following treatment, compared with pre-treatment （P 〈0.01）. There was no significant difference in various indexes between the two groups after treatment （P 〉0.05）. CONCLUSION： Acupoint electrogymnastics and traditional electroacupuncture exhibited similar curative effects in the treatment of stroke hemiplegia.
