Effect of transcranial direct current stimulation combined with acupuncture on central and upper limb function in stroke patients based on central-peripheral-central theory
10.3969/j.issn.1006-9771.2023.08.008
- VernacularTitle:基于“中枢-外周-中枢”理论的经颅直流电刺激结合针刺干预脑卒中患者中枢及上肢功能的效果
- Author:
Haiyun WANG
1
;
Yin WANG
1
;
Xinjie ZHOU
1
;
Aiqun HE
1
Author Information
1. Department of Occupational Theraphy, Guangdong Work Injury Rehabilitation Hospital, Guangzhou, Guangdong 510440, China
- Publication Type:Journal Article
- Keywords:
stroke;
upper limb;
motor function;
transcranial direct current stimulation;
acupuncture;
electroencephalogram;
electromyography
- From:
Chinese Journal of Rehabilitation Theory and Practice
2023;29(8):919-925
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the effect of transcranial direct current stimulation (tDCS) combined with acupuncture on central and upper limb function in stroke patients at flaccid stage based on central-peripheral-central theory. MethodsFrom September, 2018 to December, 2021, 120 patients with upper limb dysfunction after stroke in Guangdong Work Injury Rehabilitation Hospital were selected and randomly divided into control group 1 (n = 40), control group 2 (n = 40) and experimental group (n = 40). All the groups received conventional rehabilitation treatment. In addition, the control group 1 received acupuncture treatment, the control group 2 received anodal tDCS, and the experimental group received combined treatment of both, for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE) and modified Barthel Index (MBI) before and after treatment. Electroencephalograph (EEG) was used to detect brain symmetry index (BSI), and electromyography (EMG) was used to detect root mean square values (RMS) of triceps brachii, biceps brachii, extensor wrist and flexor wrist of the affected upper limbs. ResultsTwo cases in the control group 1, one in the control group 2 and one in the experimental group dropped off, respectively. After treatment, the scores of FMA-UE and MBI significantly increased in all the groups (t > 11.757, P < 0.001), and they were higer in the experimental group than in the control groups (P < 0.001); the BSI decreased in the control group 2 and the experimental group (t > 2.324, P < 0.05), and it was less in the experimental group than in the control group 2 (P < 0.05); the RMS of biceps increased in all the groups (t > 2.953, P < 0.01), and was higer in the experimental group than in the control groups (P < 0.05); the RMS of flexor wrist and triceps increased in the control group 1 and the experimental group (t > 2.230, P < 0.05), and were higher in the experimental group than in the control group 1 (P < 0.05); the RMS of wrist extensor muscle increased only in the experimental group (t = 3.350, P < 0.01). ConclusiontDCS combined with acupuncture based on central-peripheral-central theory could effectively improve the upper limb function of stroke patients at flaccid stage, with advantages in improving hemispheric asymmetry and enhancing the activation level of affected muscles.
