OBJECTIVE: To observe the clinical efficacy on hemiplegic shoulder pain (HSP) after stroke treated with electroacupuncture (EA) under different frequencies. METHODS: A total of 105 patients with HSP after stroke were randomly divided into a manual acupuncture group (35 cases, 2 cases dropped off), an EA continuous wave group (35 cases, 3 cases dropped off) and an EA disperse-dense wave group (35 cases). The conventional rehabilitation therapy was delivered in the three groups. Additionally, acupuncture was applied to Jianyu (LI 15), Jianzhen (SI 9), Jianliao (TE 14) and Jianqian (Extra) etc. on the affected side in the manual acupuncture group. In the EA continuous wave group and the EA disperse-dense wave group, besides the treatment as the manual acupuncture group, the electric stimulation was attached to two pairs of acupoints, i.e. Jianyu (LI 15) and Jianliao (TE 14), and Quchi (LI 11) and Shousanli (LI 10), with 15 Hz continuous wave, and 2 Hz/ 100 Hz disperse-dense wave, respectively. The treatment was given once daily, 5 times a week, for 4 weeks consecutively. The score of visual analogue scale (VAS) before treatment and after 2 and 4 weeks of treatment, as well as the passive range of motion (PROM) of shoulder forward flexion and PROM of shoulder abduction, muscle strength of the upper limb, the score of modified Barthel index (MBI) and the score of Fugl-Meyer assessment (FMA) before and after treatment were observed in each group. RESULTS: Compared with before treatment, VAS scores were reduced after 2 and 4 weeks of treatment in each group (P<0.05); and VAS scores after 4 weeks of treatment were lower than those after 2 weeks of treatment (P<0.05). After 2 and 4 weeks of treatment, VAS score in either the EA continuous wave group or the EA disperse-dense wave group was lower compared with the manual acupuncture group (P<0.05). After 4 weeks of treatment, VAS score in the EA disperse-dense wave was lower than that of the EA continuous wave group (P<0.05). Compared with before treatment, PROM of the shoulder forward flexion and abduction on the affected side after treatment was enlarged (P<0.05), the muscle strength of the upper limb was increased (P<0.05), and the scores of MBI and FMA were increased (P<0.05) in the patients of each group. After treatment, in the EA continuous wave group and the EA disperse-dense wave group, PROM of the shoulder forward flexion on the affected side was higher (P<0.05), the muscle strength of the upper limb was stronger (P<0.05) when compared with the manual acupuncture group; and the scores of MBI and FMA in the EA disperse-dense wave group were higher than those of the manual acupuncture group (P<0.05). CONCLUSION Electroacupuncture is superior to manual acupuncture in the analgesic effect and comprehensive rehabilitation effect in the patients with HSP after stroke. The therapeutic effect obtained by electroacupuncture with 2 Hz/100 Hz disperse-dense wave is better than that with 15 Hz continuous wave.
Humans ; Electroacupuncture ; Shoulder Pain/therapy* ; Hemiplegia/therapy* ; Stroke/complications* ; Acupuncture Therapy ; Treatment Outcome ; Acupuncture Points

Analysis from anatomy and physiology indicates that causes of shoulder pain are (1) decline and after-constriction of the scapula;(2) the adduction and intorsion of the humerus; (3) the spasm of the upper limb flexor. The acupuncture and moxibustion prescriptions stipulated for prevention and treatment of shoulder pain are Jianjing (GB 21), Jianzhongshu (SI 15), Jugu (LI 16), Tianzong (SI 11), Jianliao (SJ 14), Jiquan (HT 1) at the flaccid hemiplegia, and Jugu (LI 16), Jianyu (LI 15), Tianzong (SI 11), Jianliao (SJ 14), Xiaoluo (SJ 12), Shanglian (LI 9), Wenliu (LI 7) at the spastic hemiplegia , in combination with cupping at the Urinary Bladder Meridian on the back and around shoulder. Thus, it is indicated that shoulder pain not only is involved in the shoulder joint but also in all muscle groups of the shoulder girdle and the upper limb extensor at the affected side.
Acupuncture Therapy ; Hemiplegia ; complications ; Humans ; Moxibustion ; Shoulder Pain ; etiology ; prevention & control ; therapy

OBJECTIVE: To evaluate the clinical curative effect of acupuncture on unilateral spatial neglect (USN) after stroke. METHODS: Sixty-four patients with left hemiplegia after the first stroke and diagnosed with unilateral spatial neglect after stroke in the right hemisphere were randomly divided into an observation group and a control group, 32 cases in each group. In the control group, conventional acupuncture was used at Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), Waiguan (TE 5), Hegu (LI 4), Huantiao (GB 30), Yanglingquan (GB 34), Zusanli (ST 36) and Sanyinjiao (SP 6) on the affected side. In the observation group, acupuncture was applied at Baihui (GV 20), Fengfu (GV 16), Fengchi (GB 20), Xuanzhong (GB 39) and . The treatment was given once a day, 5 times as one course for 4 courses in both groups. The cancellation test, digit cancellation test, bisection line test, clock drawing test, and copying drawing test were used to assess the degree of unilateral spatial neglect, and the Fugl-Meyer motor function scores and the modified Barthel index (MBI) scores were compared before and after treatment in the two groups. RESULTS: After treatment, the scores of cancellation test, digit cancellation test, bisection line test, clock drawing test and copying drawing test were significantly lower than those before treatment in the two groups (all <0.05), and the scores of the above unilateral spatial neglect after treatment in the observation group were lower than those in the control group (all <0.01). After treatment, the scores of Fugl-Meyer motor function and MBI in the two groups were significantly higher than before treatment (all <0.05), and the difference of MBI scores before and after treatment in the observation group was higher than that in the control group (<0.01). CONCLUSION acupuncture can improve the cognition of unilateral spatial neglect in stroke patients with unilateral spatial neglect, improve the degree of bilateral spatial neglect and the motor function of hemiplegic limbs, and positively promote the improvement of cognitive impairment and self-care ability in daily life.
Acupuncture Points ; Acupuncture Therapy ; Hemiplegia ; etiology ; therapy ; Humans ; Stroke ; complications ; Treatment Outcome

OBJECTIVEOn the basic therapy, to assess the clinical effects of dynamic scalp acupuncture, scalp acupuncture combined with proprioceptive neuromuscular facilitation (PNF) therapy and simple PNF therapy for upper limb motor impairment in ischemic post-stroke spastic hemiplegia.

METHODSA total of 90 cases were randomly assigned into a PNF group, a dynamic scalp acupuncture group and a scalp acupuncture group, 30 cases in each group. Basic therapy and PNF therapy were applied in the three groups. PNF therapy was used during scalp acupuncture in the dynamic scalp acupuncture group. PNF therapy was applied after scalp acupuncture in the scalp acupuncture group. The points were the upper 1/5 and middle 2/5 of (MS 6) and (MS 7) at the lesion side, the hemiparalysis contralateral side. The treatment was given for 6 months, once a day and 1 month as a course. The modified Ashworth scale (MAS), the Fugl-Meyer motor assessment (FMA) and Barthel index (BI) were observed before treatment and 2 weeks, 1 month, 3 months, and 6 months after treatment.

RESULTSThe MAS 1 month, 3 months and 6 months after treatment were improved compared with those before treatment in the three groups ( all <0.05), and the MAS results in the dynamic scalp acupuncture group were better than those in the PNF and scalp acupuncture group (all <0.05). The FMA and BI scores 1 month, 3 months and 6 months after treatment were higher than those before treatment (all <0.05). The FMA Scores in the 3 time points and after treatment in the dynamic scalp acupuncture group were higher than those in the other two groups (all <0.05).

CONCLUSIONPNF therapy during scalp acupuncture can relieve the spasmodic condition of patients with upper limb motor impairment in ischemic post-stroke spasmodic hemiplegia, and improve the limb function and life activity, which is better than PNF therapy after scalp acupuncture and simple PNF therapy.

Acupuncture Therapy ; Brain Ischemia ; complications ; rehabilitation ; Combined Modality Therapy ; Hemiplegia ; rehabilitation ; therapy ; Humans ; Scalp ; Stroke ; complications ; Stroke Rehabilitation ; Treatment Outcome

OBJECTIVETo observe effect of acupuncture on hemiplegia spasticity of the patient with stroke and to probe an effective acupuncture method for treatment of the hemiplegia spasticity.

METHODSNinety-six cases of hemiplegia spasticity were randomly divided into a common acupuncture group, and a balance yin-yang acupuncture group. All the patients were treated with routine medicine and rehabilitation training. In the common acupuncture group, traditional acupoint selection method was used with the acupoints on the yang channels such as Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10) selected; in the balance yin-yang acupuncture group, the acupoints on the yin channels and the yang channels were combined, with Jiquan (HT 1), Chize (LU 5), Shaohai (HT 3) etc. selected, according to the TCM theory of yin for chronic and yang for acute and imbalance of muscular tension between the extensor and flesor in the patient of hemiplegia. Before and after treatment, neurological defect scoring criterion, modified Ashworth, daily living ability (ADL-Barthel index) and SIAS were respectively used for evaluation of the therapeutic effects.

RESULTSAcupuncture could significantly improve spastic dyskinesia of the patient of hemiplegia due to stroke and increase daily living ability. After treatment, the neurological defect score was 16.56 +/- 7.97, ADL-Barthel index was 57.20 +/- 12.80 in the treatment group, and 21.62 +/- 7.17, 30.66 +/- 11.34 in the control group, with very significant differences (both P < 0.001).

CONCLUSIONAcupuncture can improve spastic dyskinesia of the patient of hemiplegia due to stroke and increase daily living ability, but different needling methods have different effects.

Acupuncture Therapy ; methods ; Adult ; Aged ; Female ; Hemiplegia ; therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Stroke ; complications ; therapy

OBJECTIVES: Stroke patients may have various sensory-motor disorders, such as spasticity, muscle weakness or sensory damage. Spasticity affects 20% to 40% of stroke patients. Patients with spasticity may have problems such as pain, motor function damage, and the decreased range of motion, which leads to decline of activity and quality of daily life. Extracorporeal shock wave therapy (ESWT) is a technique that can improve post-stroke spasticity. Whole body vibration (WBV), as a passive neuromuscular muscle stimulation technique, can improve the posture control, muscle strength, and muscle work of different people. At present, there are still few studies using WBV combined with ESWT for the treatment of hemiplegic patients with stroke. This study aims to explore the effects of WBV combined with ESWT on spasticity of the affected lower limb and gait function in stroke patients. METHODS: From March 2020 to March 2021, 50 hemiplegic patients with stroke were treated in the Department of Rehabilitation Medicine of the First Hospital of Changsha and they were assigned into a control group and a combined group, 25 cases per group. Both groups carried out conventional treatment, while the control group undertook the ESWT and fake WBV based on conventional treatment, and the combined group undertook ESWT after WBV and conventional treatment. Modified Ashworth Scale (MAS), Lower Extremity portion of the Fugl-Meyer Motor Assessment (FMA-LE), Berg Balance Scale (BBS), and parameters of three-dimensional gait analysis including kinematic parameters (peak value of hip flexion and knee flexion) and spatiotemporal parameters (velocity, cadence and stride length) were assessed before and after 4-week treatment between the 2 groups. RESULTS: After 4 weeks of treatment, MAS scores in 2 groups were lower than before (both P<0.05), and the combined group was lower than the control group (P<0.001); BBS and FMA-LE scores were higher than those before treatment (both P<0.05), and the combined group was higher than the control group (both P<0.001); in the control group, the walking speed, stride frequency, and stride length were higher than those before treatment (all P<0.05), and there was no significant difference between the peak value of flexion hip and peak value of flexion knee (both P<0.05); the peak value of hip flexion, peak value of knee flexion, step speed, step frequency, and stride length in the combined group were higher than those before treatment (all P<0.05), and were higher than those in control group (P<0.05 or P<0.001). CONCLUSIONS WBV combined with ESWT can improve the spasticity and motor function of the affected lower extremity, balance, and gait in hemiplegic patients with stroke.
Extracorporeal Shockwave Therapy ; Gait ; Hemiplegia/therapy* ; Humans ; Muscle Spasticity/therapy* ; Stroke/complications* ; Stroke Rehabilitation/methods* ; Treatment Outcome ; Vibration/therapeutic use*

OBJECTIVE: To compare the therapeutic effect of - balance penetrating acupuncture combined with rehabilitation training and single rehabilitation training on upper limb spasticity in patients with stroke hemiplegia. METHODS: A total of 60 patients with upper limb spasticity of stroke hemiplegia were randomized into an observation group and a control group, 30 cases in each one. On the basis of conventional western medication, rehabilitation training was adopted in the control group. On the basis of treatment in the control group, - balance penetrating acupuncture was applied from Jianyu (LI 15) to Binao (LI 14), Quchi (LI 11) to Shaohai (HT 3), Yanglingquan (GB 34) to Yinlingquan (SP 9), Xuanzhong (GB 39) to Sanyinjiao (SP 6), etc. of the affected side in the observation group. The treatment was given once a day, 5 days were as one course, with a 2-day interval between two courses, 4 courses were required in both groups. The classification of modified Ashworth spasticity scale (MAS), surface integrated electromyogram (iEMG) of affected upper limb and the scores of National Institute of Health stroke scale (NIHSS), Fugl-Meyer assessment (FMA) of upper limb and modified Barthel index (MBI) before and after treatment were observed, the therapeutic effect was evaluated in both groups. RESULTS: ①After treatment, the MAS classification reduced in both groups (<0.05), the cases of grade 0 to Ⅰ in the observation group were more than those in the control group (<0.05); iEMG values of the maximum isometric voluntary contraction of affected usculus biceps brachii, musculus triceps brachii, musculus flexor carpi, musculus extensor carpi, extensor digitorum, aductor pollicis brevis were increased in both groups (<0.05), and the variations of iEMG of above muscles on the affected side in the observation group were larger than those in the control group (<0.05). ②After treatment, the scores of NIHSS were decreased (<0.05), the scores of FMA, MBI were increased in both groups (<0.05), and the variations of NIHSS, FMA and MBI scores were larger than those in the control group (<0.05). ③The total effective rate was 93.3% (28/30) in the observation group, which was superior to 70.0% (21/30) in the control group (<0.05). CONCLUSION - balance penetrating acupuncture combined with rehabilitation training can improve upper limb spasticity, heighten the motor function of upper limb and daily self care in patients with stroke hemiplegia, its therapeutic effect is superior to single rehabilitation training.
Acupuncture Therapy ; Hemiplegia ; etiology ; therapy ; Humans ; Stroke ; complications ; therapy ; Stroke Rehabilitation ; Treatment Outcome ; Upper Extremity ; physiopathology ; Yin-Yang

OBJECTIVETo probe the effect and mechanism of the nuchal acupuncture and abdominal acupuncture for treatment of stroke patients with spastic hemiplegia.

METHODSSixty cases were randomly divided into an observation group and a control group, 30 cases in each group. Nuchal acupuncture and abdominal acupuncture treatment was used and Fengfu (GV 16), Fengchi (GB 20), Tianzhu (BL 10), Zhongwan (CV 12) and Guanyuan (CV 4) etc. were selected in observation group, routine acupuncture was applied on Binao (LI 14), Quchi (LI 11), Huantiao (GB 30) and Futu (ST 32) etc. in control group. The scale of Ashworth and score of Fugel-Meyer of the spastic lateral upper and lower limbs and the changes of the EMG F-wave in spastic upper limb of patients in two groups were observed before and after treatment.

RESULTSThe Ashworth scale and Fugel-Meyer score of the upper and lower limbs were obviously improved, the amplitude was decreased, the duration was shorten and the threshold of the EMG F-wave of the spastic upper limb was increased (all P < 0.01) in the observation group. The observation group was superior to the control group in Fugel-Meyer score of the upper and lower limbs of the patients the Ashworth scale of the lower limb, and the amplitude, duration and threshold of the EMG F-wave of the spastic upper limb (all P < 0.01). The total effective rate of 90.0% in observation group was superior to that of 50.0% in control group (P < 0.01).

CONCLUSIONThe nuchal acupuncture and abdominal acupuncture treatment can decrease the muscle tension of the stroke patients with spastic hemiplegia.

Abdomen ; Acupuncture Therapy ; Aged ; Female ; Hemiplegia ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo observe the clinical effect of wrist-ankle acupuncture combined with conventional acupuncture on post-apoplectic unilateral sensory disturbance.

METHODSEighty cases of acute cerebral apoplexy patients of unilateral sensory disturbance were randomly divided into an observation group and a control group, 40 cases in each one. In control group, the conventional acupuncture was applied at bilateral Fengchi (GB 20), and Jianyu (LI 15), Quchi (LI 11) and Waiguan (TE 5) etc. on the affected side. In observation group, wrist-ankle acupuncture was adopted in combination with conventional acupuncture. In wrist-ankle acupuncture, the needles were inserted from the Upper 1-6 and the Lower 1-6 on the affected side, and were remained for 5 to 6 h. The needles were punctured in the morning and removed in the afternoon. The clinical efficacy, the score in the sensory disturbance assessment as well as the changes in the limb sensory disturbance degree based on the patients' feelings were observed in two groups.

RESULTSThe total effective rate in observation group was 90.0% (36/40), which was superior to 75.0% (30/40) in control group (P < 0.05). The improvements were obtained in the total scores of the limb sensory function, superficial sensibility and cortical sensibility after treatment in either group (P < 0.05, P < 0.01), but there was no remarkably improvement in proprioception (both P > 0.05). All the scores above were improved much remarkably in observation group as compared with control group (all P < 0.05).

CONCLUSIONWrist-ankle acupuncture combined with conventional acupuncture is the effective therapy for post-apoplectic unilateral sensory disturbance.

Acupuncture Therapy ; Adult ; Aged ; Female ; Hemiplegia ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Proprioception ; Sensation ; Stroke ; complications

OBJECTIVETo observe improved effects of Jingjin acupuncture on fine activity of hemiplegic hand in recovery period of stroke.

METHODSFifty cases were randomly divided into an observation group and a control group, 25 cases in each one. Regular western medicine treatment, rehabilitation training and regular acupuncture (in which Shuigou (GV 26), Baihui (GV 20), Neiguan (PC 6), etc. were selected) were applied in both groups. Additionally, muscles in palm side of affected hand, dorsal metacarpophalangeal joints and proximal interphalangeal joints were treated with acupuncture in the observation group, once every other day and electroacupuncture was applied when arrival of qi was acquired. Baxie (EX-UE 9) in the affected hand were needled in the control group, and electroacupuncture was added when arrival of qi was acquired. Ten days of treatment was considered a treatment course, and after two courses Lindmark score, Brunnstrom movement function grade, joint range of hand and Barthel index (BI) were observed in two groups.

RESULTSCompared before the treatment, the Lindmark score in two groups were both improved after the treatment (both P < 0.01). Compared with the control group, the motor coordination ability, sensory function and total score of Lindmark in observation group were obviously improved (differences before and after treatment: 8.24 +/- 3.07 vs 6.84 +/- 2.43, 3.52 +/- 2.33 vs 2.16 +/- 2.12, 11.76 +/- 3.55 vs 9.00 +/- 3.62, all P < 0.05). The Brunnstrom movement function grade was significantly improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group (P < 0.05). The joint range of hemiplegic hand was improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group [differences before and after treatment: (25.35 +/- 10.91) degrees vs (18.65 +/- 7.86) degrees, p < 0.05]. The score of BI was also significantly improved after treatment in two groups (both P < 0.01).

CONCLUSIONThe Jingjin acupuncture could effectively improve fine activity of hemiplegic hand in recovery period of stroke prove daily life ability.

Acupuncture Therapy ; Aged ; Female ; Hand ; physiopathology ; Hemiplegia ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Movement ; Recovery of Function ; Stroke ; complications ; physiopathology