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

OBJECTIVE: To compare the curative effect between interactive scalp acupuncture and traditional scalp acupuncture on hemiplegic upper extremity motor dysfunction in the patients with ischemic stroke. METHODS: Seventy cases of hemiplegic upper extremity motor dysfunction of ischemic stroke were randomly divided into an interactive scalp acupuncture group (35 cases, 1 case breaked off) and a traditional scalp acupuncture group (35 cases, 1 case dropped off). The patients of the two groups received the secondary prevention medication and routine rehabilitation therapy. Besides, in the interactive scalp acupuncture group, the upper extremity occupational therapy was operated during the needle retaining of scalp acupuncture; and in the traditional scalp acupuncture group, the upper extremity occupational therapy was delivered after the completion of scalp acupuncture. The same points were selected in the two groups such as Fuxiang head area, Fuxiang upper-limb-shoulder point, Fuxiang upper-limb-elbow point and Fuxiang upper-limb-wrist point. The needles were inserted perpendicularly by flying-needle technique and manipulated by triple technique of gentle twisting, heavy pressure and vibrating. The needles were retained for 30 min. Based on the degree of the upper extremity motor impairment, the regimen of the upper extremity occupational therapy was formulated individually and one treatment took 30 min. In the two groups, the therapies were delivered once daily, 5 times a week, lasting 4 weeks. Before and after treatment, the scores of Fugl-Meyer assessment of upper extremity (FMA-UE), Wolf motor function test (WMFT), the modified Barthel index (MBI) and the modified Ashworth scale (MAS) grade in the two groups were observed before and after treatment. RESULTS: After treatment, the scores of FMA-UE, WMFT and MBI were higher than those before treatment (P<0.01), and MAS grade was improved (P<0.05) in the two groups. The scores of FMA-UE, WMFT and MBI in the interactive scalp acupuncture group were higher than those in the traditional scalp acupuncture group (P<0.01, P<0.05), and there was no statistical significance in the difference of MAS grade between the two groups (P>0.05). CONCLUSION The interactive scalp acupuncture can effectively improve the motor function of the hemiplegic upper extremities and the activities of daily living in the patients with ischemic stroke and its efficacy is better than traditional scalp acupuncture. But these two types of scalp acupuncture obtain the similar effect on spasticity.
Humans ; Stroke/therapy* ; Ischemic Stroke/complications* ; Stroke Rehabilitation ; Activities of Daily Living ; Hemiplegia/therapy* ; Scalp ; Treatment Outcome ; Acupuncture Therapy/methods* ; Upper Extremity

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

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

OBJECTIVE: To observe the clinical efficacy and correlation of electroacupuncture combined with proprioceptive neuromuscular facilitation (PNF) on proprioception and motor function of lower limbs in stroke patients. METHODS: A total of 96 stroke patients were randomized into an electroacupuncture (EA) group, a PNF group and a combination group, 32 cases in each one. In the EA group, acupuncture was applied at cephalic motor and sensory areas, Huantiao (GB 30), Yanglingquan (GB 34), Xuanzhong (GB 39), Zusanli (ST 36) and Sanyinjiao (SP 6) on affected side, and electroacupuncture was adopted at Yanglingquan (GB 34) and Xuanzhong (GB 39), continuous wave and 2 Hz in frequency for 20 min, once every day. In the PNF group, PNF was performed for 20 min, once a day. In the combination group, electroacupuncture was given before PNF, once a day. 4 weeks as one course and totally 3 courses were required, the effect was followed up after half a year. Before treatment, after 4, 8, 12 weeks of treatment and in follow-up, the average trace error (ATE) and Time, the scores of Fugl-Meyer scale (FMA) and modified Barthel index (MBI) were observed in the 3 groups. Correlation analysis between ATE, Time and FMA was performed. RESULTS: ① The total effective rate in the combination group was 90.3% (28/31), which was superior to 64.5% (20/31) in the EA group and 62.5% (20/32) in the PNF group (<0.05). ②After 4, 8, 12 weeks of treatment and in follow-up, the ATE and Time in the 3 groups were reduced compared with before treatment (<0.05, <0.01). After 8, 12 weeks of treatment and in follow-up, the ATE in the combination group were lower than the EA group and the PNF group (<0.05, <0.01). After 12 weeks of treatment and in follow-up, the Time in the combination group were lower than the EA group and the PNF group (<0.05, <0.01). ③After 4, 8, 12 weeks of treatment and in follow-up, the FMA scores in the EA group and the combination group were increased compared with before treatment (<0.01). After 8, 12 weeks of treatment and in follow-up, the FMA scores in the PNF group were increased compared with before treatment (<0.01). After 8, 12 weeks of treatment and in follow-up, the FMA scores in the combination group were higher than the EA group and the PNF group (<0.05, <0.01). ④After 4, 8, 12 weeks of treatment and in follow-up, the MBI scores in the 3 groups were increased compared with before treatment (<0.01). After 8, 12 weeks of treatment and in follow-up, the MBI scores in the combination group were higher than the EA group (<0.01). After 12 weeks of treatment and in follow-up, the MBI scores in the combination group were higher than the PNF group (<0.01). ⑤ The correlation coefficients of ATE, Time and FMA were from 0.4 to 0.75 (<0.05), suggesting a moderate intensity correlation. CONCLUSION Electroacupuncture, PNF and combination therapy can improve proprioception and motor function of lower limbs and activities of daily living, and combination therapy has a better effect. Proprioception and motor function have a strong correlation in the recovery of stroke patients.
Activities of Daily Living ; Electroacupuncture ; methods ; Hemiplegia ; therapy ; Humans ; Lower Extremity ; Proprioception ; Stroke ; complications ; Stroke Rehabilitation ; 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 the life quality improvement of spastic hemiplegia of stroke treated with fire-needle.

METHODSSixty patients were randomly divided into a fire-needle group and a rehabilitation group, 30 cases in each one. In the two groups, the conventional treatment of neurology and rehabilitation strengthening limbs function were applied. In the fire-needle group, fire-needle was used at Jianyu (LI 15), Binao (LI 14), Quchi (LI 11), Yanglingquan (GB 34), Xuehai (SP 10) and Sanyinjiao (SP 6), etc. , once two days and continuously for 30 days (15 times). In the rehabilitation group, conventional rehabilitation exercises were given five times a week for 4 weeks (20 times). Before treatment, at the end of treating program and one month later after treatment, spasticity of upper and lower limbs was assessed by Ashworth scale and clinic spasticity index (CSI); limbs function was evaluated by Fugl-Meyer (FM) scale; life quality was estimated by patient-reported outcome (PRO). Clinical effects were compared between the two groups.

RESULTS(1) At the end of treating and one month later after treatment, the Ashworth scales were better than those before treatment in the two groups (P < 0.05, P < 0.01), and the scales of the fire-needle group were superior to those at the same time of the rehabilitation group (both P < 0.05). (2) At the end of treating and one month later after treatment, the CSIs were better than those be fore treatment in the fire-needle group (both P < 0.01), but not changed apparently in the rehabilitation group (both P > 0.05). And the indices of the fire-needle group were superior to those at the same time of the rehabilitation group (P < 0.05, P < 0.01). (3) The FM scales of upper and lower limbs at the end of treating and one month later after treatment were better than those before treatment in the two groups (all P 0.01), except the lower limbs at the end of treating in the rehabilitation group (P > 0.05). The FM scales of the fire-needle group were superior to those at the same time of the rehabilitation group (P < 0.05, P < 0.01). (4) At the end of treating and one month later after treatment, the PRO scales were better than those before treatment in the two groups (all P < 0.01), and the scales of the fire-needle group were superior to those at the same time of the rehabilitation group (P < 0.05, P < 0.01).

CONCLUSIONFire-needle can effectively relieve spastic hemiplegia of stroke, and improve limbs motor function and life quality. It is better than rehabilitation.

Acupuncture Therapy ; instrumentation ; methods ; Adult ; Aged ; Female ; Hemiplegia ; Humans ; Lower Extremity ; physiopathology ; Male ; Middle Aged ; Muscle Spasticity ; etiology ; physiopathology ; therapy ; Needles ; Quality of Life ; Stroke ; complications ; therapy ; Treatment Outcome ; Upper Extremity ; physiopathology

OBJECTIVETo compare the differences in the clinical efficacy on post-stroke upper limb spasmodio hemiplegia among the combined therapy of relaxing needling (Huici) technique combined with wheat-grain moxibustion, simple relaxing needling and conventional acupuncture.

METHODSNinety patients were-randomized into a group with the combined therapy of relaxing needling technique combined with wheat-grain moxibustion (a combined therapy group), a simple relaxing needling group and a conventional acupuncture group, 30 cases in each group. In the combined therapy group, the relaxing needling technique was used in combination with wheat-grain moxibustion. The relaxing needling technique was applied to Jianyu (LI 15), Quchi (LI 11), Shousanli (LI 10), etc. The wheat-grain moxibustion was applied to Qihai (CV 6), Guanyuan (CV 4), Mingmen (GV 4), etc. In thel simple relaxing needling group, the relaxing needling technique was used simply. In the conventional acupuncture group, the conventional lifting, thrusting and rotating technique with filiform needle was adopted at the same acupoints as the simple relaxing needling group. The treatment was given once every day; 6 treatments made one session. Totally 4 sessions were required, with 1 day at intervals. The modified Ashworth scale (MAS), Fugl-Meyer assessment (FMA) and Barthel index (BD were adopted to assess the upper limb muscle tension, motor functioni and daily life activity.

RESULTSAfter treatment, MAS score was all reduced as compared with that before treatment in each group, and FMA score and BI score were increased as compared with those before treatment (all P<0.01). MAS score in the combined therapy group was lower than that in either the simple relaxing needling group or the conventional acupuncture group (both P<0.01), and the score in the simple relaxing needling group was lower than that in the conventional acupuncture group (P<0.05). FMA score and BI score in the combined therapy group were higher than those in the simple relaxing needling group and the conventional acupuncture group (both P<0.01). FMA score in the simple relaxing needleing group was higher than that the Enventional acupuncture group (P<0.05). The total effective rate in the combined therapy group was 93.3% (28/30), higher; than 86.7% (26/30) in the simple relaxing needling group (P<0.01), and 83.8% (25/30) in the conventionaP acupuncture group (P<0.01).

CONCLUSIONThe combined therapy of relaxing needling technique and wheat-grain moxibustion achieves more satisfactory efficacy on post-stroke upper limb spasmodic hemiplegia compared with the simple relaxing needling and conventional acupuncture.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Aged ; Combined Modality Therapy ; Female ; Hemiplegia ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Moxibustion ; Stroke ; complications ; Treatment Outcome ; Triticum ; chemistry

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