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 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 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

OBJECTIVETo explore the optimized rehabilitation program in the treatment of post-stroke hemiplegia at the recovery stage.

METHODSBased on the randomized controlled principle, 60 patients were randomized into an rehabilita tion + massage group (group A) and an rehabilitation + acupuncture group (group B), 30 cases in each one. Bobath sport therapy and functional training were adopted in the two groups. In the group A, the massage therapy was added. The rolling method and palm-rubbing method were used on the affected side, the pressing, kneading and plucking methods were applied to Jianliao (LI 15), Jianzhen (SI 9), Quchi (LI 11), Huantiao (GB 30), Weizhong (BL 40), Chengshan (BL 57), Zusanli (ST 36) and the other acu points; and the nipping method was adopted at the twelve Jing-well points. In the group B, acupuncture was applied to Baihui (BL 20), Jianliao (LI 15), Quchi (LI 11), Shousanli (LI 10), Huantiao (GB 30), Yanglingquan (GB 34), Jiexi (ST 41) and the other acupoints. The treatment was given once a day, 5 treatments a week in the two groups. The efficacy was evaluated in 3 weeks. Fugl-Meyer scale, Barthel index (BI) score, modified Rankin scale and stroke-specific quality of life (SS-QOL) were used to assess the limb motor function, the activity of daily life (ADL), independent activity of life and the quality of life of the patients in the two groups before and after treatment. Based on the total cost and benefit, the health economics evaluation was conducted in the patients of the two groups.

RESULTSThe treatments all improved the limb motor function (group A: 26.00 (22) vs 37.00 (33); group B: 30.50 (21) vs 39.50 (36)), the independent activity of life, ADL (group A: 43.50 +/- 22.25 vs 57.50 +/- 22.25; group B: 52.83 +/- 16.59 vs 66.67 +/- 12.82) and the quality of life (group A: 122.23 +/- 30.00 vs 145.50 +/- 28.14; group B: 132.43 +/- 23.87 vs 151.47 +/- 22.37) in the patients of the two groups. The differences in all the indices were significant statistically before and after treatment in the two groups (all P<0.05). Above indices after treatment were not different obviously between the two groups (all P>0.05). In terms of health economics, the expense was decreased by RMB 688.48 while BI was increased by every 5 score in group A in comparison with the group B.

CONCLUSIONBoth the rehabilitation and massage therapy and the rehabilitation and acupuncture therapy improve the limb motor function and the quality of life in the patients of post-stroke hemiplegia. The therapeutic efficacies are similar between the two therapeutic programs. The program of rehabilitation and massage is more economical in the aspects of ADL improvement, being advantageous at simple operation and low cost.

Acupuncture Therapy ; Aged ; Combined Modality Therapy ; Female ; Hemiplegia ; physiopathology ; rehabilitation ; therapy ; Humans ; Male ; Massage ; Middle Aged ; Motor Activity ; 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 verify the improvement function of warming-reinforcing acupuncture combined with rehabilitation training on the early motor function of hemiparalysis patients caused by ischemic brain stroke.

METHODSEighty cases were randomly divided into a warming-reinforcing acupuncture combined with rehabilitation training group (group A) and a rehabilitation training group (group B), 40 cases in each group. Both groups were treated with internal routine treatment. The Motor Relearning Program rehabilitation was used in group B, while warming-reinforcing acupuncture combined with Motor Relearning Program rehabilitation were used in group A. Jianyu (LI 15), Quchi (LI 11), Hegu (LI 4), Yanglingquan (GB 34), Yinlingquan (SP 9), Zusanli (ST 36), Sanyinjiao (SP 6) were selected, and warming-reinforcing method was used in these points, they were treated for 3 weeks. The neurological functional deficits scores of hemiparalysis patients, Fugl-Meyer Score, Motor Function Assessment Score (MAS), Barthel Index and Mini-mental State Examination (MMSE) were used to evaluate the condition of hemiparalysis patients before and after treatment.

RESULTSThe effective rate of group A (87.5%, 35/40) superior to that of group B (67.5%, 27/40) (P < 0.05). The neurological functional deficit scores, Fugl-Meyer score, MAS and Barthel Index of both groups were improved after treatment (P < 0.01, P < 0.05), and the improved degree of group A was better than that of group B (P < 0.01, P < 0.05).

CONCLUSIONThere is obvious improvement function of warming-reinforcing acupuncture combined with rehabilitation training on the early motor function of hemiparalysis patients caused by ischemic brain stroke, and the function is better than that of simple rehabilitation training.

Activities of Daily Living ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Brain Ischemia ; complications ; Hemiplegia ; physiopathology ; rehabilitation ; therapy ; Humans ; Male ; Middle Aged ; Motor Activity ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo observe the effects of two different acupuncture treatment on cerebral blood flow velocity and early rehabilitation of hemiparalysis caused by cerebral infarction.

METHODSEighty patients were randomly divided into an alternate acupuncture group (n = 40) and a routine acupuncture group (n = 40). Both of the groups were treated with routine neurology medicine and application of good limb position combined with acupuncture. The patients in the alternate acupuncture group were treated by opposing needling and non-opposing needling, i. e. acupuncture at acupoints on both the healthy and affected sides alternately, twice each day, respectively. The routine acupuncture group was treated by acupuncture at the affected side, once daily. Scores of Scandinavian Stroke Scale (SSS) were evaluated before and after treatment in the two groups, and the mean blood flow velocity of middle cerebral artery (MCA) on the affected side was monitored during two different acupuncture treatment by using Transcranial Doppler (TCD).

RESULTSThe cured and markedly effective rate was 65.0% in the alternate acupuncture group and 37.5% in the routine acupuncture group with a significant difference between the two groups (P < 0.01). After treatment, the SSS score in the alternate acupuncture group was significantly lower than that in the routine acupuncture group (P < 0.01). The mean blood flow velocity of MCA during two different acupuncture treatment was both decreased significantly (both P < 0.05) and the mean blood flow velocity of MCA before the last treatment was decreased significantly in the alternate acupuncture group than those in the routine acupuncture group (P < 0.05).

CONCLUSIONThe therapeutic effect of the alternate acupuncture program for hemiparalysis caused by cerebral infarction is superior to that of the routine acupuncture program. It is suggested that the mechanism of acupuncture in treating hemiparalysis caused by cerebral infarction is to dilate cerebral blood vessels and improve cerebral perfusion.

Acupuncture Therapy ; Adult ; Aged ; Blood Flow Velocity ; Cerebral Arteries ; physiopathology ; Cerebral Infarction ; complications ; Hemiplegia ; physiopathology ; rehabilitation ; therapy ; Humans ; Male ; Middle Aged

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 search for the best way to elevate the clinical therapeutic effect in the hemiplegic patient of cerebral thrombosis at convalescent period.

METHODSAdopting single-blind, randomized controlled method, 90 cases of cerebral thrombosis at convalescent period were assigned to 3 groups: a scalp acupuncture group (group A), a rehabilitation therapy group (group B) and a scalp acupuncture combined with rehabilitation therapy group (group C). Group A were treated with scalp acupuncture at the anterior oblique line of vertex-temporal and the posterior oblique line of vertex-temporal on the healthy side; group B were treated with modern rehabilitation medical therapy, making limb function treatment; group C were treated with the scalp acupuncture in the group A combined with the rehabilitation therapy in the group B. Improvement of neural function defect and activity of daily life (ADL), and clinical therapeutic effect were observed.

RESULTSAfter treatment, the scores of neural function defect of 6.14 +/- 0.36 in the group C was significantly lower than 8.94 +/- 0.56 in the group A and 8.64 +/- 0.49 in the group B (P<0.05); the score of ADL of 88.39 +/- 10.02 and clinical therapeutic effect of 90.0% in the group C were significantly higher than 74.19 +/- 12.12 and 76.7% in the group A and 72.29 +/- 11.52 and 73.3% in the group B (P<0.05).

CONCLUSIONThe scalp acupuncture and rehabilitation therapy have synergistic action in improving motor function for the hemiplegic patient of cerebral thrombosis at convalescent period, and it is a better method for cerebral thrombosis at the convalescent stage.

Activities of Daily Living ; Acupuncture Therapy ; methods ; Aged ; Female ; Hemiplegia ; physiopathology ; rehabilitation ; therapy ; Humans ; Intracranial Thrombosis ; complications ; physiopathology ; therapy ; Male ; Middle Aged ; Scalp ; Single-Blind Method

PURPOSE: We investigated the usefulness of video based, fluoroscopically guided abduction motion analysis of hemiplegic shoulders. PATIENTS AND METHODS: Twenty-two stroke patients with Brunnstrom stages 3-4 (Group 1) or 5-6 (Group 2) were enrolled in this study. Patients with shoulder pain and significant spasticity (MAS 2) were excluded. We recorded motion pictures of the abductions of affected and unaffected shoulder joints under an AP fluoroscopic guide. Lateral scapular slide distances (D1: T2- superior angle, D2: T3- scapular spine, D3: T7-inferior angle) were measured at 30 degrees, 60 degrees, 90 degrees during glenohumeral abduction in a captured photographic image. The angles of scapular rotation and trajectory (stromotion) of the humeral head center, relative to the 3rd thoracic spine in the abduction motion were analyzed. RESULTS: In Group 1, a significant difference was found in the lateral scapular slide distance between the affected and sound sides. However, no significant side to side difference was found in Group 2. Scapular angles in abduction were also increased in Group 1. Patients with a more synergistic movement pattern showed less scapular stabilizing muscle activity and, instead, exhibited a compensatory "shrugging" like motion accomplished by spinal tilting. CONCLUSION: The present findings support the notion that the above parameters of fluoroscopically guided shoulder abduction motion analysis correlate well with clinical findings. These parameters should be useful for evaluations of hemiplegic shoulder biomechanics.
Video Recording ; Shoulder Joint/*physiopathology/radiography ; Movement/*physiology ; Middle Aged ; Humans ; Hemiplegia/etiology/*physiopathology/radiography ; Functional Laterality ; Fluoroscopy ; Cerebrovascular Accident/complications ; Cerebral Infarction/complications ; Aged