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

Epilepsy ; etiology ; Hemiplegia ; complications ; genetics ; Humans ; Infant ; Male ; Mutation ; Sodium-Potassium-Exchanging ATPase ; genetics

OBJECTIVETo investigate the clinical symptoms and features of interictal epileptiform discharges (IED) on electroencephalogram (EEG) in children with spastic hemiplegic cerebral palsy (CP) and to analyze the risk factors for IED.

METHODSEighty-three children with spastic hemiplegic CP were recruited, and their clinical data, results of video-electroencephalogram, imaging findings, and cognitive levels were collected. The influencing factors for IED were determined by multiple logistic regression analysis.

RESULTSThe incidence of epilepsy was 13% in children with spastic hemiplegic CP; 34% of these cases had IED. The incidence of epilepsy in children with IED (32%) was significantly higher than that in those without IED (4%) (P<0.01). The incidence of IED in children with complications and brain cortex impairment increased significantly (P<0.01). The incidence of IED varied significantly between patients with different cognitive levels (P<0.01). Brain cortex impairment (OR=11.521) and low cognitive level (OR=2.238)were risk factors for IED in children with spastic hemiplegic CP (P<0.05).

CONCLUSIONSSpastic hemiplegic CP is often found with IED on EEG, and the incidence of epilepsy is higher in children with IED than in those without IED. Brain cortex impairment and low cognitive level have predictive values for IED in children with spastic hemiplegic CP.

Cerebral Cortex ; physiopathology ; Cerebral Palsy ; physiopathology ; Child ; Child, Preschool ; Electroencephalography ; Epilepsy ; epidemiology ; etiology ; Female ; Hemiplegia ; physiopathology ; Humans ; Incidence ; Infant ; Male ; Risk Factors

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 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

PURPOSE: The purpose of our study was to investigate the effect of gait training with rhythmic auditory stimulation (RAS) on both kinematic and temporospatial gait patterns in patients with hemiplegia. MATERIALS AND METHODS: Eighteen hemiplegic patients diagnosed with either cerebral palsy or stroke participated in this study. All participants underwent the 4-week gait training with RAS. The treatment was performed for 30 minutes per each session, three sessions per week. RAS was provided with rhythmic beats using a chord progression on a keyboard. Kinematic and temporospatial data were collected and analyzed using a three-dimensional motion analysis system. RESULTS: Gait training with RAS significantly improved both proximal and distal joint kinematic patterns in hip adduction, knee flexion, and ankle plantar flexion, enhancing the gait deviation index (GDI) as well as ameliorating temporal asymmetry of the stance and swing phases in patients with hemiplegia. Stroke patients with previous walking experience demonstrated significant kinematic improvement in knee flexion in mid-swing and ankle dorsiflexion in terminal stance. Among stroke patients, subacute patients showed a significantly increased GDI score compared with chronic patients. In addition, household ambulators showed a significant effect on reducing anterior tilt of the pelvis with an enhanced GDI score, while community ambulators significantly increased knee flexion in mid-swing phase and ankle dorsiflexion in terminal stance phase. CONCLUSION: Gait training with RAS has beneficial effects on both kinematic and temporospatial patterns in patients with hemiplegia, providing not only clinical implications of locomotor rehabilitation with goal-oriented external feedback using RAS but also differential effects according to ambulatory function.
Acoustic Stimulation/*methods ; Aged ; Ankle Joint/physiopathology ; Biomechanical Phenomena ; Cerebral Palsy/*diagnosis/physiopathology ; Female ; Foot Joints/physiopathology ; *Gait ; Gait Disorders, Neurologic/etiology/physiopathology/*rehabilitation ; Hemiplegia ; Humans ; Knee/physiopathology ; Knee Joint/physiopathology ; Male ; Middle Aged ; Stroke/*diagnosis/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 observe the impacts on post-stroke spastic hemiplegia treated with temporal three-needle therapy, spastic three-needle therapy, and rehabilitative therapy as well as combined application.

METHODSOne hundred cases were randomized into a Jin's three-needle group (35 cases), a rehabilitation group (33 cases) and a combined therapy group (32 cases). Beside the basic treatment, the acupuncture therapy of temporal three-needle and spastic three-needle techniques, rehabilitation training, and the combined therapy of acupuncture and rehabilitation were applied in the Jin's three-needle group, the rehabilitation group and the combined therapy group, respectively. Before treatment, in 7 days and 14 days of treatment, the functional comprehensive assessment scale (FCA), clinical neurological defect score (NDS), four-limb simplified Fugl-Meyer assessment (FMA) and clinical spasm index (CSI) were adopted to assess the spastic degree and limb function, respectively.

RESULTSIn terms of FCA, NDS and FMA, in 7 days of treatment, except the rehabilitation group, the results in the other two groups were all improved as compared with those before treatment (all P < 0.05). The results in the Jin's three-needle group and the combined therapy group were better than those in the rehabilitation group (all P < 0.05). In 14 days of treatment, the results in the three groups were improved as compared with those before treatment and in 7 days of treatment (P < 0.05, P < 0.01). The results in the combined therapy group were better than those in the other two groups (all P < 0.05). Regarding CSI assessment, in 7 days of treatment, the results of the three groups were all improved significantly as compared with those before treatment (P < 0.05, P < 0.01), and the results in the combined therapy group were better than those in the other two groups (all P < 0.05). In 14 days of treatment, CSI scores were further improved in the three groups, but the difference was not significant in comparison (all P > 0.05).

CONCLUSIONThe Jin's three-needle therapy, rehabilitation therapy and the combined application all relieve the symptoms of post-stroke spastic hemiplegia. The effect in the Jin's three-needle group and the combined therapy group is achieved in 7 days of treatment, which is better than that in the rehabilitation group. The combined therapy a chieves the best effect on spasm in comparison with the single therapy.

Acupuncture Points ; Acupuncture Therapy ; methods ; Adult ; Aged ; Aged, 80 and over ; Female ; Hemiplegia ; etiology ; rehabilitation ; therapy ; Humans ; Male ; Middle Aged ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo assess the clinical efficacy of acupuncture at key acupoints combined with the routine rehabilitation training of limb function on spasmodic hemiplegia after cerebral infarction.

METHODSEighty-six cases were randomized into an acupuncture combined with rehabilitation group (group A, 44 cases) and a rehabilitation group (group B, 42 cases). In group A, the key acupoints were selected from head, face, chest, abdomen, shoulder, back, hands, feet and ankles such as Cuanzhu (BL 2), Danzhong (CV 17), Jianyu (LI 15) and Yanglao (SI 16) were stimulated with acupuncture. In combination, the routine limb rehabilitation training was applied, once every day. In group B, the routine limb rehabilitation training was applied alone. In both groups, 10 treatments made one session and 2 sessions were required totally. Before and after treatment, Fugl-Meyer scale and functional independent measurement (FIM) scale were adopted to assess the limb motor level and the activity of daily life in the patients respectively. The modified Ashworth scale was used to assess the effect of anti-spasm.

RESULTSThe total effective rate of anti-spasm was 90.9% (40/44) in the group A, which was superior to 73.8% (32/42) in the group B (P < 0.05). After 2 sessions of treatment, Fugl-Meyer score and FIM score were all improved in both groups (all P < 0.05) and the results in the group A were better than those in the group B (all P < 0.05). Additionally, the improvement of FIM score after the 1st session of treatment in the group A was better as compared with the group B, indicating the significant difference (P < 0.05).

CONCLUSIONAcupuncture at key acupoints combined with rehabilitation therapy effectively relieves the spasmodic condition of the patients with post-stroke spasmodic hemiplegia, improves the limb function and the life activity of the patients.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Cerebral Infarction ; complications ; Female ; Hemiplegia ; etiology ; rehabilitation ; therapy ; Humans ; Male ; Middle Aged ; Treatment Outcome