指压穴位刺激对脑卒中患者胫前肌和腓骨长、短肌的表面肌电影响

Effects of acupressure acupoint stimulation on tibialis anterior muscle and fibula long, short muscle in stroke patients: a surface EMG research

目的:利用指压刺激脑卒中患者偏瘫侧丘墟穴,观察对比胫前肌和腓骨长、短肌最大等长收缩的表面肌电信号变化,初步探讨指压穴位刺激法在脑卒中偏瘫患者恢复早期诱发肌肉收缩的有效性和作用机制。方法:30例脑卒中偏瘫早期患者,指压偏瘫侧丘墟穴,对比静息状态,刺激前、刺激即刻3s、停止刺激后第一个3s、第二个3s、第三个3s的胫前肌和腓骨长、短肌最大等长收缩的平均肌电值(AEMG)、积分肌电值(iEMG)。结果:胫前肌和腓骨长、短肌最大等长收缩AEMG、iEMG刺激即刻明显高于刺激前,停止刺激后第一个3s、第二个3s、第三个3s的AEMG、iEMG呈逐渐下降趋势,且第三个3s的AEMG、iEMG仍略高于刺激前(P<0.05)。结论:指压刺激偏瘫侧丘墟穴可诱发偏瘫侧胫前肌和腓骨长、短肌收缩,提高上述肌肉的兴奋性,并且即刻效应和延续效应良好。指压穴位刺激法可作为一种有效的易化技术应用于脑卒中偏瘫患者恢复的早期。

Objective： To investigate the changes of sEMG（surface EMG） of maximum isometric contraction of tibialis anterior muscle and fibula long, short muscle when acupressure acupoint stimulation was applied at Qiuxu（GB40） acupoint of affected side of stroke patient, to preliminary discuss the effectiveness and mechanism of acupressure acupoint stimulation inducing muscle contraction in early recovery stages of stroke patients. Method： Thirty stroke patients in early recovery stage participated in this study. Acupressure acupoint stimula- tion was applied to Qiuxu of affected side. Average EMG（AEMG） and integrated EMG（iEMG） of maximum isometric contraction of tibialis anterior muscle and fibula long, short muscle at different time points were observed, including resting, before stimulation, at stimulation immediate 3s, the first 3s after stimulation, the second 3s after stimulation and the third 3s after stimulation. Result： AEMG and iEMG of maximum isometric contraction of tibialis anterior muscle and fibula long, short muscle at stimulation immediate 3s improved significantly when compared with before stimulation. It gradually declined at the time points of the first 3s after stimulation, the second 3s after stimulation and the third 3s after stimulation. AEMG and iEMG at the third 3s after stimulation showed a slight but significant improvement when compared with before stimulation（P〈0.05）. Conclusion： Acupressure acupoint stimulation applied to Qiuxu of affected side in stroke patients could induce the contraction of tibialis anterior muscle and fibula long, short muscle and increase the excitability of these muscles effectively. Also, it showed good immediate effect and continued effect. Acupressure acupoint stimulation could be used as an effective facilitation technique in stroke patients in early recovery stage.