The Promoting Role of TCM Nursing in the Rehabilitation of Stroke Hemiplegia Patients

Objective: To explore the promoting function of TCM nursing in the rehabilitation of hemiplegia patients with stroke. Methods: 78 stroke hemiplegic patients admitted from April 2022 to April 2024 were randomly divided into a control group of 38 cases who received routine care, and an experimental group of 40 cases who received routine nursing basis plus traditional Chinese medicine nursing;the nursing effects of the two groups of patients were compared. Results: After 12 days of nursing care, the experimental group showed better psychological status [SAS score (21.71 ± 3.21), SDS score (22.18 ± 2.31)], limb motor function, daily living ability, and neurological function [NIHSS score (12.23 ± 2.21)] than the control group, with significant differences in data (P Conclusion: Traditional Chinese medicine nursing for stroke hemiplegia patients is more conducive to promoting rehabilitation than routine nursing.

Effects of Acupuncture and Tuina Combined with Rehabilitation Therapy on Oxidative Stress Response and Motor Function in Stroke Hemiplegia Patients

Objective:To explore the effects of acupuncture and tuina combined with rehabilitation therapy on oxidative stress response and motor function in stroke hemiplegia patients.Methods:Sixty stroke hemiplegia patients were randomly divided into observation and control groups,with 30 cases each.The control group received conventional rehabilitation therapy,while the observation group also underwent acupuncture and tuina.After 8 weeks of treatment,oxidative stress indicators[malondialdehyde(MDA),superoxide dismutase(SOD),glutathione peroxidase(GSH-Px)],neurological deficit scores(NIHSS),Fugl-Meyer motor function scores(FMA),and activities of daily living(Barthel Index)were compared between the two groups.Results:Before treatment,there were no significant differences in MDA,NIHSS scores,FMA scores,and Barthel Index between the two groups(P>0.05).After 8 weeks,the observation group had lower MDA and NIHSS scores,but higher SOD,GSH-Px,FMA scores,and Barthel Index compared to the control group,with statistically significant differences(P<0.05).Conclusion:Acupuncture and tuina combined with rehabilitation therapy can effectively improve oxidative stress levels,promote neurological recovery,enhance motor function,and improve daily living activities in stroke hemiplegia patients.This combined therapy is recommended for clinical application.

Comprehensive Rehabilitation Therapy of Traditional Chinese Medicine Combined with Modern Rehabilitation Training Improves the Spasticity and Motor Function of Hemiplegia after Stroke

Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiplegia.Methods:Seventy-nine stroke and hemiplegia patients admitted to the hospital from June 2021 to June 2023 were selected and randomly divided into a control group(39 cases)using modern rehabilitation training,and an observation group combined with comprehensive TCM rehabilitation therapy(40 cases),over 1 month.The clinical index data of the two groups were compared.Results:There were differences in the clinical index data between the two groups.The total effective rate after 2 treatment in the observation group(92.50%)was higher than that of the control group(74.36%)(χ^(2)=4.727,P<0.05).All central sensitization inventory(CSI)and stroke quality of life(PRO)scores in both groups were lower after treatment,with the observation group having lower scores as compared to the control group(P<0.05).The scores of FMA(upper limbs,lower limbs),Barthel index scores,and Functional Ambulation Categories(FAC)scores of both groups increased after treatment,with the observation group having higher scores as compared to the control group(P<0.05).Conclusion:Comprehensive TCM rehabilitation therapy had a significant therapeutic effect on patients with hemiplegia after stroke.It improved the patient’s spasticity,limb movement,and walking function.Their daily living abilities and quality of life were also enhanced.

Effect of Walking Speed Intervention for Stroke Hemiplegia Using Neurorehabilitation-Robot

Sufficient hip joint extension range of motion is important in improving the walking speed of patients with spastic hemiplegia. In this study, we developed a piston device for the hip (PDH) that simulates the action of the piston technique for hip joints (PTH), which is a method for improving hip joint extension range of motion. We then evaluated the efficacy of PDH on 10 spastic hemiplegia patients suffering from a limited range of hip joint extension. Results confirmed rapid improvement of hip joint range of motion and increase in walking speed.

Hemiplegia Patients Treatment Should Combine Acupuncture with Rehabilitation Treatment

The acupuncturetherapy for hemiplegiapatients is popular insome Asian countries,and it has been graduallyaccepted in the rehabili-tative medical field ofsome developed countries.Although numer-ous clinical and experimental studies have beendone,many doctors usu-

Application of cross-migration theory in limb rehabilitation of stroke patients with hemiplegia

BACKGROUND Stroke is a common cause of neurological dysfunction,often resulting in hemiplegia.Thus,rehabilitation of limb function in stroke patients is an important step towards accelerating recovery and improving quality of life.AIM To investigate whether unilateral strength training in hemiplegic stroke patients could lead to cross-migration,an increase in bilateral muscle strength,and an improvement in lower limb motor function.METHODS We randomly divided 120 patients with hemiplegic stroke into two groups:Eexperimental and control groups,with 60 patients in each group.Both groups received routine rehabilitation treatment,while the experimental group additional-ly received ankle dorsiflexion resistance training on the healthy side for 6 wk.We measured the maximum voluntary contract(MVC),changes in surface electromyography(EMG),and the lower limb motor function using the simplified Fugl Meyer Motor Function Assessment Scale(FMA)before and within 1 wk after training.RESULTS The FMA score in the experimental group improved significantly compared to both their pre-training score and the control group's post-training score(P<0.05).The integrated EMG of the anterior tibialis muscle and pulmonary intestine muscle in the experimental group were significantly different after training than before(P<0.05).Furthermore,the MVC of the anterior tibialis muscle on both the healthy and affected sides and the MVC of the pulmonary intestine muscle on both sides showed significant improvement compared with before training and the control group(P<0.05).CONCLUSION Our findings suggest that ankle dorsiflexion resistance training on the healthy side in hemiplegic stroke patients can increase strength in the opposite tibialis anterior muscle and antagonist's muscle,indicating a cross-migration phenomenon of strength training.Furthermore,this type of training can also improve lower limb motor function,providing a new exercise method for improving early ankle dorsiflexion dysfunction.

Effects of acupuncture and balance facilitation of muscular tension on the early rehabilitationof patients with stroke and hemiplegia

Objective To explore the effects of acupuncture and balance facilitation of muscular tension on the early rehabilitation of patients with stroke and hemiplegia.Methods Divided the 96 patients with acute stroke hemiplegia into group A and B randomly (group B as control). Evaluate the rehabilitation before and after therapy, and deal with the data in statistics. The courses are 26 to 28 days. In group A, stab negative channel and points of upper limb as well as positive channel and points of lower limb of paralysis side in flaccid paralysis stage. After the muscular tension resumed, stab positive points of upper limb and negative points of lower limb, and try to recover the balance of muscular tension, and avoid muscular spasm to establish normal moving pattern. Results Compared with control group, group A had prominent difference on the process of muscular tension resuming, incidence rate of muscular spasm, the ratio of reducing of neurologic impairment scores and increasing of motor function integral (FMA), MBI of the ability of daily life (ADL) as well as index of quality of life (QLI), P<0.01. Conclusion Acuppuncture and balance facillitation of muscular tension are useful in the early rehabilitation in hemiplegia.

Effect of six-month standardized tertiary rehabilitation program on the activities of daily living in stroke patients with hemiplegia

BACKGROUND： At present, there are many studies on the rehabilitation therapy of stroke patients with hemiplegia, but there is deficiency of corresponding standardized rehabilitation program. OBJECTIVE： To explore the effects of standardized tertiary rehabilitation on the activities of daily living in stroke patients with hemiplegia within 6 months after attack. DESIGN： A clinical observation. SETTING： Department of Rehabilitation Medicine, Huashan Hospital of Fudan University. PARTICIPANTS： Eighty-two outpatients and inpatients with acute stroke were selected from the Department of Neurology, Shanghai Huashan Hosptial from January 1999 to June 2003, including 49 males and 33 females, 40 - 80 years of age, with a mean age of （65 ±11） years old. Inclusive criteria： According to the diagnostic standards for cerebrovascular diseases set by Fourth National Academic Meeting for Cerebrovascular Disease in 1995, the patients were diagnosed as new attack of cerebral infarction or cerebral hemorrhage, and confirmed by CT or MRI to be initial patients; They should be accorded with the following conditions, including within 1 week after stabilization of life signs, Glasgow coma score 〉 8 points, 40 - 80 years of age, with disturbance of limb function. Informed consents were obtained from all the patients or their relatives. Exclusive criteria： Patients were excluded due to active liver disease, liver and kidney malfunction, congestive heart failure, malignant tumor, history of dementia, failure in respiratory function, tetraplegia; cerebral infarction or cerebral hemorrhage for more than 3 weeks; unable to be followed up due to in other cities and provinces; psychiatric history; deafness and muteness. According to the will of the patients or their relatives, the patients who accepted the standardized rehabilitation program were enrolled as the treatment group （n =42）, and the others as the control group （n =40）. Approval was obtained from the ethical committee of the hospital. METHODS： All the patients were given routine therapies of internal medicine after admission. According to the conditions of Brunnstom recovery 6-phase evaluation, the patients in the treatment group were trained with the pre-designed comprehensive standardized rehabilitation program for corresponding period. At early period （within about 1 month after attack）, the patients received rehabilitative interventions in the Department of Emergency or Department of Neurology, once a day, 45 minutes for each time, 5 times a week; At middle period （about 1 - 3 months after attack）, the patients received rehabilitative interventions in the rehabilitation ward or center, once to twice a day, 30 - 45 minutes for each time, 4 - 5 days a week; At late period （about 3 - 6 months after attack）, the patients received rehabilitative intervention mainly assisted by rehabilitation physician in the community, relatives and volunteers, 3 - 4 times a week, and they were followed in the house or outpatient department once every two weeks. MAIN OUTCOME MEASURES： The patients were evaluated blindly by the same rehabilitation physician using scale of modified Barthel index at admission and 1, 3 and 6 months after attack respectively. RESULTS： Totally 82 patients with acute stroke were enrolled, and 3 cases in the treatment group missed, including 2 cases died at 1 month after admission, and 1 case refused the follow up l0 days later, all the others were involved in the analysis of results. The scores of modified Barthel index at corresponding time points after admission in the treatment group were all obviously higher than those in the control group （P 〈 0,01）, and the score differences were also obviously higher than those in the control group （P 〈 0,01）. The activities of daily living at admission and 1, 3 and 6 months after admission in the treatment group were 22,50%, 46.43%, 75,95% and 89,52% of that of normal people respectively, and those in the control group were 17.09%, 25,77%, 43,38% and 55,00% respectively, The activities of daily Diving at admission and 1, 3 and 6 months in the treatment group were 131.66%, 180.17%, 175.08% and 162.76% of those in the controlgroup. As compared with at admission, the percentage of the score difference to the total score at the ends of the 1^st, 3^rd and 6^th months were 23.93%, 53.45% and 67.02% in the treatment group, while 8.67%, 25.36% and 36.98% in the control group. CONCLUSION： Standardized tertiary rehabilitation can obviously promote the activities of daily living in stroke patients with hemiplegia.

Effects of core stability exercise on rehabilitation in stroke patients with hemiplegia： a meta-analysis

Objective： To evaluate the effects of core stability exercise （CST） on rehabilitation in stroke patients with hemiplegia. Methods： Randomly controlled trials about the effects of CST on rehabilitation in stroke patients with hemiplegia were searched in the database, including PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang, CBM and VIP. Search terms include “core stability training / core stability exercise / core stabilization training / core stabilization exercise/ core strength training / core strength exercise” and “stroke / brain ischemia / cerebral infarction / cerebral hemorrhage / intracranial thrombosis / brain hemorrhage / cerebrovascular disorder /cerebrovascular accident, cerebrovascular disease / hemiplegia / hemiparesis/ stroke rehabilitation”. Study screening, data extraction and quality assessment were conducted by two researchers independently. Data was analyzed using RevMan 5.3 software. Results： Totally 11 studies and 704 patients were included with 352 patients in experiment group and 352 in control group. Results of meta-analysis showed that combination of CST and conventional rehabilitation had better effects on trunk control [MD = 10.44, 95% CI （8.83-12.04）, P 〈 0.001], banlace [MD = 5.6, 95% CI （4.81-6.39）, P 〈 0.001], activities of daily living [MD = 12.06, 95% CI （7.65-16.46）, P 〈 0.001], ambulation functional [MD = 0.72, 95% CI （0.32-1.12）, P 〈 0.001] and walking speed [MD = 3.39, 95% CI （2.03-4.76）, P 〈 0.001] than conventional rehabilitation, but there is no clear difference on walking stride [MD = 2.52, 95% CI （-0.25-5.29）, P = 0.07] between two groups. Conclusion： CST together with conventional rehabilitation can better improve trunk control, banlace, activities of daily living, ambulation functional and walking speed in stroke patients compared with conventional rehabilitation, but can not make the walking stride better significantly. However, since the conclusion of this meta-analysis was drawn based on middle quality RCTs, future high quality researchs should be conducted to confirm its positive intervention effects.

Early Rehabilitation Nursing for Stroke Patients with Hemiplegia in Neurology Department

Objective:To study the clinical nursing effect of early rehabilitation nursing on stroke patients with hemiplegia in neurology department.Methods:Stroke patients with hemiplegia treated in our hospital from March 2018 to March 2020 were selected for the present study.Twenty patients in each group were divided into two groups by random number table method,either in experimental group or control group.Routine nursing was used in the control group,while early rehabilitation nursing was carried out in the experimental group.The clinical nursing effect of the two groups of patients was compared.Results:After nursing,the neurological function of the patients was significantly improved(P<0.05),the improvement of the experimental group was better than that of the control group(P<0.01),the daily activities of the patients in the experimental group were significantly improved,and the score of the experimental group was higher than that of the control group(P<0.05).After nursing,anxiety and depression scores in the experimental group were significantly lower than those in the control group(P<0.05),and the recovery of limb function in the experimental group was better than that in the control group(P<0.05).Conclusion:The implementation of early rehabilitation nursing measures plays an important role in the recovery of stroke patients with hemiplegia by promoting the recovery of neurological function,improving the psychological state of patients,and promoting the recovery of limbs.

Influence of early rehabilitation intervention on motor function of acute stroke patients with severe hemiplegia

Objective To observe influence of early rehabilitation intervention on motor function of acute stroke patients with severe hemiplegia.Method We evaluate 58 cases of acute stroke with severe hemiplegia with FMA method and Barthel index, observe influence of early rehabilitation intervention on recovery of motor function.Result Motor function after treatment was promoted apparently compared with control group(P< 0.05).Conclusion Early rehabilitation intervention can promote motor function recovery of acute stroke patients with severe hemiplegia.

Bibliometric and visual analysis of post-stroke hemiplegia in the past 20 years

Objective:The purpose of this study is to use CiteSpace software to examine the development patterns and hotspots in post-stroke hemiplegia research during the last 20 years.Methods:Articles about post-stroke hemiplegia from January 2005 to December 2024 were analyzed in the Web of Science database.CiteSpace software was used to conduct co-citation analysis of the articles about post-stroke hemiplegia as well as cooperative network analyses of authors,countries,and institutions,as well as keyword co-occurrence,clustering,emergence,and time line analyses.The results were displayed in a visual atlas.Result:A total of 2625 papers were obtained,and there were more publications overall.China and the United States had the most number of articles,while Chae,John was the author with the most number of articles.Capital Med University and Ohio State University had the most articles among their agencies.The keywords"stroke"and"rehabilitation"were used the most.The key word analysis indicates that the present study focus is on exercise rehabilitation measures and post-stroke treatment.Conclusion:Using CiteSpace software to analyze the literature on post-stroke hemiplegia,it is discovered that the use of new technologies in the field of mechanical thrombectomy and the effectiveness of rehabilitation techniques like mirror treatment are the key areas of study attention.This study has positive significance for finding safer and more effective treatments for post-stroke hemiplegia.

Analyzing the Combination Effects of Repetitive Transcranial Magnetic Stimulation and Motor Control Training on Balance Function and Gait in Patients with Stroke-Induced Hemiplegia

Objective:To analyze the effects of repetitive transcranial magnetic stimulation combined with motor control training on the treatment of stroke-induced hemiplegia,specifically focusing on the impact on patients’balance function and gait.Methods:Fifty-two cases of hemiplegic stroke patients were randomly divided into two groups,26 in the control group and 26 in the observation group,using computer-generated random grouping.All participants underwent conventional treatment and rehabilitation training.In addition to these,the control group received repetitive transcranial magnetic pseudo-stimulation therapy+motor control training,while the observation group received repetitive transcranial magnetic stimulation therapy+motor control training.The balance function and gait parameters of both groups were compared before and after the interventions and assessed the satisfaction of the interventions in both groups.Results:Before the invention,there were no significant differences in balance function scores and each gait parameter between the two groups(P>0.05).However,after the intervention,the observation group showed higher balance function scores compared to the control group(P<0.05).The observation group also exhibited higher step speed and step frequency,longer step length,and a higher overall satisfaction level with the intervention compared to the control group(P<0.05).Conclusion:The combination of repetitive transcranial magnetic stimulation and motor control training in the treatment of stroke-induced hemiplegia has demonstrated positive effects.It not only improves the patient’s balance function and gait but also contributes to overall physical rehabilitation.

OBSERVATION OF CLINICAL THERAPEUTIC EFFECTS ON HEMIPLEGIA INDUCED BY NEUROSURGICAL OPERATION TREATED WITH ACUPUNCTURE

Objective To probe into the optimum therapy for hemiplegia induced by neurosurgical operation. Methods 50 cases were randomized into treatment group （25 cases） and control group （25 cases）. In control group, the routine western drugs in internal medicine were applied; in treatment group, on the basis of the treatment in control group, acupuncture was supplemented 3 days after the operation. Acupoints were Neiguan （内关 PC 6）, Shuigou （水沟 GV26）, QSchi （ 曲池LI 11）, Hégü （合谷 LI 4）, Sanyinjiao （三阴交 SP 6）, Jiquan （极泉 HT 1）, Weizhong （委中BL 40）, etc. The scalp acupuncture was applied in combination. Such treatment was given for 30 days （once per day）. The functional evaluation was conducted based on neurological functional defect scale （NDS） before and after treatment. Results Acupuncture improved re markably NDS, the total effective rate was 76.0% in treatment group and was 42.4% in control group, indicating significant difference by statistical management （P〈0.05）. Conclusion The therapeutic effect in treatment group is superior to that in control group. The coordinative action is achieved in the combination of acupuncture with western medicine for hemiplegia after neurosurgical operation and the therapeutic effect is much improved.

Motor function outcomes of pediatric patients with hemiplegic cerebral palsy after rehabilitation treatment:a diffusion tensor imaging study

Previous diffusion tensor imaging （DTI） studies regarding pediatric patients with motor dys-function have conifrmed the correlation between DTI parameters of the injured corticospinal tract and the severity of motor dysfunction. There is also evidence that DTI parameters can help predict the prognosis of motor function of patients with cerebral palsy. But few studies are re-ported on the DTI parameters that can relfect the motor function outcomes of pediatric patients with hemiplegic cerebral palsy after rehabilitation treatment. In the present study, 36 pediatric patients with hemiplegic cerebral palsy were included. Before and after rehabilitation treatment, DTI was used to measure the ifber number （FN）, fractional anisotropy （FA） and apparent dif-fusion coefifcient （ADC） of bilateral corticospinal tracts. Functional Level of Hemiplegia scale （FxL） was used to assess the therapeutic effect of rehabilitative therapy on clinical hemiplegia. Correlation analysis was performed to assess the statistical interrelationship between the change amount of DTI parameters and FxL. DTI ifndings obtained at the initial and follow-up evalua-tions demonstrated that more affected corticospinal tract yielded signiifcantly decreased FN and FA values and signiifcantly increased ADC value compared to the less affected corticospinal tract. Correlation analysis results showed that the change amount of FxL was positively correlated to FN and FA values, and the correlation to FN was stronger than the correlation to FA. The results suggest that FN and FA values can be used to evaluate the motor function outcomes of pediatric patients with hemiplegic cerebral palsy after rehabilitation treatment and FN is of more signiif-cance for evaluation.

Contralateral needling at unblocked collaterals for hemiplegia following acute ischemic stroke

Hemiplegia caused by stroke indicates dysfunction of the network between the brain and limbs, namely collateral shock in the brain. Contralateral needling is the insertion of needles into acupoints on the relative healthy side of the body to treat diseases such as apoplexy. However, there is little well-designed and controlled clinical evidence for this practice. This study investigated whether contralateral needling could treat hemiplegia after acute ischemic stroke in 106 randomly selected patients with acute ischemic stroke. These patients were randomly assigned to three groups： 45 in the contralateral needling group, receiving acupuncture on the unaffected limbs; 45 in the conven- tional acupuncture group, receiving acupuncture on the hemiplegic limbs; and 16 in the control group, receiving routine treatments without acupuncture. Acupuncture at acupoints Chize （LU5） in the upper limb and Jianliao （TEl4） in the lower limb was performed for 45 minutes daily for 30 consecutive days. The therapeutic effective rate, Neurological Deficit Score, Modified Barthel Index and FugI-Meyer Assessment were evaluated. The therapeutic effective rate of contralateral nee- dling was higher than that of conventional acupuncture （46.67% vs. 31.11%, P 〈 0.05）. The neuro- logical deficit score of contralateral needling was significantly decreased compared with conven- tional acupuncture （P 〈 0.01）. The Modified Barthel Index and FugI-Meyer Assessment score of contralateral needling increased more significantly than those of conventional acupuncture （both P 〈 0.01）. The present findings suggest that contralateral needling unblocks collaterals and might be more effective than conventional acupuncture in the treatment of hemiplegia following acute ischemic stroke.

任务导向训练联合下肢康复机器人对脑卒中偏瘫患者下肢功能的影响

目的:探讨下肢康复机器人联合任务导向训练对脑卒中偏瘫患者的治疗效果。方法:选取我院2023年1月~12月收治的脑卒中偏瘫患者100例,随机分为对照组和观察组各50例。对照组在康复师的辅助下进行任务导向训练,观察组在对照组基础上给予下肢康复机器人训练。观察两组患者治疗前后下肢平衡、下肢肌力、运动功能、踝关节功能、膝关节屈曲活动范围及行走能力。结果:治疗后,两组患者BBS评分、股四头肌评分、腘绳肌评分、FMA-LE评分及AOFAS评分均较治疗前升高(P<0.05),且观察组治疗后的BBS评分、股四头肌评分、腘绳肌评分、FMA-LE评分及AOFAS评分均显著高于对照组(P<0.05);治疗后,两组患者的膝关节屈曲活动范围及6 min步行距离均较治疗前升高(P<0.05),且观察组治疗后的膝关节屈曲活动范围及6 min步行距离显著大于对照组(P<0.05)。结论:在脑卒中患者的临床治疗中,任务导向训练与下肢康复机器人相结合,可有效提高下肢肌力,促进平衡功能的恢复,对运动功能的恢复效果显著,可提高脑卒中患者的行走能力和膝关节屈曲的活动范围,达到较为理想的治疗效果。

Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

Acupoint electrogymnastics therapy in stroke hemiplegia

BACKGROUND： Electrogymnastics can offer a range of proprioceptive, motor, and cutaneous sensation impulses to the central nerve system. The center receives perception of the paralyzed muscle through the aid of these impulses. During this process, functional reorganization of connecting network between segment and intersegment takes place. OBJECTIVE： To observe the therapeutic efficacy of acupoint electrogymnastics and traditional electroacupuncture on stroke hemiplegia. DESIGN, TIME AND SETTING： A multicenter, randomized, controlled, blinded, clinical study was performed at the College of Acu-moxibustion and Massage in Shanghai University of Traditional Chinese Medicine from May 2004 to September 2006. PARTICIPANTS： A total of 153 patients suffering from stroke hemiplegia, comprising 83 males and 70 females, aged 63-70 years, were admitted to outpatient and inpatient at LongHua Hospital Affiliated Shanghai University of Traditional Chinese medicine, Putuo District Traditional Chinese Medicine Hospital and Changqiao Street Community Health Service Center of Shanghai. METHODS： The patients were randomly divided into treatment （n = 77） and control （n = 76） groups. They were treated with acupoint electrogymnastics and traditional electroacupuncture, respectively. In the treatment group, two pairs of positive and negative JD-2008 type electrodes from a hemiplegia treatment apparatus were directly pasted on the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan （GB34） acupoints of the lower limb, respectively. In the control group, needles were consecutively inserted into the above acupoints. Using the method of lifting-inserting and twisting-rotating, the needle was manipulated with small amplitude of 5-7 mm and a fast frequency of 80-120 times/min when the needle was inserted to a suitable depth. When the sensation of needling was attained, the two pairs of positive and negative electrodes of type G6805-Ⅱelectro-acupuncture apparatus were connected to the Shousanli （LI 10） and Waiguan （SJ5） acupoints of the upper limb, as well as the Zusanli （S36） and Yanglingquan（GB 34） acupoints of the lower limb, respectively. MAIN OUTCOME MEASURES： The Fugl-Meyer evaluation method was used to assess upper limb movement, lower limb movement, sensory stimulation of all limbs, balance, and joint range of motion. RESULTS： Upper-lower limb motor function, limb sensory function, balance, and joint range of motion were significantly ameliorated following treatment, compared with pre-treatment （P 〈0.01）. There was no significant difference in various indexes between the two groups after treatment （P 〉0.05）. CONCLUSION： Acupoint electrogymnastics and traditional electroacupuncture exhibited similar curative effects in the treatment of stroke hemiplegia.

Research on Combined Rehabilitation Method and Its Mechanism of Traditional Chinese Medicine Daoyin Technique with Biofeedback Technique

Objective: To study an anti resistance active exercise training method which is consistent with the principle of “transcendental goal power” to promote the plasticity change of central nervous system (CNS) in order to recover the motor function after CNS injury, observe its clinical effect and explore its mechanism. Methods: The potential of CNS was induced by six-step Daoyin technique of Chinese medicine, and the potential signal was received in real time by bio-electrical signal receiving equipment and displayed in curve form. Combined with the Operant conditioning biofeedback technique, targeted guidance was given to patients to continuously enhance the action muscle signal intensity and weaken the antagonistic muscle signal intensity, so that the motor program was gradually re-established. Sixty-four patients with hemiplegic elbow dysfunction of old cerebral infarction who had been trained but could not be improved further and had a history of more than 1 year were treated for one course, 90 times and 45 minutes each time. Lovett, Elbow Rom, Fugl-Meyer, program signal intensity and proportion were evaluated before and after treatment. The data were analyzed statistically. Before and after treatment, Lovett MMT, ROM of elbow joint, Fugl Meyer, motor program signal intensity and proportion were assessed, and the data were statistically analyzed. Results: After treatment and before treatment, there was a significant difference between the functional evaluation data (P < 0.01). The function of elbow joint was improved;this is the result of reconstructing the motor program on the basis of developing the potential of CNS by means of the “transcendental goal power” mechanism of the method. There was no recurrence after 6 months of follow-up. Conclusion: The Chinese Medicine Daoyin feedback rehabilitation technique is an effective method to improve elbow joint function of hemiplegia patients with cerebral infarction.