| ObjectiveThis study aims to observe the therapeutic effects of TaiChi Tuina on the spasticity,upper limb motor function and ability of daily living in patients with upper limb elbow flexion spasm after stroke,and relying on Myoton technology to quantitatively evaluate the effects of TaiChi Tuina on the biomechanical properties(muscle tone,stiffness and elasticity)of elbow flexion spasm muscle,and to further analyze the correlation between the measured value of Myoton PRO and the scores of each scale,in order to provide a basis for the clinical treatment of spasticity after stroke by TaiChi Tuina,and to promote the application of Myoton technology.MethodsIn this study,inpatients or outpatients with stroke elbow flexor spasm after stroke in the Department of Massage/Rehabilitation Medicine of Hubei Provincial Hospital of Traditional Chinese Medicine were recruited from September 2020 to February 2021.Patients who met the inclusion criteria were strictly screened and randomly divided into the experimental group and the control group according to the ratio of 1∶1 by random number table method.Both groups included basic medical treatment.On this basis,the experimental group was treated with TaiChi Tuina combined with conventional rehabilitation training,while the control group only received routine rehabilitation training.Once a day,6 times a week,1 day off,continuous treatment for 2 weeks as a course of treatment,after a course of treatment,rest for 2days,a total of 2 courses of treatment,namely 4 weeks.The Modified Ashworth Scale(MAS),Fugl-Meyer Assessment(FMA)and Modified Barthel Index(MBI)were used for assessment before and after treatment,respectively.Myoton PRO was used to measure the Frequency(F),stiffness(S)and decrement(D)of elbow flexor muscles(biceps brachialis and brachioradialis)on the affected side of patients in both groups;The data of the two groups before and after treatment were compared within and between groups,and the correlation between F,S,D values and MAS,FMA,MBI scores was analyzed,and the conclusions were drawn.Results1.Baseline resultsA total of 62 patients with upper limb elbow flexor spasm after stroke were included in this study,of which 2 cases dropped out.A total of 60 cases were finally completed,30 cases in the experimental group and 30 cases in the control group.After statistical analysis,the gender,age,course of disease,type of stroke,and side of spasticity between the two groups showed P >0.05,and the difference was not statistically significant.MAS,FMA,MBI scores and F,S and D values of biceps brachii and brachioradialis measured by Myoton PRO before treatment were all >0.05,indicating no statistically significant difference,which was comparable.2.Treatment results(1)Clinical efficacy: After 4 weeks of treatment,the total clinical effective rate of the experimental group(83.3%)was significantly higher than that of the control group(73.3%)(P <0.05).(2)Changes in MAS grade: After treatment,MAS grade in both groups of patients was generally lower than that before treatment(P < 0.01);After treatment,the decrease was more significant in the experimental group than in the control group(P < 0.05).(3)Changes in FMA scores: The FMA scores in both groups increased after 4 weeks of treatment(experimental group P < 0.01,control group P < 0.05);After the end of treatment,the FMA score of experimental group increased more significantly than that of control group(P < 0.05).(4)Changes in MBI scores: Compared with before treatment,MBI scores in both groups were increased after treatment(P < 0.01);After 4 weeks of treatment,the MBI score of the experimental group increased more significantly than that of the control group(P <0.05).(5)Changes in the measured values of Myoton PRO: After treatment,the F,S,and D values of biceps brachii in the experimental group were lower than before treatment(P < 0.01),and the F,S,and D values of the brachioradialis were all lower than before treatment.(P < 0.01 for F and S values,P < 0.05 for D),and the F,S,D values of biceps brachii and brachioradialis in the control group were also lower than before treatment(P < 0.05);After treatment,the F and S values of the biceps brachii and brachioradialis in the experimental group decreased more significantly than those in the control group(P < 0.05),but there was no significant difference in the D values(P > 0.05).3.Correlation analysis resultsAccording to Pearson correlation analysis test,whether in the experimental group or the control group,the F,S,D values of biceps brachii and brachioradialis measured by Myoton PRO were positively correlated with MAS score and negatively correlated with FMA and MBI scores,and the P values were all < 0.01,showing statistically significant differences.Conclusions1.TaiChi Tuina combined with rehabilitation training and separate rehabilitation training therapy can improve the degree of spasticity in patients with upper limb elbow flexion spasm after stroke,help to improve the upper limb motor function and the ability of daily living activities,can effectively reduce the muscle tone and stiffness and increase muscle elasticity of biceps brachii and brachioradialis,but TaiChi Tuina combined with rehabilitation training is better than rehabilitation training alone.2.Myoton technology can be used as an objective quantitative evaluation method for patients with upper limb elbow flexion spasm after stroke.The muscle tone,stiffness,and elasticity measured by Myoton PRO may be important prognostic indicators for stroke patients after spasm.3.Compared to muscle tone and stiffness,Myoton PRO may be less sensitive to small changes in muscle elasticity.4.In patients with upper limb elbow flexion spasm after stroke,the most affected elbow flexion spasm muscle may be brachioradialis,not biceps brachii,which needs to be further verified. |
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