| Objective Musculoskeletal ultrasound technology was used to guide electro-acupuncture at Juliao point to the muscle layer of the gluteus medius on the hemiplegic side of the post-stroke patient,and the related scales were used to evaluate its influence on lower limb motor function,balance function and activities of daily living in post-stroke patients,and compare the changes of gluteus medius contraction ratio and thickness before and after treatment;to explore the correlation of gluteus medius on lower limb motor function,balance function and activities of daily living in patients after stroke.MethodsIn this study,the clinical randomized controlled research method was adopted,and 68 stroke hemiplegia patients were randomly divided into observation group and control group,34 cases in each group,and received 4-week treatment.The final number of completed cases was 64 cases,with 32 cases in each group.Control group:basic medical disease treatment combined with conventional acupuncture and conventional rehabilitation training;Observation group:electro-acupuncture at GB29(hemiplegic side),based on the control group.The two groups were evaluated by the lower limb Fugl-Meyer Assessment(FMA),the Berg Balance Scale(BBS),and the Modified Barthel Index(MBI)before treatment,after 2 weeks,and after 4weeks.Measurement of gluteus medius thickness,calculation of contraction ratio,analysis of activation capacity was performed before and 4 weeks after treatment.Results1.Standardized gluteus medius contraction ratio before treatment:The contraction ratio of the gluteus medius on the hemiplegic side in the observation group was compared with the contraction ratio of the gluteus medius on the non-hemiplegic side in the observation group(P<0.05),The contraction ratio of the gluteus medius on the hemiplegic side in the control group was compared with the contraction ratio of the gluteus medius on the non-hemiplegic side in the control group(P<0.05),the difference was statistically significant,and the contraction ratio of the gluteus medius on the hemiplegic side in the two groups was lower than that on the non-hemiplegic side.2.Resting state gluteus medius thickness before treatment: The thickness of the gluteus medius on the hemiplegic side of the observation group was compared with the thickness of the gluteus medius on the non-hemiplegic side of the observation group(P<0.05),The thickness of the gluteus medius on the hemiplegic side of the control group was compared with the thickness of the gluteus medius on the non-hemiplegic side of the control group(P<0.05),the difference was statistically significant,and the thickness of the gluteus medius on the hemiplegic side was smaller than that on the non-hemiplegic side in the two groups.3.Standardized gluteus medius contraction ratio before and after reatment:(1)Comparing the gluteus medius contraction ratio of the hemiplegic side in the observation group before and after treatment,the difference was statistically significant(P<0.05),and the contraction ratio after treatment was higher than before treatment,there was no significant difference in the contraction ratio of the gluteus medius on the non-hemiplegic side of the observation group before and after treatment(P=0.678);The comparison of the contraction ratio of the gluteus medius on the hemiplegic side in the control group before and after treatment showed a statistically significant difference(P<0.05),and the contraction ratio after treatment was higher than that before treatment,there was no significant difference in the contraction ratio of the gluteus medius on the non-hemiplegic side of the control group before and after treatment(P=0.206).(2)After treatment,the gluteus medius contraction ratio between the hemiplegic side and the non-hemiplegic side in the observation group was significantly different(P<0.05),and the contraction ratio of the non-hemiplegic side was higher than that of the hemiplegic side;The comparison of the contraction ratio of the gluteus medius on the hemiplegic side and the non-hemiplegic side in the control group after treatment was statistically significant(P<0.05),and the contraction ratio of the non-hemiplegic side was higher than that of the hemiplegic side;But overall,the difference between the contraction ratios on both sides of the observation group was significantly smaller than that of the control group.(3)Comparison of the contraction ratio of the gluteus medius on the hemiplegic side after treatment between the observation group and the control group,The difference was statistically significant(P<0.05),and the observation group was higher than the control group;There was no significant difference in the contraction ratio of the gluteus medius on the non-hemiplegic side after treatment between the observation group and the control group(P=0.097).(4)There was a statistically significant difference in the difference in the contraction ratio of the gluteus medius on the hemiplegic side between the two groups before and after treatment(P<0.05),and the difference in the observation group was greater than that in the control group.4.Resting state gluteus medius thickness before and after treatment:(1)Comparison of the thickness of the gluteus medius on the hemiplegic side of the observation group before and after treatment,the difference was statistically significant(P<0.05),and the thickness after treatment was greater than before treatment;There was no significant difference in the thickness of the gluteus medius on the non-hemiplegic side of the observation group before and after treatment(P=0.130).The gluteus medius thickness of the hemiplegic side in the control group was compared before and after treatment,and the difference was statistically significant(P<0.05),and the thickness after treatment was greater than that before treatment;There was no significant difference in the thickness of the gluteus medius on the non-hemiplegic side of the control group before and after treatment(P=0.129).(2)There was significant difference in the thickness of gluteus medius between hemiplegic side and non hemiplegic side in the observation group(P<0.05),and the thickness of non hemiplegic side was greater than that of hemiplegic side;There was significant difference in the thickness of gluteus medius between hemiplegic side and non hemiplegic side in the control group(P<0.05),and the thickness of non hemiplegic side was greater than that of hemiplegic side.But overall,the difference in thickness between the two sides of the observation group was significantly smaller than that of the control group.(3)There was no significant difference in the thickness of the gluteus medius on the hemiplegic side between the observation group and the control group after treatment(P=0.507);there was no significant difference in the thickness of the gluteus medius on the non-hemiplegic side between the observation group and the control group after treatment(P=0.507).(4)Comparison of the difference in the thickness of the gluteus medius on the hemiplegic side between the two groups before and after treatment,the difference was statistically significant(P<0.05),and the difference in the observation group was greater than that in the control group.5.the lower limb FMA score: After repeated measures analysis,(P<0.05)at the time point,(P<0.05)at the time point*group and(P<0.05)at the group.The scores of both groups increased after 4 weeks of treatment(P<0.05).After 2 weeks of treatment,there was no significant difference in the scores between the two groups(P>0.05),and the scores in the observation group were higher than those in the control group after 4 weeks of treatment(P<0.05).6.BBS score: After repeated measures analysis,(P<0.05)at the time point,(P<0.05)at the time point*group and(P<0.05)at the group.The scores of both groups increased after 4 weeks of treatment(P<0.05).After 2 weeks of treatment,there was no significant difference in the scores between the two groups(P>0.05),and the scores in the observation group were higher than those in the control group after 4 weeks of treatment(P<0.05).7.MBI score: After repeated measures analysis,(P<0.05)at the time point,(P<0.05)at the time point*group and(P<0.05)at the group.The scores of both groups increased after 4 weeks of treatment(P<0.05).After 2 weeks of treatment,there was no significant difference in the scores between the two groups(P>0.05),and the scores in the observation group were higher than those in the control group after 4 weeks of treatment(P<0.05).8.Correlation analysis of gluteus medius contraction ratio and the lower limb FMA,BBS,and MBI: Before treatment,gluteus medius contraction ratio was positively correlated with lower extremity FMA,BBS,and MBI scores(ρ=0.852,P<0.05;r=0.784,P<0.05;r=0.775,P<0.05).Conclusions1.Electro-acupuncture at Juliao point on the hemiplegic side can effectively activate the gluteus medius on the hemiplegic side,provide a stability mechanism for the lumbar-pelvic-hip complex,and improve the lower limb motor function,balance function and activities of daily living of stroke patients.2.The activation degree of gluteus medius muscle was positively correlated with lower limb motor function,balance function and activities of daily living in stroke patients.3.In this study,the time factor is of great significance,and the treatment effect is positively correlated with time,and the 4th week is the key node of the course of treatment. |
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