Clinical Study On Treatment Of Wrist And Hand Dysfunction After Stroke With Scalp Acupuncture Combined With Occupational Therapy

ObjectiveThe clinical efficacy and safety of scalp acupuncture combined with occupational therapy and occupational therapy-alone in the treatment of patients with wrist and hand dysfunction after stroke were compared,and the efficacy of scalp acupuncture combined with occupational therapy was objectively evaluated.MethodThe 40 patients with wrist and hand dysfunction after stroke who met the inclusion criteria of this trial were randomly divided into observation group and control group with20 patients in each group.On conventional basic therapy,the observation group was treated with scalp acupuncture combined with occupational therapy,The cephalic acupoint refers to the "International Standardization Program for the Name of scalp Acupuncture Point" to take the anterior temporal oblique and the posterior posttemporal oblique of the parietal temporal and perform the penetration method;and the control group was occupational therapy-alone treatment.The two groups were treated 6 times a week,once a day,30 minutes each time,rest for 1 day after every 6 treatments,14 days as a course of treatment.There are four courses of treatment,48 times in total.FMAUE,AROM and s EMG’s i EMG were used as observation indexes,and the efficacy was evaluated before treatment,4 weeks of treatment and 8 weeks of treatment.Results1.Hand Motor Function Scale(FMA-UE)Score on the diseased side4 weeks later,the FMA-UE of wrist and hand of stroke patients increased distinctly(P<0.01),but there was no significant difference between the two groups(P>0.05).8weeks passed,the FMA-UE scores was higher than that before treatment and 4 weeks after treatment(P<0.01),and observation group score was better(P<0.05).The comparison of total clinical efficacy showed no statistically significant difference between the two groups(P>0.05),It shows that both therapies can improve wrist and hand dysfunction after stroke,and if long-term treatment is adhered to,scalp acupuncture combined with occupational therapy has better clinical efficacy than occupational therapy-alone.2.Active wrist dorsal extension range of motion(AROM)on the diseased sideActive wrist flexion range of motion of the diseased wrist:after 4 weeks and 8 weeks of treatment,the AROM(wrist flexion)was significantly improved in both groups compared with before treatment(P<0.01),but there was no significant difference in AROM(wrist flexion)between the two groups after 4 weeks of treatment(P>0.05).There was a significant difference in AROM(wrist flexion)between the two groups after 8weeks of treatment(P<0.01)and after 4 weeks of treatment(P<0.01).The results showed that compared with occupational therapy-alone,scalp acupuncture combined with occupational therapy could significantly improve wrist flexion range of stroke patients.Active wrist extension range of motion of the diseased wrist:after 4 weeks of treatment,the AROM(wrist extension)was better than before(P<0.01)and also different in groups(P<0.05),which means observed group had better efficacy.After 8 weeks of treatment,there were differences between the observation group and the control group compared with preceding AROM(wrist extension)and 4 weeks(P<0.05),and the difference in the observation group was more evident(P<0.01),as well as in the two groups(P<0.01),indicating that both therapies can effectively improve the range of motion of wrist dorsiflexion in stroke patients,and the treatment effect of scalp acupuncture combined with occupational therapy is more significant.3.i EMG value of surface electromyography(s EMG).After 4 weeks and 8 weeks of treatment,the i EMG values of s EMG of flexor radial carpi and extensor radial carpi in both groups were significantly higher(P<0.01),compared the two groups,it was no imparity after 4 weeks(P>0.05),but statistically unliked after 8 weeks(P<0.01),and compared with 4 weeks after treatment,the i EMG values of both groups were significantly increased(P<0.01).The results showed that the combination of scalp acupuncture with occupational therapy and occupational therapy-alone could effectively improve the muscle strength of the radial carpal flexor and radial wrist extensor muscles in stroke patients,and the former had a better treatment effect.Conclusion1.Compared with occupational therapy-alone,the combination of scalp acupuncture combined with occupational therapy in the treatment of wrist and hand dysfunction after stroke is more effective,which can improve the motor function of the diseased hand,improve the range of motion of the active wrist and dorsal extension,and the muscle strength of the radial wrist flexion and extensor muscles of the diseased hand,which increases the credibility of the clinical efficacy evaluation of the study and has few side effects.2.The combination of scalp acupuncture and occupational therapy can dispel patients’ fear of acupuncture treatment and achieve clinical efficacy,which can promote further research,development and application.